- Molina Healthcare (Bellevue, NE)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Bellevue, NE)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... controls that internal teams and delegated vendors must follow, and you keep complaint data synchronized across appeals & grievances, enrollment, claims, pharmacy, and quality functions. You surface systemic issues, steer partners toward durable fixes, and… more
- Molina Healthcare (Bellevue, NE)
- …with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring and training of local plans' provider dispute and appeals ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare's maximum STAR… more
- First National Bank of Omaha (Omaha, NE)
- …flexibility are important to you. We also recognize that flexible and remote positions can become opportunities for military partners, caregivers, and individuals ... is subject to change based on business needs. **Summary of the Job:** The Director of Risk Evaluation and Assurance is responsible for the Partnership and Credit… more
- Molina Healthcare (Bellevue, NE)
- …practitioners, pharmacists, and drug representatives + Collaborates with and keeps Director /AVP apprised of operational issues, including staffing resources, ... pharmacy quality, cost effectiveness and compliance and working closely with the Pharmacy Director or AVP to ensure that the Health Plan Pharmacy Program is… more
- Molina Healthcare (Bellevue, NE)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more