- Elevance Health (Independence, OH)
- **Medical Director - Medicare (Part-time)** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the...creating a culture that is designed to advance our strategy but will also lead to personal and professional… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and strategic ... for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CVS Health (Columbus, OH)
- …We are looking for a Principal Data Scientist to join our Aetna Medicare (STARS Portfolio) team at CVS Health. This high-level individual contributor will partner ... closely with the Executive Director of Aetna STARS Analytics to drive hands on...best practices + Provides guidance to develop enterprise-wide analytics strategy and roadmap **Required Qualifications** + 10+ years of… more
- Highmark Health (Columbus, OH)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** As part of the enterprise strategy to integrate and scale pharmacy solutions that disrupt the pharmacy supply ... responsible for the execution and value realization related to strategy development, operational excellence, pricing optimization, vendor coordination, and assisting… more
- NASCO (Columbus, OH)
- …parent's Enterprise Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship ... **Overview** As Executive Director , Compliance you will lead and provide oversight...Medicare Advantage and Exchange customers, including contract management, strategy development, operational delivery and invoicing + Engages with… more
- Humana (Columbus, OH)
- …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- Molina Healthcare (Cleveland, OH)
- **Job Description** **Job Summary** The National Program Director - Value-Based Care is a strategic leadership role responsible for the development, implementation, ... evolution of value-based care (VBC) programs across all lines of business-Medicaid, Medicare , and Marketplace. This role is critical in driving clinical and… more
- Humana (Columbus, OH)
- …of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy , and identifying improvement opportunities for a ... projects from concept to execution **Additional Information** This role reports to the Director of Strategy , works collaboratively with members of rest of the… more
- Cleveland Clinic (Beachwood, OH)
- Cleveland Clinic is seeking a strategic, mission-driven ** Director of Talent Acquisition** to lead a high-performing team of recruiters focused on attracting, ... this role is responsible for driving a data-informed, candidate-centered recruitment strategy aligned with Cleveland Clinic's workforce planning priorities. The … more
- CenterWell (Columbus, OH)
- …are followed, and fosters collaboration across entities within the Primary Care Organization. ** Strategy :** + In partnership with AVP, Risk Adjustment and AVP, MRA ... Strategy , responsible for driving ongoing efficiency and effectiveness of...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- Humana (Columbus, OH)
- …experience for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals), you will be accountable for ... leaders to achieve overall Resolution team operational goals, including transformation strategy + Increases Stars scores by improving timeliness and decision making… more
- Humana (Columbus, OH)
- …well-being and overall experience with our products. As the Associate Director of DevOps Platforms in the Enterprise Engineering Enablement organization, you ... Work Arrangements Available **Reporting Information** + You'll report to the Director of Enterprise DevOps and Enterprise Engineering Enablement. + You'll be… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Trade Client Relations Director - Remote **Job Description** The Trade Client Relations Director is ... related product development and implementation + Lead and coordinate work for Prime's Medicare Center of Excellence, maintaining an in depth understanding of work in… more
- Kestra Medical Technologies, Inc (Cleveland, OH)
- …care teams harmoniously monitor, manage, and protect life. The Regional Sales Director is responsible for leading and managing a sales team independently, often ... discounts and expenses . Responsible for field reinforcement of products and positioning strategy . Communicate openly and share information with others. . Adhere to… more
- Evolent (Columbus, OH)
- …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to solve ... teams of actuaries and non-actuaries, including support for team engagement and strategy + Present reports and analyses to clients and internal executives… more
- Molina Healthcare (Cleveland, OH)
- …* Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). ... and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates.… more
- ChenMed (Maple Heights, OH)
- …and long-term sales and profits. **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Develops a sales strategy and tactics and works with Director , Center (DoC) or ... rapidly expanding and we need great people to join our team. The Director , Growth and Business Development directs, establishes, maintains, and plans the policies,… more
- Molina Healthcare (Cincinnati, OH)
- …Contracting jobs are responsible for the value-based payments (VBP) network strategy and development with respect to financial performance and operational ... Operating Committees, and delegation oversight. * In conjunction with Director , Provider Contracts, develops health plan-specific VBP provider contracting… more
- Option Care Health (Cincinnati, OH)
- …**Job Description Summary:** Under the direction of the Regional Sales Director , Health Systems Solutions (RSD, HSS), manages the development and execution ... Develops appropriate business plans for new initiatives addressing market entry strategy , financial analysis and projected costs, timelines, and necessary resources.… more
- Humana (Columbus, OH)
- …in DevOps practices. You will be responsible for driving the vision and strategy for our DevOps platform(s), ensuring that our software engineers can deliver ... Work Arrangements Available **Reporting Information** + You will report to the Director of Enterprise DevOps and Enterprise Engineering Enablement. + You will be… more