- Humana (Trenton, NJ)
- …government and state agencies + Agile Product Development, Project Management, and Process Improvement qualifications (certifications a plus) + Proven ability to ... frameworks to maximize available resources to achieve growth. The Medicaid Insurance Product Strategy Lead - Benefits...website. **Modern Hire Statement** As part of our hiring process for this opportunity, we will be using an… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Process Improvement Lead provides analysis of current medical management ... in a clear, timely, accurate and meaningful manner. The ** Process Improvement Lead ** will provide...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Trenton, NJ)
- …Policies and Procedures as requested. + Create and present education as requested by the Process Improvement Lead . + Support Operations Managers in quality ... put health first** Humana Healthy Horizons is seeking a Process Improvement Professional who analyzes and measures...Experience working within a health plan and understanding of Medicaid or Medicare guidelines. + Proven oral / written… more
- Humana (Trenton, NJ)
- …with a specialization in Healthcare Management + Project Management and Process Improvement qualifications **Additional Information** + Travel: Role will ... caring community and help us put health first** The Market Entry Capture Strategy Lead will lead initiatives to develop and execute strategy to successfully… more
- Humana (Trenton, NJ)
- …of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid , and other health plans to millions. By integrating insurance with care ... role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's...experience to join this team. As an Insurance Strategy Lead , you will directly contribute to high-impact strategy projects,… more
- Humana (Trenton, NJ)
- …team to deliver value efficiently and effectively through people, data, and process improvement opportunities that support impactful research at scale. As ... external stakeholders. HHR is seeking a Research Strategy Advancement Lead that will play a pivotal role in driving...and Pharmacy team by standardizing HHR's hiring and onboarding process + Establish consistency in pricing across HHR's lines… more
- Humana (Trenton, NJ)
- …Additionally, this role will be instrumental in our department's continuous process improvement , operational excellence objectives, and quality management. ... a part of our caring community and help us put health first** The Lead , Data Quality/Integrity understands end-to-end master data processes and flows and uses that… more
- Humana (Trenton, NJ)
- …and help us put health first** The Stars Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, members ... towards value-based relationships and/or improved quality metrics. The Program Delivery Lead works on problems of diverse scope and complexity ranging from… more
- Prime Therapeutics (Trenton, NJ)
- …or assigned client/s and identify further opportunity to drive consistency and improvement + Lead the development, negotiation, standardization and compliance of ... levels within an organization + Demonstrated ability driving the identification of improvement opportunities and leading the implementation of process changes +… more
- Highmark Health (Trenton, NJ)
- …the key BU's for the Organization's value-based reimbursement programs and continuous improvement models. Lead or support key strategic initiatives across ... providers enrolled in the Organization's value-based reimbursement programs and continuous improvement models. The incumbent plays different potential roles on a… more
- Public Consulting Group (Trenton, NJ)
- …LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to ... key member of the executive team, the CIO will lead the Practice Area's tech vision, ensuring that the...Health Practice Area provides proprietary software platforms to state Medicaid agencies and other publicly focused healthcare programs and… more
- CenterWell (Trenton, NJ)
- …at the division and market level; Partners with Clinical Documentation Improvement , Audit, and Education to develop programs to improve clinical documentation. ... Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, provider coding improvement opportunities, risk score… more
- Humana (Trenton, NJ)
- …categories** + Strong experience in **contract negotiation, vendor management, and process improvement ** + Analytical and financial acumen with proficiency ... at Humana. This role focuses on driving efficiency, operational consistency, process governance, and supplier accountability, while closely partnering with vendor… more
- Humana (Trenton, NJ)
- …and take proactive steps to resolve. + Ability to identify opportunities for process improvement , savings and risk abatement. + Excellent analytical and critical ... report directly into the Director of IT Infrastructure Procurement and will lead the development of category strategies, design sourcing plans, oversee negotiations,… more
- Genesis Healthcare (Huntingdon Valley, PA)
- …at the center level, with a focus on measurable outcomes? + Can you lead and improve all aspects of the **revenue cycle** -from pre-admission through discharge-to ... training needs** and communicating them effectively to ensure continuous performance improvement across your team? + Do you consistently demonstrate a strong… more
- Arc Mercer (Ewing Township, NJ)
- …analysis and generate reports summarizing goal effectiveness, trends, and areas for improvement . + Conduct quality assurance (QA) checks to ensure goals align with ... practices and organizational standards. + Ensure compliance with internal policies, Medicaid , and other regulatory requirements in goal documentation. + Conduct… more
- Mathematica (Princeton, NJ)
- …and manage backlog/revenue to forecast and optimize future revenue opportunities. + Lead initiatives to identify and convert new business opportunities, growing both ... to ensure the delivery of exceptional, high-quality products and services. + Lead high performing team(s) consisting of client partners, data innovation lab staff,… more
- Humana (Trenton, NJ)
- …design, development, deployment, and overall success of Humana's Enterprise APIs. + Lead and design product value streams within the EAI organization. + Define ... with other Product Owners and Product Managers to align API maintenance and improvement with internal business requirements. + Manage and collaborate with a team of… more
- Prime Therapeutics (Trenton, NJ)
- …issues to Compliance leadership as appropriate + Support and at times, lead the project management efforts of Compliance initiatives + Represent the Compliance ... delivery of compliance training, administering the annual conflict of interest process , or completing regular review of standard operating procedures and policies;… more
- Datavant (Trenton, NJ)
- …to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process . (We can only see aggregate responses, not ... team. **What you will do** : + Set and lead the day-to-day work of their direct reports with...3+ years of experience working with Medicare, ACA, and/or Medicaid risk adjustment models + 5+ years of data… more