- Valvoline Global (Lexington, KY)
- …better future. With a global presence, we develop **future-ready products** and provide **best-in-class services** for our partners around the world. For us, ... oversight of executive protection, facility security, global travel risk management , regulatory compliance, crisis response, and security technology integration. The… more
- Molina Healthcare (Lexington, KY)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Molina Healthcare (Lexington, KY)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Lexington, KY)
- …optimization, and service delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations… more
- Molina Healthcare (Lexington, KY)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management /Network Adequacy. **Knowledge/Skills/Abilities** + ... work with other teams including New Markets team, Network Management , Product Teams, PDM and IT. **Job Qualifications** **REQUIRED...EXPERIENCE:** + Advanced Excel skills. + Power BI. + Provider Data Analytics. To all current Molina… more
- Molina Healthcare (Lexington, KY)
- …regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization Management ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Lexington, KY)
- …of value-based care models, provider enablement strategies, and population health management . + Strong knowledge of data integration, EMR systems, and ... programs focused on provider enablement, ensuring access to tools, training, and data for success in VBC models. + Design and implement VBC training programs,… more
- Molina Healthcare (Lexington, KY)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Assists in recruitment, hiring and training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts… more
- Molina Healthcare (Lexington, KY)
- …* Provides direct oversight, monitoring and training of local plans' provider dispute and appeals units to ensure adherence with Medicare standards ... and requirements related to non-contracted provider dispute/appeals processing. * Establishes member and non-contracted provider grievance/dispute and appeals… more
- CommonSpirit Health at Home (Lexington, KY)
- …mission of delivering hope and healing to those we serve. The Director , Clinical Services is responsible for the planning, direction, coordination, supervision, ... & Compliance:** Uphold the Corporate Compliance Program. + **Operational Support:** Provide prompt and professional assistance to office and clinical staff. +… more
- WESCO (Lexington, KY)
- As the Senior Director - LEAN, you will be responsible for strategic leadership of operational excellence and continuous improvement efforts. You will work across ... of resources to solve problems to meet business objectives. + Utilize customer data to influence leaders to achieve positive business results. + Participate in… more
- Molina Healthcare (Lexington, KY)
- …timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, ... business rules as they apply to each database. Validate data to be housed on provider databases...Identified as contract system lead by developing and maintaining provider contracts in contract management software. *… more
- Molina Healthcare (Lexington, KY)
- …compliance program, including annual, periodic, focal, etc. audits. * Performance Management & KPI Expertise: Develop, implement, and monitor KPIs, including leading ... adherence, diagnose root causes of misses, and drive accountability across functions. * Data Insight & Decision Support: Ingest and interpret complex data from… more
- Grifols Shared Services North America, Inc (Lexington, KY)
- …solutions and services in more than 110 countries and regions. The Director , Pricing & Access Analytics is responsible for developing and applying advanced ... + Track win/loss trends to refine pricing and contracting strategies. Provide insights into pricing and contracting performance and recommend adjustments based… more
- Molina Healthcare (Lexington, KY)
- …development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and supports (LTSS), ... establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Responsible… more
- Valvoline Global (Lexington, KY)
- …a better future. With a global presence, we develop future-ready products and provide best-in-class services for our partners around the world. For us, originality ... this role provides thought leadership at the intersection of technology, data , and business transformation-partnering with C-suite leaders to institutionalize AI as… more
- V2X (Lexington, KY)
- …award.** **Key Responsibilities** + Lead the full lifecycle of contract management for the SOF GLSS program, including solicitation, negotiation, award, ... milestones, funding obligations, and performance metrics. + Ensure accurate contract data is maintained across internal systems and aligns with government platforms… more
- Marriott (Lexington, KY)
- …**Schedule** Full Time **Located Remotely?** N **Position Type** Management **Expiration Date:** 10/28/2025 **Additional Information:** This hotel is ... you will be employed by a franchisee, not Marriott. Responsible for the management of all front office functions and staff. Areas of responsibility include Bell… more
- Option Care Health (Lexington, KY)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- CMTA, Inc (Lexington, KY)
- …are a collaborative, innovative, and energetic team that leverages a data -driven, holistic approach to consulting engineering, performance contracting, and zero ... the project. We are seeking candidates who have proven experience with project management and business development as well. This position will be located onsite in… more
