- Molina Healthcare (Salt Lake City, UT)
- …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 (West Valley City, UT)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (West Valley City, UT)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- CenterWell (Salt Lake City, UT)
- …improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement ... and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical...skills; ability to collaborate effectively with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare … more
- Prime Therapeutics (Salt Lake City, UT)
- …passion and drives every decision we make. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is ... As the primary point of contact for their designated BCBS clients, the director promotes and recommends Prime standard offerings to meet client requirements and… more
- Molina Healthcare (West Valley City, UT)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- Waystar (Lehi, UT)
- **ABOUT THIS POSITION** The Internal Audit Director is a critical leadership role responsible for developing, implementing, and overseeing the internal audit ... across the organization. The position will be focused on oversight of the entire SOX compliance program (including both...and ITGCs) and may expand to cover risk based operational audits in the future. The ideal candidate should… more
- Baylor Scott & White Health (Salt Lake City, UT)
- …, Denial Resource Center is responsible for the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor ... Scott and White Health (BSWH). The Director , Denial Resource Center will lead a highly skilled...function for BSWH. + Recommends and implements strategic and operational plans and priorities for clinical denial management aligned… more
- Humana (Salt Lake City, UT)
- …to deliver agile, data-driven, and personalized member experiences at scale. As Director of Marketing Communication Operations, you will play a pivotal leadership ... approaches and compliance with CMS, Medicaid, and Pharmacy marketing standards ** Operational Excellence & Vendor Ecosystem** + Design and implement scalable… more
- Molina Healthcare (West Valley City, UT)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
- Molina Healthcare (Salt Lake City, UT)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more