• Lead , Medicaid Ins Product Strategy

    Humana (Columbus, OH)
    …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 (04/29/25)
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  • Medicaid Lead , Technology Solutions

    Humana (Columbus, OH)
    …scope and complexity ranging from moderate to substantial. **Role Description** The Medicaid Lead , Technology Solutions builds strategic partnerships and manages ... and align to the overarching IT strategy. **Responsibilities** + **This State Technology Lead role will exclusively cover the Ohio Medicaid product lines.** +… more
    Humana (04/18/25)
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  • Medicaid Quality Management Health Plan…

    Elevance Health (Woodbridge, NJ)
    …management skills. + Serves as a resource for the design and evaluation of process improvement plans/quality improvement plans and ensures they meet ... ** Medicaid Quality Management Health Plan Director** **Preferred Location:...and implementation of a strategic clinical quality management and improvement program within assigned health plan. Responsible for working… more
    Elevance Health (04/23/25)
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  • Senior Manager, Medicaid Revenue Integrity

    CVS Health (Columbus, OH)
    lead the work and deliverables of multiple complex projects, focusing on process improvement , production, and data analysis. This individual should have ... heart, each and every day. **Position Summary** Reporting to the Lead Director of Medicaid Revenue Integrity, the Senior Manager will work closely with various… more
    CVS Health (04/03/25)
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  • Associate Counsel, Medicaid

    BlueCross BlueShield of North Carolina (NC)
    …the healthcare industry? Join our team as an Associate Counsel for our Health Blue Medicaid line of business. In this role, you will: * Provide expert legal services ... our company's policies and procedures, contributing to their development and continuous improvement . If you are a detail-oriented legal professional with a strong… more
    BlueCross BlueShield of North Carolina (04/09/25)
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  • Medical Director Specialty Medical Services…

    Molina Healthcare (Columbus, OH)
    …in collaboration with the clinical lead , the medical director, and quality improvement staff. + Facilitates conformance to Medicare, Medicaid , NCQA and other ... performance. Performance activities include physician auditing, training, and performance improvement activities. Additionally, they will serve as subject matter… more
    Molina Healthcare (04/09/25)
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  • Medicaid Contract Director

    Highmark Health (Albany, NY)
    …Description :** **JOB SUMMARY** This job is responsible for the oversight of the Medicaid contract and is available for prompt response to direct inquiries from the ... requirements, overall profitability, member satisfaction and state regulator satisfaction. Lead efforts to capture plan performance, work with vendor partners… more
    Highmark Health (04/29/25)
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  • Encounters Submission Manager - Medicaid

    Elevance Health (Norfolk, VA)
    **Encounters Submission Manager - Medicaid /Medicare** **Location** : This position will work a hybrid model (remote and office). The Ideal candidate will live within ... our Elevance Health PulsePoint locations. The **Encounters Submission Manager - Medicaid /Medicare** is responsible for managing a staff of associates whose primary… more
    Elevance Health (04/29/25)
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  • Senior Clinical Account Executive (Non-IC)…

    The Cigna Group (St. Louis, MO)
    …point of contact for various corporate initiatives including developing and implementing process improvement initiatives across the various Centene support teams ... etc., and ensures the timely delivery, consistency, and success of the process + Leads, participates, and contributes in all client-related meetings, both external… more
    The Cigna Group (05/02/25)
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  • Process Improvement Lead

    Humana (Columbus, OH)
    …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 (04/26/25)
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  • Process Improvement Professional

    Humana (Columbus, OH)
    …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 (04/29/25)
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  • Market Entry Capture Strategy Lead

    Humana (Columbus, OH)
    …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 (04/24/25)
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  • Assoc. Executive Director of Continuous Quality…

    St. Catherine's Center for Children (Albany, NY)
    …making regarding care, treatment, and services to clients. + Participate as the lead of the Continuous Quality Improvement Board of Directors Committee, ... ASSOCIATE EXECUTIVE DIRECTOR OF CONTINUOUS QUALITY IMPROVEMENT Program : Administration Type: Full-time/ Exempt Pay Range: $83,000 - $93,000 (yearly) Location:… more
    St. Catherine's Center for Children (04/04/25)
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  • Government Analyst II / Transformation…

    MyFlorida (Tallahassee, FL)
    …tasks are completed in a timely and accurate manner. Identify areas for process improvement and implement effective solutions. Monitor and analyze key ... 68047261 - GOVERNMENT ANALYST II / TRANSFORMATION COMMUNICATION LEAD Date: Apr 24, 2025 The State Personnel...is tasked with the modernization of the AHCA MES ( Medicaid Enterprise Systems), driving a transformation of people, business… more
    MyFlorida (04/25/25)
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  • Senior Info Tech Business Consultant / Info Hub…

    MyFlorida (Tallahassee, FL)
    …monitor Knowledge Repository Info Hub KPIs for projects and continuous quality improvement activities. + Review Medicaid policies and procedures, identifies ... - SENIOR INFO TECH BUSINESS CONSULTANT / INFO HUB LEAD Date: Apr 18, 2025 The State Personnel System...is tasked with the modernization of the AHCA MES ( Medicaid Enterprise Systems), driving a transformation of people, business… more
    MyFlorida (04/19/25)
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  • Director Quality Improvement

    Banner Health (Mesa, AZ)
    …entity leadership to plan and coordinate local Quality Councils/QAPIs. 2. Performance and Process Improvement -Serves as a subject matter expert in performance ... meetings occasionally for stakeholders. In this position you will lead a team of Quality Improvement Specialists...and process improvement , project management and change management… more
    Banner Health (03/08/25)
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  • Quality Improvement Manager- Atlanta

    State of Georgia (Fulton County, GA)
    …and assist the Department and Providers in the development of comprehensive quality improvement plans . Lead and facilitate initiatives to monitor and improve ... Quality Improvement Manager- Atlanta Georgia - Fulton - Atlanta...of ensuring easy access to high quality services that lead to a life of independence and recovery for… more
    State of Georgia (04/04/25)
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  • Insurance Strategy Lead

    Humana (Columbus, OH)
    …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 (04/03/25)
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  • Technical Support Specialist Lead

    AmeriHealth Caritas (West Chester, PA)
    …Discover more about us at www.amerihealthcaritas.com . The **Technical Support Specialist Lead ** will support a Healthcare Care Management System platform for a ... Long Term Services & Support (LTSS). In this role you will lead a technical production support team focused on environment stability, processing optimization… more
    AmeriHealth Caritas (05/01/25)
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  • Lead SW Care Coordinator II

    Fairview Health Services (Edina, MN)
    lead position role models the Fairview Commitments by supporting process improvement , communicating effectively with members and interdisciplinary colleagues, ... for continuous improvement projects on the team. Assist with or lead special projects and data gathering for health plan requests/reports. Provide care… more
    Fairview Health Services (03/31/25)
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