- Molina Healthcare (Las Cruces, NM)
- …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 (Las Cruces, NM)
- … 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 (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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
- Mass Markets (Mesilla, NM)
- …Customer Experience Provider (CXP), Customer Service, Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software ... expanding, industry-leading organization. TheCall Center Site Directoris responsible for the management and development of supervisors and all other operational … more
- Molina Healthcare (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …* 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
- Molina Healthcare (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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
- YesCare Corp (Las Cruces, NM)
- …assess candidates' knowledge, skills, and fit within the corrections environment. + Provide ongoing education and training for nursing and healthcare staff. + ... + Manage departmental budgets, monitor healthcare supplies, and oversee medication management . + Develop and maintain nursing staff schedules to ensure adequate… more
- Community Health Systems (Las Cruces, NM)
- …utilization. This includes, when appropriate, reviewing monthly provider utilization data and working with the Corporate Optimization Director to schedule ... are terminated. + Consults with local market leadership as requested (Administrator, Sr. Director Clinics, Director of Clinics, Medical Director , Medical… more
- Mass Markets (Las Cruces, NM)
- …Customer Experience Provider (CXP), Customer Service, Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software ... and possess a strong work ethic. A background in call center operations management is required, and customer service, technical support, or back-office experience is… more
- Mass Markets (Mesilla, NM)
- …High school diploma or equivalent + 2+ years of experience in call center operations management + Strong data entry and computer skills + Fluent in English ... Customer Experience Provider (CXP), Customer Service, Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software… more
- Community Health Systems (Las Cruces, NM)
- …and delivering high-quality care based on established clinical protocols and physician/ provider orders. The RN collaborates with physicians, nurses, and other ... team members. + Utilizes knowledge of human growth and development to provide age-appropriate care and education. + Administers prescribed medications, monitors for… more
- Community Health Systems (Las Cruces, NM)
- **_MountainView Regional Medical Center_** is your community healthcare provider . This 168-bed facility, accredited by The Joint Commission, provides a broad range ... execute financial and operational strategies that drive revenue growth and cost management . + Works closely with corporate senior leadership, providing updates on… more
- City of Las Cruces, NM (Las Cruces, NM)
- …and written forms; prepare clear and concise reports; document animal care and provide input to animal management ; establish and maintain effective working ... OF LAS CRUCES. Under general supervision and direction from the Medical Director performs veterinary services, including a broad variety of clinical and laboratory… more
- Community Health Systems (Las Cruces, NM)
- …and delivering high-quality care based on established clinical protocols and physician/ provider orders. The RN collaborates with physicians, nurses, and other ... team members. + Utilizes knowledge of human growth and development to provide age-appropriate care and education. + Administers prescribed medications, monitors for… more