- CVS Health (Moon Township, PA)
- …oversight of a team of claim processors and all claim related functions for Medicaid Claim Operations . We are seeking a highly motivated individual who will ... will include: + Managing a team of claim processors and overseeing daily operations for assigned health plan to achieve state required metrics. + Manage employee… more
- Highmark Health (Pittsburgh, PA)
- …the Highmark Health Quality, Safety & Value (QSV) Strategy & Operations plan aligned with organizational goals, regulatory requirements, and population health ... demonstrate the wholistic achievement of better health outcomes. + Ensures the business has the appropriate capabilities, people, processes, and technology in place… more
- Highmark Health (Pittsburgh, PA)
- …assess strategic fit for Highmark, (2) prioritize potential opportunities and (4) support development of business cases to facilitate decision to move forward ... delivery industry + Experience influencing change in complex organizational systems + Medicaid and Medicare managed care operations and technology experience +… more
- UPMC (Pittsburgh, PA)
- …Risk, Compliance & Ethics Officer and strategically and operationally leads the development , implementation, and management of a robust and effective set of Fraud, ... agreements, standards, and requirements in a manner that continually supports the business and operational areas across the wide array of highly diversified products… more