- Providence (MT)
- …for services and take proper steps to pay vendors + Inform Senior Manager Operations of large or complex claims and claims with potential for media ... empower them.** **Providence is calling a Sr. Medical Malpractice Claims Manager - Professional Liability who will:**...roundtables + Assist in Regional CEO Conferences with Senior Manager Operations + Facilitate and participate in… more
- Marriott (Nashville, TN)
- …school diploma or GED; 3 years experience in the human resources, management operations , or related professional area. OR * 2-year degree from an accredited ... or related major; 1 year experience in the human resources, management operations , or related professional area. **CORE WORK ACTIVITIES** **Managing Recruitment and… more
- The Mount Sinai Health System (New York, NY)
- …1. Analyzes data requests using information technology, enrollment, claims , pharmacy, clinical, contract, medical management, financial, administrative and ... care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a...CMS Medicare regulations and related reporting requirements, such as STARS ,QARR, MMCOR, MEDS, RAPS and HEDIS is a strong… more
- Medical Mutual of Ohio (OH)
- …guidelines and Medicare Part D (pharmacy) and the ability to apply to business operations . . Strong knowledge of pharmacy claims processing through retail or ... I** Working under general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare… more
- LA Care Health Plan (Los Angeles, CA)
- …Sales and Marketing (PSSM) service area and the enterprise. The Product Solutions Manager III leads in supporting ongoing operations of the assigned product ... population. Direct experience in Medicare and Duals program administration including stars , quality, financial performance review, operational functions ( claims ,… more
- Parsons Corporation (Centreville, VA)
- …for. **Job Description:** Parsons is looking for an amazingly talented **Subcontract Program Manager ** to join our team! In this role you will get to **support ... throughout program performance + Serves as the Cost Account Manager (CAM) for supply chain related expenditures to the...the needs to document and defend change order and claims . + Assists in analyzing the Prime Contract to… more
- Waste Connections (Castaic, CA)
- Chiquita Canyon Landfill, a Waste Connections company is currently seeking a **Safety Manager ** to be based out of our site in **Castaic, CA** ! **Who Are We?** ... work! We work in an environment where empowered, self-directed all- stars know what they do is important. * **INTEGRITY:**...serve. As a member of our elite Waste Connections Operations team, you will be signing up for a… more
- LA Care Health Plan (Los Angeles, CA)
- …population. Direct experience in Medicare and Duals program administration including stars , quality, financial performance review, operational functions ( claims , ... Medi-Cal Product Solutions Manager II Job Category: Sales & Marketing Department:...managed care plans. Understanding of managed care principles and operations . Medi-Cal Plan Partners: Required: Experience serving Medi-Cal population.… more
- VNS Health (Manhattan, NY)
- …Relations, Claims , Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances. + Ensures the accuracy ... processes for continued improvement in staff knowledge, engagement with internal departments, STARS Measures, and enrichment of members experience with A&G. + Tracks… more
- The Cigna Group (Bloomfield, CT)
- …(PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager , Director, and Other Administrators. Provider Performance Enablement (PPE) is responsible ... with providers, provider staff, and/or physician leadership. + Manage joint operations committee (JOC) meetings. This includes: formulating meeting agenda, and… more
- Trinity Health (Albany, NY)
- …visitors, vendors, various regulatory and professional agencies. **SUPERVISED BY:** Manager of Risk Management **SUPERVISES:** none **CAREER PATH:** Management ** ... OPERATIONS /COMPLIANCE:** Is responsible for data management, investigation & reporting....leadership to develop risk mitigation plans associated with litigated claims . Ensures that patient care-related incidents are reported to… more