- Molina Healthcare (Lexington, KY)
- …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 (Lexington, KY)
- … 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 (Lexington, KY)
- …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 (Lexington, KY)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight ... and data completeness training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data , and chart collection… more
- Molina Healthcare (Lexington, KY)
- …or Contact Center technology leadership. + 5+ years in a senior management or director -level role overseeing **large-scale, cloud-based UCaaS/CCaaS environments ... **Job Description** **Job Summary** The Director of IT (Telecom) provides strategic and operational...and simplify secure access across channels. + Collaborate with data and analytics teams to leverage AI-driven insights for… more
- Molina Healthcare (Lexington, KY)
- …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 (Lexington, KY)
- …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 (Lexington, KY)
- …and problem-solving capabilities. + **Preferred Experience** 10 years + of IT Data Center Operations, Project Management , Cyber Recovery, Business Continuity ... **Job Description** **Job Summary** The Director of Cyber Recovery will oversee and manage...the Network Operating Center (NOC) and Enterprise Business Continuity Management (EBCM) Team. This role is primarily responsible for… more
- CommonSpirit Health at Home (Lexington, KY)
- …mission of delivering hope and healing to those we serve. The Director , Clinical Services is responsible for the planning, direction, coordination, supervision, ... & Compliance:** Uphold the Corporate Compliance Program. + **Operational Support:** Provide prompt and professional assistance to office and clinical staff. +… more
- Molina Healthcare (Lexington, KY)
- **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial and ... of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment… more
- Molina Healthcare (Lexington, KY)
- …care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Determines ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
- Valvoline Global (Lexington, KY)
- …better future. With a global presence, we develop **future-ready products** and provide **best-in-class services** for our partners around the world. For us, ... oversight of executive protection, facility security, global travel risk management , regulatory compliance, crisis response, and security technology integration. The… more
- V2X (Lexington, KY)
- …award.** **Key Responsibilities** + Lead the full lifecycle of contract management for the SOF GLSS program, including solicitation, negotiation, award, ... milestones, funding obligations, and performance metrics. + Ensure accurate contract data is maintained across internal systems and aligns with government platforms… more
- Option Care Health (Lexington, KY)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Fresenius Medical Center (Georgetown, KY)
- …motivating employees, performance management , and decision making. + Demonstrated management skills necessary to provide leadership in the supervision of ... issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including...for unexcused and missed treatments in collaboration with the Director . + Plans, coordinates and acts as the liaison… more
- Molina Healthcare (Lexington, KY)
- …with other functional areas that interface with the segment including medical management , network contracting and provider relations, member services, claims ... clinical practice experience, and at least 2 years as a medical director in managed care organization supporting utilization management /quality program … more
- CMTA, Inc (Lexington, KY)
- …are a collaborative, innovative, and energetic team that leverages a data -driven, holistic approach to consulting engineering, performance contracting, and zero ... the project. We are seeking candidates who have proven experience with project management and business development as well. This position will be located onsite in… more
- Catholic Health Initiatives (Lexington, KY)
- **Job Summary and Responsibilities** The Environmental Services Supervisor will provide day-to-day supervision for the EVS department under guidance of Director ... financial stewardship of department operations and collaboration with other management team members to support the department in its...techniques, process and mission metrics (KPIs) to ensure we provide a clean safe environment as we help save… more
- Molina Healthcare (Lexington, KY)
- …our innovative Risk Adjustment department to assist our diverse team of data leaders, risk adjustment experts, and developers in the development and implementation ... of business strategies, operations and vendor management related to in-home assessment activities in all government...by acting as a key business partner to the Director , Prospective Programs, Market & Segment Leaders, health plan… more
- Molina Healthcare (Lexington, KY)
- …Compliance. + Implements key quality strategies, which may include initiation and management of provider , member and/or community interventions (eg, removing ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more