- Molina Healthcare (Green Bay, WI)
- …Summary** Provides subject matter expertise and leadership to healthcare services function - providing support for project/ program /process design, execution, ... into functional requirements. + Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality… more
- Healthcare Services Group, Inc. (Green Bay, WI)
- Overview Who We Are Healthcare Services Group (HCSG) is an experienced partner managing housekeeping, laundry, dining, and nutritional services within the ... and embraced. Join Our Team Join Our Team (https://careers-hcsgcorp.icims.com/jobs/672268/environmental- services manager -in-training/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336028984) Submission FAQs (https://icims.help/candidate-faq) Job… more
- Molina Healthcare (Green Bay, WI)
- …in Georgia. JOB DESCRIPTION Job Summary Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following ... and application of protocols and guidelines. + Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources,… more
- Molina Healthcare (Green Bay, WI)
- **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment department to assist our diverse team of ... medical loss ratio (MLR) targets. In conjunction with the Manager of the In-Home Assessment Program , this...Programs, Market & Segment Leaders, health plan teams, member services , provider services , external vendors, actuary, and… more
- Molina Healthcare (Green Bay, WI)
- …Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team ... processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate… more
- Molina Healthcare (Green Bay, WI)
- …quality and cost-effective member care. This position will support our Molina One Care Services business in Massachusetts. We are looking for a candidate with a MA ... for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services...resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and… more
- Molina Healthcare (Green Bay, WI)
- …to improve member quality of life and to control costs. + Train/educate healthcare services staff on professional standards of documentation + Reeducate staff ... that align with Molina programs and protocols + Assists Manager with data for team member performance reviews +...quality of life and to control costs. + Train/educate healthcare services staff on professional standards of… more
- Molina Healthcare (Green Bay, WI)
- …Responsible for creating, operating, and monitoring Molina Health Plan's pharmacy services programs in accordance with all federal and state laws. ... **Knowledge/Skills/Abilities** + Monitor the operational aspects of the Pharmacy Benefits Manager and other delegates to assure compliance with contractual and… more
- Walgreens (De Pere, WI)
- …when using the pharmacy. Enhances customer experience by increasing focus on healthcare services . **Operations** + Responsible for assisting pharmacist in the ... allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any… more
- Humana (Appleton, WI)
- …first - for our teammates, our customers, and our company. Through our Humana insurance services , and our CenterWell healthcare services , we make it easier ... to serve members in the Wisconsin Family Care (FC) program in Fond du Lac, Outagamie, and Winnebago Counties....member. Key Responsibilities include: + Partner with a social services care manager (also referred to as… more
- Molina Healthcare (Green Bay, WI)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan ... of service . **KNOWLEDGE/SKILLS/ABILITIES** + Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from… more
- Compass Group, North America (Appleton, WI)
- …the next step in your career with TouchPoint as a Clinical Nutrition Manager ** **!** **Location** : Ascension NE Wisconsin St. Elizabeth Hospital - Appleton, WI ... largest employers of Dietitians in a variety of settings: + Hospitals and healthcare systems + Senior living communities + Schools and universities + Corporate… more
- Molina Healthcare (Green Bay, WI)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... interpretation, and appropriate level of care for provision of member services in alignment with state, federal, accrediting, and billing/coding guidelines and… more
- Molina Healthcare (Green Bay, WI)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified ... National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and… more
- Molina Healthcare (Green Bay, WI)
- …oversight and expertise related to behavioral health and chemical dependency services , and assists with implementation of integrated behavioral health care programs ... management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize… more
- Molina Healthcare (Green Bay, WI)
- …Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an ... Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional… more
- Molina Healthcare (Green Bay, WI)
- …medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for ... Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports plan utilization management program… more
- Molina Healthcare (Green Bay, WI)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, Overpayment… more
- Walmart (Green Bay, WI)
- …team is dedicated to providing comprehensive patient care and ensuring the highest standards of service . As a Pharmacy Manager , you will lead the team to success ... operations and leading people? Join Walmart as a Pharmacy Manager and lead our team of pharmacists and pharmacy...enforce, and provide direction and guidance on proper customer service approaches and techniques to ensure customer needs are… more
- CVS Health (Appleton, WI)
- …from advising on prescriptions to helping manage chronic and specialty conditions. As Pharmacy Manager , you have one of the most significant roles in our company - ... Practice + Regulatory Requirements + Quality Assurance + Customer Service + Personnel Management + Inventory Management + Financial...+ Workflow Management A key component of the Pharmacy Manager role is keeping your customers and patients healthy… more