- Molina Healthcare (Lexington, KY)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Lexington, KY)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- CommonSpirit Health (Lexington, KY)
- …Bachelor's Degree - equivalent education and experience in payer strategy, managed care or provider network senior level role may be considered in lieu of degree ... a strong preference for someone in the KY or TN area. The Market Director , Payer Strategy and Relationships (PSR), is responsible for managed care policies, goals… more
- Molina Healthcare (Lexington, KY)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- CVS Health (Frankfort, KY)
- …medical license without encumbrances in one of these states.** + In the Medical Director role you will provide oversight for medical policy implementation. + You ... Appeals / Special Projects and Committee participation when needed. + The Medical Director will provide clinical, coding, and reimbursement expertise as well as… more
- CVS Health (Frankfort, KY)
- …developing their strategy / solving complex strategic questions as needed, across network / provider partnership strategy, clinical strategy, and product ... it all with heart, each and every day. **Position Summary** The Lead Director , Mental Well-being Strategy is responsible for leading the development and execution on… more
- CommonSpirit Health at Home (Lexington, KY)
- …and Responsibilities** VNA Health at Home is part of an expansive health care network that is committed to providing better patient care, with better outcomes, where ... mission of delivering hope and healing to those we serve. The Director , Clinical Services is responsible for the planning, direction, coordination, supervision,… more
- Molina Healthcare (Lexington, KY)
- …the Network Operating Center (NOC) and Enterprise Business Continuity Management (EBCM) Team. This role is primarily responsible for Cyber Recovery activities ... **Job Description** **Job Summary** The Director of Cyber Recovery will oversee and manage...Cloud, disaster recovery, business continuity, team leadership, and project management . + Strong knowledge of application, network ,… 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
- Fresenius Medical Center (Georgetown, KY)
- …statements with Director + Responsible for participating in all required Network reporting and on-site state or federal surveys. + Participates in the completion ... for unexcused and missed treatments in collaboration with the Director . + Plans, coordinates and acts as the liaison...performance management , and decision making. + Demonstrated management skills necessary to provide leadership in… more
- Danaher Corporation (Lexington, KY)
- …initiatives. This role plays a pivotal part in supporting funnel management , activity tracking, and large account planning initiatives, while partnering with ... the North America Commercial Sales Enablement team and report to the Senior Director , North America Sales Enablement responsible for CRM, CPQ, and sales enablement… more
- Catholic Health Initiatives (Lexington, KY)
- …requirements ESSENTIAL KEY JOB RESPONSIBILITIES 1. Participates in the evaluation and management of diseases and health conditions in collaboration with other health ... pharmaceutical agents as outline in the approved collaborative drug therapy management agreement including initiating, adjusting, and discontinuing drug therapy 3.… more