- Molina Healthcare (Owensboro, KY)
- …SummaryProvides 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
- Molina Healthcare (Owensboro, KY)
- …work of external vendors. Assigns, directs, and monitors system analysis and program staff. These positions' primary focus is project/ program management, rather ... teams in planning and executing business programs. Assigns and monitors work of program management staff providing support and direction. + Serves as the subject… more
- Molina Healthcare (Owensboro, KY)
- …(No Weekends or Holidays) Job Summary Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: ... and application of protocols and guidelines. * Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources,… more
- Molina Healthcare (Owensboro, KY)
- …and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits and overpayment ... and executing projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment… more
- Molina Healthcare (Owensboro, KY)
- …governance framework and decision-making processes, as needed. + At the direction of program (CoE, Shared Service or other functional area) leadership, supports ... or a similar field). + Relevant work experience in healthcare compliance program operations and risk management;...experience. + Managed Care experience, preferably in a shared service , CoE or matrixed environment. + Experience with Microsoft… more
- Molina Healthcare (Owensboro, KY)
- …lives in Kentucky and must be licensed for the state of Kentucky Case Manager RN will work with KY Behavioral Health Medicaid population providing telephonic case ... 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 (Owensboro, KY)
- …verbal and written communication skills. * Microsoft Office suite/applicable software program (s) proficiency. Preferred Qualifications * Certified Case Manager ... in Kentucky and must be licensed for the state of Kentucky. Case Manager will work with KY Medicaid/Medicare population providing telephonic case management support.… more
- Molina Healthcare (Owensboro, KY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide ... daily investigative activities as a back-up to the SIU Manager . This position will be accountable for tracking on...policies and be able to apply them in ensuring program compliance via payment integrity programs. The position must… more
- Molina Healthcare (Owensboro, KY)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. +… more
- Molina Healthcare (Owensboro, KY)
- …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 (Owensboro, KY)
- …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 (Owensboro, KY)
- …entry and telephone and clerical support for team facilitating care management related services for members. * Facilitates initial review of assigned case levels and ... needs and works under the direction of the care manager to implement care plan. * Schedules member visits...care management staff during process of identifying appropriate member services . * Coordinates required member services in… more
- Molina Healthcare (Owensboro, KY)
- …Duties** * Hires, trains, develops, and supervises a team of pharmacy service representatives supporting processes involved with Medicare Stars and Pharmacy quality ... and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. * Ensures that adequate staffing coverage is present at all… more
- US Bank (Owensboro, KY)
- …verification system operated by the US Citizenship and Immigration Services . Learn more about the E-Verify program ... + Providing consultative advice to customers, growing portfolios through various program optimization activities, and making appropriate decisions on how to boost… more
- US Bank (Owensboro, KY)
- …verification system operated by the US Citizenship and Immigration Services . Learn more about the E-Verify program ... the operational activities for Mortgage/Consumer Servicing complaints. Ensures quality service and effective operations support for all assigned internal and… more
- CVS Health (Owensboro, KY)
- …the district to cover pharmacist scheduling gaps, under the direction of the Pharmacy Manager (PM) and Rx District Leader (DL) to support our pharmacy teams. While ... Performance Coordinator (DPC); overseeing the pharmacy and serving as the Pharmacy Manager 's proxy during bench shifts without overlap + Supporting safe and accurate… more
- Amgen (Owensboro, KY)
- …marketing strategy and promoting Amgen products as led by the District Manager . Responsibilities include: + Provide current and comprehensive knowledge of Amgen's ... targets through both in-person and virtual engagement + Develop relationships to service and manage accounts which may include: customizing discussions and customer… more
- CenterWell (Owensboro, KY)
- …of senior-focused primary care, one of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on ... you will: + Evaluate, direct and provide speech/language pathology service to patients in the home or facility +...+ Provide counsel and instruction to patients, families and healthcare staff. + Maintain and submit documentation as required… more
- CenterWell (Owensboro, KY)
- …of senior-focused primary care, one of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on ... you will: + Evaluate, direct and provide speech/language pathology service to patients in the home or facility +...+ Provide counsel and instruction to patients, families and healthcare staff. + Maintain and submit documentation as required… more
- Addiction Recovery Care (Owensboro, KY)
- …has been leading the way and has become one of the fastest growing healthcare systems in Kentucky (and beyond!) in addiction treatment, mental health services ... enter through our doors. ARC is a thriving, dynamic, and fast-paced healthcare system environment where compassion, accountability, respect for the dignity of life,… more