- Molina Healthcare (Meridian, ID)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- CenterWell (Boise, ID)
- …and communicate remediation plan to IPA Dyad partners. + Partners with market operational leaders to identify operational issues that impact clinician and coder ... staff workload and redistribute resources as needed to meet market operational demands. + Monitor coding processes, identify inefficiency, and develop… more
- CenterWell (Boise, ID)
- …Director , the Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. ... (ACO) business. This role will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid… more
- Elevance Health (ID)
- …a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid ... Plan will have primary responsibility for the whole health, fiscal, operational , legislative, regulatory, and human resources objectives/agenda for assigned Medicaid… more
- Molina Healthcare (Meridian, ID)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more
- Molina Healthcare (Meridian, ID)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more