- 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)
- …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
- Molina Healthcare (Owensboro, KY)
- **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 (Owensboro, KY)
- **JOB DESCRIPTION** Job Summary: The AI Program Manager serves as a strategic leader driving the execution of AI initiatives to deliver meaningful business ... process improvement and organizational change management to operationalize the AI program vision. This includes end-to-end program planning (estimating,… more
- Molina Healthcare (Owensboro, KY)
- …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 (Owensboro, KY)
- …including behavioral health, long-term care, and population health-related education and services for members with high-need potential. Strives to ensure member ... and written communication skills. * Microsoft Office suite/applicable software program (s) proficiency. Preferred Qualifications **LVN is preferred for this role.**… more
- Molina Healthcare (Owensboro, KY)
- …standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team responsible for the ... appeals and denials. * Previous experience leading projects. * Strong customer service experience. * Strong organizational and time management skills; ability to… more
- Walgreens (Owensboro, KY)
- …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
- Molina Healthcare (Owensboro, KY)
- …Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), ... business segment (ie Medicare, Marketplace, advanced imaging/central utilization management services ) in the development and execution of care management,… more
- Molina Healthcare (Owensboro, KY)
- …supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific program experience as needed ... Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified… 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
- CVS Health (Owensboro, KY)
- …Supervisor or Manager **Preferred Qualifications:** + Completion of the CVS Pharmacy Manager Emerging Leader (PM-EL) program + 3-5 years of related work ... genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager , you will lead and develop a pharmacy team that provides exceptional patient care… more
- Molina Healthcare (Owensboro, KY)
- …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 (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)
- …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 (Tell City, IN)
- …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
- US Bank (Owensboro, KY)
- …verification system operated by the US Citizenship and Immigration Services . Learn more about the E-Verify program ... at-all from Day One. **Job Description** The Operations Group Manager - Global Delivery Insights & Enablement leads the...may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional… more
- US Bank (Owensboro, KY)
- …verification system operated by the US Citizenship and Immigration Services . Learn more about the E-Verify program ... may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional...participates in the US Department of Homeland Security E-Verify program in all facilities located in the United States… more
- US Bank (Owensboro, KY)
- …Responsible for providing a broad variety of administrative, operational and staff support services for an assigned group(s) or manager (s). + Actively engaged in ... may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional...verification system operated by the US Citizenship and Immigration Services . Learn more about the E-Verify program … more