- Molina Healthcare (Macon, GA)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. ... limited to: Risk / Quality rate trending and forecasting; provider Risk / Quality measure performance , CAHPS and survey analytics, health equity and… more
- Molina Healthcare (Macon, GA)
- …processes. Assist with setting annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of Quality / ... **JOB DESCRIPTION** **Job Summary** The Regional Manager Value Based Programs plays a critical role...strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as… more
- Molina Healthcare (Macon, GA)
- …and post-go‑live; steward change management (training, SOPs, job aids, communications). + Risk , Compliance & Quality : Ensure alignment to CMS, HIPAA, state ... leading readiness, cutover planning, and post-go live stabilization. + Hands-on governance, quality assurance, risk management, and escalation handling in a… more
- Molina Healthcare (Macon, GA)
- **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... Molina Healthcare products. Analyzes data and dashboard reports to monitor health plan performance and identify the root causes of medical cost trends. With those… more
- CDM Smith (Macon, GA)
- …the day-to-day delivery operation of TSG, including company reputation, project performance , P&L, overhead efficiency, pricing strategies, risk management, ... reporting, health and safety and monitoring of monthly performance figures. * Analyzes monthly performance metrics...estimates at completion (EAC) variances, revenue execution, schedule, budget, quality , and risk in compliance with CDM… more
- CDM Smith (Macon, GA)
- …of all relevant legislation that impacts the industrial market. * Knowledge of risk management and quality assurance practices. * Contract knowledge and ... construction delivery organization. * Oversees groups operations including staffing, quality , profitability, sales support and client service. * Monitors business… more
- Molina Healthcare (Macon, GA)
- …contracting and provider relations, member services, claims management, payment integrity, pharmacy, quality and risk adjustment. * Acts as a critical segment ... Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC),… more
- Molina Healthcare (Macon, GA)
- …Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize ... for working in partnership with the Credentialing Supervisor or Manager , serving as a team lead for credentialing staff....ensures turn-around time requirements are being met and monitors quality of work by conducting regular audits and tracking… more