- Valvoline Global (Lexington, KY)
- …better future. With a global presence, we develop **future-ready products** and provide **best-in-class services** for our partners around the world. For us, ... Risk Management** + Lead a global travel monitoring and risk mitigation program , issuing timely advisories and security alerts. + Create region-specific traveler… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations ... operational readiness efforts for new processes, systems, and operational initiatives across provider data and credentialing + Driving launch execution for new… more
- Molina Healthcare (Lexington, KY)
- …Information process functions. + Partner with stakeholders to creatively design solutions utilizing provider data such as the Provider Online Directory, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Molina Healthcare (Lexington, KY)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight ... with the Health Plan Risk/Quality leaders to strategically plan for supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record… more
- Molina Healthcare (Lexington, KY)
- …programs focused on provider enablement, ensuring access to tools, training, and data for success in VBC models. + Design and implement VBC training programs, ... This role focuses on equipping providers with the tools, training, data , and support needed to deliver high-quality, efficient care. Oversees initiatives… more
- CVS Health (Frankfort, KY)
- …The Pharmacy Director is responsible for managing the pharmacy benefit program offered by the health plan. This includes benefit set-up, claims processing, ... new legislation, Drug Utilization Review (DUR) and formulary/guideline changes. + ** Provider and Vendor Management:** The Pharmacy Director collaborates with… more
- CVS Health (Frankfort, KY)
- …with markets and shared services departments to support development of provider performance improvement initiatives + Establish a program management ... And we do it all with heart, each and every day. The Lead Director , National VBC Performance Planning & Insights will act as a strategic leader driving… more
- V2X (Lexington, KY)
- …the full lifecycle of contract management for the SOF GLSS program , including solicitation, negotiation, award, administration, and closeout. + Evaluate procurement ... USSOCOM mission requirements and internal approval protocols. + Collaborate with program managers, finance, and supply chain teams to develop acquisition strategies… more
- Molina Healthcare (Lexington, KY)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Lexington, KY)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Lexington, KY)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Assists in recruitment, hiring and training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts… more
- CommonSpirit Health at Home (Lexington, KY)
- …service. + **Ethical Conduct & Compliance:** Uphold the Corporate Compliance Program . + **Operational Support:** Provide prompt and professional assistance ... 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)
- …requiring consistent oversight. May include travel up to 25%. * Defines program scope, establish approach for implementation and maintain program infrastructure ... of Corporate Operations units via establishment of an internal compliance program , including annual, periodic, focal, etc. audits. * Performance Management &… more
- Molina Healthcare (Lexington, KY)
- …and identifies and implements solutions with alignment from key stakeholders. * Uses data to evaluate actual to expected program performance. * Synthesizes and ... to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Under the… more
- CVS Health (Frankfort, KY)
- …with business objectives. This role requires strategic oversight, data -driven decision-making, and cross-functional leadership to optimize vendor contributions ... + Oversee the collection, analysis, and reporting of vendor performance data . Create clear, actionable reports and scorecards for executive leadership and… 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 ... services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality… more
- Molina Healthcare (Lexington, 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 data ... be assist with implementing and managing the in-home assessment program that leads to the overall achievement of improved...by acting as a key business partner to the Director , Prospective Programs, Market & Segment Leaders, health plan… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- …requirement, provided that such programs were sanctioned by the VHA Central Office Program Director for Psychology and the VHA Office of Academic Affiliations ... the program activities of a complex and intensive inpatient multidisciplinary program , they will provide direct patient care and ensure that patients… more
- Option Care Health (Lexington, KY)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Fresenius Medical Center (Georgetown, KY)
- …values and customer service philosophy. Adheres to the FMCNA Compliance Program , including following all regulatory and FMS policy requirements. Ensure provision ... programs. Adheres to all requirements of the FMCNA Compliance Program , and FMS patient care and administrative policies as...issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including… more
