- Molina Healthcare (Lexington, KY)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- CVS Health (Frankfort, KY)
- …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 ... guide business decisions for national and local providers. The Director will also play a key role in supporting...efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas… more
- Molina Healthcare (Lexington, KY)
- …activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- CVS Health (Frankfort, KY)
- …current skills and development needs. Assesses training needs and works with SIU Director on development plans for team members. Develops and maintains close working ... Coordinates and collaborates with program integrity staff, compliance, and senior leadership. Contributes to the development and delivery of educational… more