- Molina Healthcare (Akron, OH)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Akron, OH)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Akron, OH)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Akron, OH)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Molina Healthcare (Akron, OH)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Akron, OH)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Akron, OH)
- …the Network Operating Center (NOC) and Enterprise Business Continuity Management (EBCM) Team. This role is primarily responsible for Disaster Recovery activities ... **Job Description** **Job Summary** The Director of Disaster Recovery (DR) will oversee and...Cloud, disaster recovery, business continuity, team leadership, and project management . + Strong knowledge of application, network ,… more
- Molina Healthcare (Akron, OH)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- Bellefaire JCB (Medina, OH)
- …out "Bellefaire JCB: Join Our Team" (https://vimeo.com/894121531) on Vimeo! SUMMARY: The Director of Medina Programs will oversee all aspects of service delivery and ... program staff in all aspects of daily operations including case management , individual counseling, school-based services, home based services, consultation and… more
- Sanofi Group (Akron, OH)
- **Job Title:** Regional Business Director , Mideast **Location:** US Remote **About the Job** Regional Business Directors (RBDs) are key members of the national sales ... serve as strategic leaders and collaborate closely with partners across Account Management , CPE, Marketing, Medical, and Patient Support Services to ensure the… more
- Molina Healthcare (Akron, OH)
- …care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Determines ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
- Cleveland Clinic (Canton, OH)
- …Canton, Plain Township and Tuscarawas County. Mercy also has a growing hospital-owned provider network - Mercy Professional Care Corporation - that offers ... in all aspects of Breast Surgery including both benign and malignant disease management . The ideal candidate will have advanced surgical procedures such as nipple… more