- Molina Healthcare (Bowling Green, KY)
- … healthcare experience + Understanding of the drivers and strategies across functions in managed care organizations (MCOs) as well as broad knowledge of the ... Summary** The role, reporting directly to the Head of Strategy , is a critical member of the Strategy... Strategy , is a critical member of the Strategy team, which supports senior executives in creating corporate,… more
- Molina Healthcare (Bowling Green, KY)
- …with value-based contracting. * In-depth knowledge of managed care business, regulatory/legal requirements, products, programs, strategy and objectives. ... **Job Description** **Job Summary** Leads the market's strategy and planning in the successful development of the provider network, including development,… more
- Ascension Health (Brentwood, TN)
- …for assigned geographic market(s) or assigned business segment(s) in government managed care , specialty/horizontals, or value-based contracting. + Oversee the ... the time of the offer._ **Responsibilities** Oversee payer revenue strategy and contracting for one or more assigned markets...design and implementation of value based care models and plans. + Lead or participate in… more
- Elevance Health (Nashville, TN)
- …+ MA/MBA preferred. + Proven leadership experience working in the managed care /healthcare insurance industry. + Exceptional strategic thinking, decision-making, ... ** Director II Customer Care ** **Location:** This...** Director II Customer Care ** **Location:** This role will be full time...creating a culture that is designed to advance our strategy but will also lead to personal and professional… more
- Elevance Health (Nashville, TN)
- …+ MA/MBA preferred. + Proven leadership experience working in the managed care /healthcare insurance industry. + Exceptional strategic thinking, decision-making, ... ** Director I Customer Care ** **Location:** This...** Director I Customer Care ** **Location:** This role will be full time...creating a culture that is designed to advance our strategy but will also lead to personal and professional… more
- Humana (Nashville, TN)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Molina Healthcare (Bowling Green, KY)
- …and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 8+ years of Medicaid managed care experience or in an equivalent related field * Ability ... with Medicaid Proposals and/or business development and requires demonstrated Medicaid managed care experience comprised of technical operational, sales, growth,… more
- Tractor Supply Company (Brentwood, TN)
- Senior Director , Digital **Overall Job Summary** This position will have a robust understanding of the digital business, will leverage analytics and data to identify ... to drive performance, and ultimately drive accountability of directly managed and cross functional teams to evolve Tractor Supply's...to help define and prioritize our med-long term business strategy to ensure 2x growth over the next 5… more
- Humana (Nashville, TN)
- …relevant advanced degree + Healthcare industry experience, particularly in managed care or provider sectors + Experience leading strategy projects from ... concept to execution **Additional Information** This role reports to the Director of Strategy , works collaboratively with members of rest of the team, and with… more
- Evolent (Nashville, TN)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to… more
- CenterWell (Nashville, TN)
- …which you are required to practice + Eight (8) years of clinical experience in managed care or equivalent experience + Five (5) years' experience in effectively ... caring community and help us put health first** The Director Drug Trend and Pipeline Forecasting will be the...teams at all levels on the concepts, opportunities and strategy of managing traditional and specialty medications + Ability… more
- Highmark Health (Nashville, TN)
- …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery ... budgetary responsibility and authority. + Develop the overall conceptualization, strategy alignment, financial models, and high-level design of new reimbursement… more
- Molina Healthcare (Bowling Green, KY)
- …experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care , and/or Provider Network Mgmt & Operations with an ... of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider… more
- Grifols Shared Services North America, Inc (Nashville, TN)
- …connect them with the customer as appropriate + Possess an understanding of the Managed Care landscape and when to utilize necessary internal resources to assist ... and functions including Territory Sales Representatives, Regional Sales Directors, Managed Markets, the Product Brand Team and other necessary stakeholders.… more
- e CancerCare (Nashville, TN)
- …and aligns negotiation with strategy . Essential Functions: In collaboration with the Director of Managed Care , negotiate and manage assigned contracts, ... companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing… more
- Zurich NA (Nashville, TN)
- …profitability goals and ensure the delivery of quality, cost effective services to our Managed Care stakeholders. You will act as a subject matter expert and ... technical resource to Managed Care stakeholders regarding operational and regulatory...we insure 90% of the Fortune 500(R). Our growth strategy is not limited to our business. As an… more
- CVS Health (Nashville, TN)
- …and with relevant external constituents** + **At least 3 years of experience in managed care which may include PBM, Pharma, market access, account management, ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...Services Growth is a critical member of the Trade Strategy team, which is tasked with leveraging CVS Health's… more
- HCA Healthcare (Nashville, TN)
- …is responsible for assisting in the development and evolution of the overall strategy for Physician Services Coding Operations. The RCOM is responsible for oversight ... as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of Coding Operations...to ensure that financial and operational risks are properly managed . + Works with the division operations team and… more
- HCA Healthcare (Nashville, TN)
- …is responsible for assisting in the development and evolution of the overall strategy for Physician Services Coding Operations. The RCOM is responsible for oversight ... as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of Coding Operations...to ensure that financial and operational risks are properly managed . + Works with the division operations team and… more
- BrightSpring Health Services (Nashville, TN)
- …Initiates and coordinates contract negotiations with facilities, insurance companies, and managed care organizations + Participates in community and ... Recruitment Manager is responsible for leading recruitment efforts in Family Foster Care Parent home development. The Foster Parent Recruitment Manager will lead… more