Job Description Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading
About Pair Team At Pair Team, were an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social -
Project Controls Specialist (Hybrid) Long Beach & Los Angeles, CA What We’re Looking For: Michael Baker International is seeking a Project Controls Specialist to support project delivery across our Long Beach and Los Angeles offices. This
Description Location: Long Beach, CA (Hybrid) Job Type: Full-Time Schedule: Hybrid schedule is 2 days in-clinic 8-hour shift Monday to Friday Day Shift We are looking for a compassionate person who loves an opportunity to make
Job Title Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures
Remote Sales Opportunity with Unlimited Potential — Sales Customer Representative at Joseph and Young Joseph and Young is currently looking for motivated individuals to join our growing remote team. As a Sales Customer Representative, you’ll have
Work Remotely. Earn Without Limits. Launch Your Career with Expert Training. Looking for a career that offers flexibility, unlimited earning potential, and the freedom to work from anywhere? Beacon National Agency is seeking motivated individuals to
Job Title Provides lead level support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy
Job Title Leads and directs team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and system
Risk & Quality Performance Manager The Risk & Quality Performance Manager position will support Molinas Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage
Job Title Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual quality
Job Title Job Summary Will require to be infield twice a week subject to change Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point
Delegation Oversight Manager Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Collaborates closely with internal
Job Title Provides analyst support for financial analysis activities including data/text mining, analysis, modeling, and predicting to understand business issues, develop solutions and enable informed business decisions. Essential Job Duties Extracts and compiles information from large data
Job Title Investigative Support For Special Investigation Unit Job Description Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud
Job Title Provides senior level analyst support for finance activities including financial analysis, reporting, forecasting, trending and modeling to support planning for future business decisions for the Kentucky Health Plan. Job Summary Provides senior level analyst support
Job Description Provides senior level support for all aspects of taxation including compliance, planning, forecasting, merger and acquisition (M&A) evaluation, expense, liability and asset recordation, securities and exchange (SEC) and statutory reporting disclosure, Sarbanes-Oxley (SOX) compliance,