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American multinational healthcare company
Position Purpose: Manage the triage process of prior authorizations, including supervising pharmacy technicians, manage departmental work flow; identify and develop prior authorization procedures and policies. Key…
Position Purpose: Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and corporate teams to…
Position Purpose: Independently owns the vision, strategy, roadmap, prioritization, and measurable outcomes for a complex or business-critical product or capability. Leads cross-functional product discovery, investment…
Position Purpose: Supervises the processing and review of appeals, disputes, and reconsiderations including escalation for the most complex issues in accordance with state and National Committee for Quality Assurance…
Position Purpose: The position will provide Executive Assistant support to the Chief Information Officer . Responsible for leading and providing executive level support for the Chief Information Officer in partnership…
Position Purpose: Participate in the development of strategic business plans, coordinate and communicate the product strategy and determine key priorities, policies and procedures for product lines and programs. Key…
Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical…
Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to…
Position Purpose: Responsible for analytical data needs. Handle complex data requests, reports, and predictive data modeling. Key Details: Must be authorized to work in the U.S. without the need for employment-based…
Position Purpose - Oversee the implementation of products/plans into Claims business units, ensuring alignment with strategies and goals and consistency in implementation processes, methodology, and models, which could…
Position Purpose: The Portfolio Manager will perform various analytic and strategic tasks in order to support the function. The Portfolio Manager will analyze portfolio data, documentation, and processes and…
Position Purpose: Develop and produce marketing materials and coordinate website changes. Provide support to implement the strategic public relations and communication plan for the organization. Work closely with…
Position Purpose: Within our Oregon's Trillium Community Health Plan Provider Contracting team, you will serve as the primary business lead for provider network adequacy monitoring, reporting, and strategic network…
Position Purpose: Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity…
Position Purpose: Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members.…
Position Purpose: Functions as a program development manager in collaboration with Quality, Health Services and Operations business owners or cross-functional work groups in the development and implementation of…
This positions is located in Southern TX and requires the ability to travel to Brownsville, Laredo, Eagle Pass, Corpus Christi, and Victoria Position Purpose: Maintain partnerships between the health plan and the…
Position Purpose: Plans, coordinates, and controls the daily activities related to the maintenance and repair of Fidelis Care New York vehicles. Manages the drivers, and assists the driving staff with all requests as…
Position Purpose: Responsible for understanding the business, assisting in the prioritization of projects, auditing project alignment with overall technical or business strategy, guiding resource allocation, and…
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