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American multinational healthcare company
The Senior Care Manager (RN) supports high-risk members through assessments, individualized care planning, outreach, and complex caseload management. The role also assists with case setup and backup training.…
The Lead Care Manager will support the pediatric and maternity care management population, with responsibilities that include managing complex cases, setting up cases, supporting audits, and assisting with the training…
Position Purpose: Serve as a senior operational and analytical partner for assigned National Provider organizations. This remote role owns provider-facing coordination, roster reconciliation, provider data integrity,…
Position Purpose: Provides in-depth technical and business knowledge with regards to SAS. Adds advanced technical support to one or more business areas through developed and ad hoc analysis/reporting within SAS, as…
Position Purpose: Direct, strategize, negotiate and handle activities of the marketing and sales functions. Support the company’s strategic plan and establish the strategic vision, objectives, and policies and…
Position Purpose: Manage strategic vendor partnerships and enterprise initiatives, including vendor evaluation, contracting, implementation, governance, and performance oversight to support clinical, operational, and…
Manager, Patient Services (Call Center - Pharmacy) Position Purpose: Manage the customer service function, including technology needs and implementation. Coordinate with various operational departments to research and…
Position Purpose: As a Senior Compliance Analyst, you will d rive and coordinate end-to-end external audit process along with providing regulatory interpretation, perform compliance reporting, lead special projects,…
Position Purpose: Lead the development and execution of business development strategies that expand the company's market presence and drive growth of Individual Coverage Health Reimbursement Arrangements (ICHRAs).…
Position Purpose: Manage and oversee the coordination of regulatory audits, examinations, and oversight activities for a regional portfolio of Medicaid health plans across the West Region. Provide leadership and…
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: Through collaboration with the business and IT, leads or co-leads project-based efforts to drive operational efficiency. Following prescriptive methodology, results are achieved through benchmarking,…
Pharmacy Operations Specialist II (FWA) Position Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks. This role…
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based…
Position Purpose: Supervises drafting and processing of correspondence in accordance with National Committee for Quality Assurance (NCQA) requirements. Supervises day-to-day activities and provides guidance to the team…
Position Purpose: Serves as a strategic business partner overseeing both vendor relationship management and financial performance for assigned business units or delegated entities. Integrates operational oversight with…
Position Purpose: Drive market-leading business acquisition growth and retention through national operating scale and consumer-insight driven marketing activations for our ICHRA plans. Key Details: Centene is advancing…
Position Purpose: Key financial leader with primary responsibility for month end and year end close as well as quarterly and annual forecasting. In addition, they negotiate and handle activities of the business unit’s…
Responsible for advanced predictive data analytics using big data and data science technology for healthcare innovation, performing analysis on structured/unstructured data, developing algorithms, and using tools like SAS, R, and database technologies.
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