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American multinational healthcare company
Position Purpose: This position is responsible for leading recoupment claim inventory management and BOT automation monitoring to ensure Payment Integrity Amisys, Facets, Xcelys, and ABS recovery processes operate as…
Position Purpose: Lead the development, coordination, and execution of operational strategies and process improvements across shared services to support enterprise and market‑level product growth, implementation, and…
Position Purpose: Promote increased program efficiency, service levels, and value by capturing and monitoring performance, and then identifying opportunities for improvement and strategies to realize those…
Position Purpose: Perform duties to develop, direct and implement a pharmacy benefit management program. Aid the Vice President of Medical Affairs in formulating and administering related organizational policies and…
Position Purpose: Define and develop standard and custom formularies for assigned plan. Key Details: Indiana Clinical Pharmacist (Formulary & Quality). Current Indiana licensure highly preferred but will also…
Position Purpose: Direct and oversee regulatory compliance operations to ensure fully compliance with all applicable laws and regulations for assigned products/services. Key Details : The role is fully remote. Must be…
Position Purpose: The Program Manager leads and supports strategic initiatives and ongoing operational priorities across Member and Provider Services. This role coordinates cross-functional stakeholders, manages risks…
Position Purpose: Develop, implement and oversee the pharmacy benefit management program across multiple product lines in both centralized and regional environments with multiple locations. Ensure compliance with…
Position Purpose: Ensure regulatory compliance with Washington state and other government agencies related to the health insurance industry, Centene Corporation, and its business subsidiaries. Key Details: Candidates…
Position Purpose: The Director of Government Affairs is responsible for coordinating state government relations and legislation for the Department of State Government Relations and assists the Department of Legislative…
This is a remote position that can be located anywhere in the US. Position Purpose: Drive strategic healthcare transformation initiatives across health plan operations by identifying opportunities to improve clinical…
This is a remote position and can be located anywhere in the US. Position Purpose: Promote increased program efficiency, service levels, and value by capturing and monitoring performance, and then identifying…
Position Purpose: Lead the development, implementation, and ongoing optimization of Medicaid benefit programs and supporting vendor solutions throughout the product life cycle. Partner with regional Medicaid markets to…
Position Purpose: Manages the correspondence and/or appeals, disputes, and reconsiderations process including the drafting and review of correspondence to ensure regulatory compliance. Manages issues and provides…
Position Purpose: Oversee the development and implementation of contracting activities in network development and enhancement. Key Details: The Senior Director, Network Development & Contracting is responsible for…
Position Purpose: A key executive role responsible for leading and managing billing and enrollment processes across multiple regions. this position ensures operational efficiency, accuracy, and compliance with…
Position Purpose: Ensure regulatory compliance with state and other government agencies related to Health Net, Centene Corporation, and its business subsidiaries. Key Details: Applicants for this role must live in the…
Manages multiple concurrent projects and coordinates enterprise regulatory responses for a large healthcare organization, working cross-functionally with compliance, legal, risk, and business teams to ensure timely and accurate regulatory submissions.
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