Negotiate pharmacy agreements across retail, mail, and quality-based channels.
Create and manage network contracting campaigns, analyzing performance metrics.
Work with analytics teams to assess network adequacy and compliance.
Jobgether is a company that uses AI to power the job application process. They ensure applications are reviewed quickly, objectively, and fairly against a role's core requirements.
Identify, implement, and evaluate information systems and operational processes.
Collaborate with diverse stakeholders to elicit, analyze, communicate, and validate requirements.
Determine resource needs and ensure efficient and effective use of resources to support the EMR.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually. CommonSpirit has more than 157,000 employees and contributes more than $4.2 billion annually in charity care.
Serve as primary contact for patients, families, and providers
Schedule and coordinate medical appointments
Manage patient documentation and EMR updates
Pine Park Health is a value-based primary care practice redesigning how residents of senior living communities get or stay healthy. They aim to dramatically improve healthcare for seniors with a new model designed around patients, families, community staff, providers, and payers.
The System Senior Vice President (SSVP), Quality and Safety, is a transformational senior healthcare executive charged with advancing an unparalleled culture of clinical excellence, safety, and patient-centered care.
This leader will be the principal architect and executive champion for system-wide strategies and initiatives that elevate performance, reduce unwarranted variation, and eliminate preventable harm.
The SSVP will ensure impeccable regulatory compliance, guide critical decision-making with expert counsel, and position CommonSpirit Health as a national leader in clinical quality and patient-safety innovation.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually.
Identify and implement best-in-class practices for da Vinci Surgery.
Work in partnership with hospital leadership and cross-functional teams.
They are committed to minimally invasive care through ingenuity and intelligent technology. Intuitive has been built by great people from diverse backgrounds and strives to foster an inclusive culture built around diversity of thought and mutual respect.
Monitor and interpret CMS, state Medicaid, and industry risk adjustment and quality regulations.
Provide SME guidance to Product, Sales, and Account Management on RA policy and program implications.
Partner with product teams to ensure solutions align with regulatory and audit requirements.
Cotiviti is a company that focuses on healthcare solutions. They offer a competitive benefits package to address a wide range of personal and family needs.
Serve as primary contact for patients, families, and providers
Schedule and coordinate medical appointments
Manage patient documentation and EMR updates
Pine Park Health is a value-based primary care practice redesigning how residents of senior living communities get or stay healthy and lead a life they love. They've expanded to over 185 communities across Arizona, California, and Nevada with investments from firms like First Round Capital and Google’s AI fund.
Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions.
Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
Support effective implementation of performance improvement initiatives for capitated providers.
Centene is committed to helping people live healthier lives. They provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well. Centene is an equal opportunity employer that is committed to diversity and inclusion.
Provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems.
Ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure and serving as a key liaison between business and technical teams.
Research and analyze system and business issues, develop high-level requirements, test and implement solutions, and audit and document outcomes.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust and motivated by member well-being, not profits. They are committed to providing best-in-class service, sustainability, and innovation.
Oversee day-to-day operations for the CCPM and TOC care management teams.
Ensure delivery of high-quality longitudinal chronic/complex care management and best-in-class transitions of care.
Continuously evaluate and improve the performance of CCPM and TOC programs and team members.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. They are committed to improving patient outcomes and quality of life for patients living with kidney disease. This is achieved by delaying disease progression, shifting care to the home, and accelerating kidney transplants.