Oversee enrollment and billing operations across all Government Programs including Medicare Advantage, Medicare Supplement, CHIP, and ACA products to ensure accuracy and operational performance.
Lead Medicare Advantage appeals and grievances operations to ensure timely, compliant resolution and audit readiness in accordance with CMS requirements.
Drive process improvement initiatives and cross-functional coordination to enhance regulatory outcomes, member experience, and operational efficiency.
Capital Blue Cross is a health insurance company and independent licensee of the Blue Cross Blue Shield Association that promises to go the extra mile for its team and community. It is consistently voted one of the 'Best Places to Work in PA,' fosters a flexible environment prioritizing health and wellbeing, and invests heavily in employee training and continuing education.
Own team-wide performance metrics and translate the care model into operational workflows and performance targets.
Lead and develop a team of behavioral health care managers and leads, building a culture that is accountable, collaborative, and mission-driven.
Partner with clinical, finance, and operations teams to ensure care delivery performs against clinical, operational, and financial goals.
Protocol provides cancer-specific behavioral health treatment to patients by partnering with oncology clinics and cancer centers. We are a fast-growing, early-stage company focused on expanding access to care through strong partnerships with leading oncology providers.
Lead and develop a team of remote pre-screening clinical research coordinators, managing performance and quality within direct and matrixed structures.
Own operational management of pre-screening activities, including tracking, analyzing, and reporting key performance metrics to inform decisions.
Drive change management initiatives and process improvements, partnering with stakeholders to implement new workflows and enhance site performance.
Paradigm is a clinical research company rebuilding the ecosystem to enable equitable trial access for all patients and improve efficiency for healthcare providers. It is a venture-backed team from diverse disciplines committed to bringing life-saving therapies to patients faster.