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ProfessionalPosition Purpose: Supervise the daily operations of the utilization management (UM) department Supervise the daily operations of the UM staff Ensure appropriate usage of resources in order to facilitate the UM process Ensure compliance within applicable state program guidelines Evaluate compliance policies and procedures and analyze/recommend enhancements Assist with ensuring consis...
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ProfessionalPosition Purpose: Research, identify, and implement best practices to improve HEDIS measures into operations in collaboration with various departments Direct activities, resources, methods, and procedures to achieve improvement in HEDIS measures Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal ...
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Videos Duties Duties Summary THIS IS A NATIONAL GUARD TITLE 32 EXCEPTED SERVICE POSITION. NATIONWIDE. All members of the New Mexico Air National Guard or current Active Duty/Reserve military members eligible and wiling to become members of the New Mexico Air National Guard. This National Guard position is for a AVIATION RESOURCE MANAGEMENT SPECIALIST, Job description Number D1891000 and is part...
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Job Number: R0034218 Risk Manager Key Role: Assist with the identification and assessment of risk for major defense programs. Work with a team of risk managers from diverse stakeholder organizations to provide inputs and develop a program wide risk architecture. Develop documentation, including risk management plans, risk tracking sheets, risk process training, and presentation materials. Inter...
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Spanish Trails Rehabilitation Suites 1610 N Renaissance Blvd NE, Albuquerque, NM 87107 P: 505-600-XXXX spanishtrailsrehabilitation.com Full-time: Days About the Position: You've heard the expression "you only get 1 chance to make a great 1st impression"? This position lives this expression every single day. As the 1st point of contact for new patients, families and the general public, this posi...
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Comcast brings together the best in media and technology. We drive innovation to create the world's best entertainment and on-line experiences. As a Fortune 50 leader, we set the pace in a variety of innovative and fascinating businesses and create position openings across a broad range of locations and disciplines. We are at the forefront of change and move at an amazing pace, thanks to our re...
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Our client, a leading biotechnology company, is currently recruiting an Associate Director of Project Management who will infuse the Project Team with their talent, energy and leadership skills. This is an exceptional opportunity to join a corporate culture that is known for its innovative and growth-oriented vision. Assignments include: 1) Drive new project introduction processes 2) Develop an...
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ProfessionalPosition Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, ...
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Pipeline - GeneralPosition Purpose: Perform duties to conduct and manage the day to day operations of the care management functions communicating with departmental and plan administrative staff to facilitate daily department functions. *Manage the delivery of services to members, ensuring services are appropriate and cost effective. - Develop, implement, and oversee care management policies and...
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ProfessionalPosition Purpose: Lead analytical data needs for all HP's and business units. Initiate and lead company wide data processes improvements Lead cross functional activities related to large-scale analytic projects to deliver on schedule, within budget and with superior quality Develop and lead activities to accomplish overall strategic department goals and lead the communication of the...
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ProfessionalPosition Purpose: Conduct and manage the day to day operations of the Program Coordinators in the Case Management department. Develop and maintain efficient processes designed to timely facilitate case management referrals and member outreach. Ensure timely member enrollment into appropriate case management programs. Manage the day-to-day operations and functions of the Program Coor...
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ProfessionalPosition Purpose: Oversee all of the reporting and data analytics for the department and/or customer, including operational scorecards other reporting and data qualifications as defined by management. Oversee the timely and accurate development and analysis of complex financial, statistical, ad-hoc and various reports Monitor business unit and/or client performance on various metric...
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ProfessionalPosition Purpose: Develop telehealth strategy and lead relevant health plan executive directors' participation in telehealth activities Design, introduce and oversee all telehealth services and programs to pilot and subsequent providers and monitor all implementation strategies Ensure high-quality monitoring, tracking, reporting and documentation of program functions to effectively ...
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ProfessionalPosition Purpose:Accountable for aligning human resources strategy with business strategy. Drives the HR agenda, partnering closely with Centers of Ability (COEs), HR Operations and business unit leaders to effectively and efficiently deliver HR processes and initiatives for a business unit. Drive the planning, review and execution of HR strategies for a mid-sized to large or comple...
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ProfessionalPosition Purpose: Perform duties to conduct and manage the day to day operations of the utilization management function. Communicate with staff to facilitate daily department functions. Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. Promote compliance with federal and state regulations and contractual agre...
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ProfessionalPosition Purpose: Ensure compliance with accreditation qualifications and conduct routine readiness assessment and evaluation of policies and procedures, processed and records Oversee the health plan NCQA preparations for accreditation surveys Educate the health plans on NCQA and/or Center for Medicare/Medicaid Services (CMS) standards and qualifications Evaluate compliance of the c...
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ProfessionalPosition Purpose: Perform duties to conduct and manage the day to day operations of the utilization management functions to include denials. Communicate with departmental and plan administrative staff to facilitate daily operations of the utilization management functions. Ensure compliance with established referral, pre-certification and authorization policies, procedures and proces...
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RiskSense, Inc. Senior Technical Program Manager Research and Development - Full-time What we ll do for you: RiskSense is a rapidly growing team of security and software engineers working to revolutionize vulnerability management. As a software engineer, you will directly implement software used to protect businesses and the nation s infrastructure. Working for RiskSense means you ll work and b...
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About the Opportunity The Center for Action and Contemplation (CAC) exists to awaken a more loving world through the teaching and practice of the contemplative tradition. Internally, we are working to create an impactful, modern workplace that is grounded in the values of the contemplative tradition that we represent. As we grow, we are looking for an experienced Program Manager to shape scalab...
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Payroll Implementation Project Manager (#1,062,511,233) Job offer #1,062,511,233 in Albuquerque (New Mexico) USA JOB DESCRIPTION: The Payroll Implementation Project Manager is responsible for overseeing the on-boarding of existing and new clients and ensuring the successful implementation and integration into the new payroll platform. The Payroll Implementation Manager supervises the implementa...
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