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Seeking Director to head up Membership Administration Systems for this healthcare enterprise. A Highly visible role for Healthcare Leader with experience in Operations, Membership Services in the implementation of Healthcare Health Systems and Large scope multi-year project management. Job description Responsible for the management and leadership of a range of process improvement and process management activities. Activities managed include planning, performing, and implementing process....


Supervisor, Utilization Management (RN preferred) Orlando, FL Currently seeking a Supervisor to lead the daily operations of the utilization management (UM) department in the Orlando, FL area. The ideal candidate will hold a current state's LPN, LVN, or RN license and possess 3+ years of utilization management/quality improvement experience in a managed care environment.. Responsibilities of the Supervisor, Utilization Management Supervise the daily operations of the UM staffEnsure....


Contract Implementation Analyst Columbus, OH Currently seeking a Contract Implementation Analyst for a great opportunity in the Columbus, OH area. The ideal candidate will possess 1+ years of provider contract implementation, contract analysis or claims analysis experience in managed care, health care or TPA setting. Responsibilities of the Contract Implementation Analyst Perform day to day duties and testing of contract implementation, including UAT to ensure that systems accurately....


Leading multi-line healthcare enterprise offering both core Medicaid and specialty services is seeking a Board Certified Psychiatrist to head up our Behavioral Health unit. Job Description The Medical Director (Behavioral Health) will assist the Chief Medical Director to lead and coordinate the medical management, quality improvement and credentialing functions for this leading health plan through: 1) Medical Leadership 2) Medical Reviews 3) Cost Containment 4) Quality & Performance....


Nationwide Search for Senior Director, Contracting & Network Development Fantastic opportunity to join our Fortune 100 leading healthcare enterprise experiencing incredible growth and market expansion! Senior Director will oversee the development and implementation of contracting activities in network development and enhancement.Work with Business Development and Providers to develop a strategy for developing new networks including plans to meet network access and unit cost....

- Yonkers, NY

POSITION OVERVIEW:Provide psychiatric services and care to the agency’s clients, including provision of a full behavioral health (including health) assessment; diagnosis; treatment recommendations; treatment planning; treatment; and follow up planning. The practitioner also provides clinical consultation to agency non-medical staff, is the signature of record for all treatment planning, and participates in the learning environment of the program. Welcoming and inspiring care is provided in....

- Fort Lauderdale, FL

Job descriptionPosition 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, and medical review of complex, controversial, or experimental medical services. Supports effective

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