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The IT Software Development team builds and manages software and services critical to the Client’s operation. We are trusted business partners, first-class software engineers, and digital transformation leaders. As a Software Engineering Team Lead for IT Financial Systems, you will execute the technical design and build of our Workday Financial Management implementation and develop the go-forward strategy of our existing Financial business software and data integrations. In this entry-level....

- Millville, NJ

Exclusive National Search for Process Engineer with Injection Molding experience for major Global Manufacturing Organization.Are you ready for advancement and growth opportunities? Willing to be mentored and be a leader?What's Great About This Opportunity: Location - ½ way between Philly and the Jersey Shore, Atlantic city reasonable drive. Best Known for: its Sports, Theatre, Horse farms and protected time lands, and is both beautiful and quiet. Schools: Great schools to raise kids....


Nationwide Search for Director of Risk Adjustment Analytics (T-SQL) to oversee the general organization and efficient management of the Medicare Comprehensive Health Assessment Program (CHAPs) data activities for leading healthcare organization. Includes participation in ongoing data mining and analysis, oversight of, development and delivery of education and identification of opportunities to improve reimbursement through proper coding and documentation. Responsible for the ongoing....


Seeking an Executive leader committed to the medical management function, who thrives on coaching and mentoring a large organization, has a creative and visionary style of leadership with excellent communication skills Are you looking for an opportunity to shine and have ideas that can make a positive impact on programs of care management? Do you have creative ideas and want to work with a GREAT Team? The Director will work closely with the Medical Informatics team to identify trends that need


Seeking expert in Claims Configuration to Direct and oversee the claims configuration and pricing/benefits set up within the claims payment system ensuring accurate reflection of provider contracts and claims payments with large healthcare enterprise. Ensures timely and accurate configurations and pricing/benefits set up for new business implementationsEnsure changes in provider contracts are reflected in the claims payment systemCollaborate with stakeholders to gather business requirements....


Seeking an Executive leader committed to the medical management function, who thrives on coaching and mentoring a large organization, has a creative and visionary style of leadership with excellent communication skills Are you looking for an opportunity to shine and have ideas that can make a positive impact on programs of care management? Do you have creative ideas and want to work with a GREAT Team? The Director will work closely with the Medical Informatics team to identify trends that need

- Orlando, FL

Exclusive Search for Director, Marketing to oversee creative marketing programs to brand and promote the organization.at the corporate and national level. · Responsible with establishing and maintaining the marketing department’s strategic vision, video storytelling, and visual brand, objectives, and policies & procedures · Direct fresh ideas, creative content, and marketing programs for this corporation and its entities · Interpret and clearly communicate relevant corporate strategic....

- Murphysboro, IL

Exclusive Search for HR Business Partner responsible for HR strategies for large enterprise to drive the HR agenda, partnering closely with Centers of Expertise (COEs), HR Operations and key business unit leaders to effectively and efficiently deliver HR processes and initiatives for the business unit.Responsible for coaching the front line people managers and partner with them to resolve employee-related mattersDevelop and analyze HR data to guide business leaders in planning and execution of

- St Louis, MO

Exclusive Search for Finance/Data Analyst with 6+ years complex and high-level financial analysis experience to lead various financial projects. Focus: Cost-effectively manage the utilization of services and develop measures to track, trend and forecast related impacts of organizational strategic initiatives. Run pre-established reports as well as development of new reports for internal stakeholders and regulatory agenciesDevelop metrics to evaluate financial impact of proposed contract....


Exclusive, Nationwide Search for a strong dynamic high-level nurse leader with a decade of medical management experience. This highly visible role will involve presenting to key stakeholders, coordinating with the medical management, quality improvement, and credentialing teams to support the strategies, vision, and policies of the health plan organization. Direct and coordinate activities of department and aid the chief officer of the health plan and appropriate corporate staff in formulating


Exclusive Search for Regional Medical Director to serve as liaison for the health plan. Responsibilities and focus to ensure that all the opportunities are highlighted through detailed reporting to the leadership building creditable and trusting relationships with stakeholders regarding performance metrics and serving as the clinical lead with large employer groups in the bid process. Manage assigned departments or functions with an emphasis on execution, outcomes, continual improvement and....


Position Purpose: Position Responsibilities: Develop a roadmap and plan for Continuous Feedback and Delivery initiatives. Build platforms that teams can leverage to accelerate innovation in the areas of reliability, scalability and velocity. Develop cross functional code base for automation. Mentor team members in object oriented programming strategies. Provide technical leadership for software development and software operation transformation initiatives. Implement and customize service mesh....


Job descriptionPosition Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Reports to Chief Medical Director. 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....

- Richmond Heights, MO

Position Purpose: Design, build, test and maintain scalable and stable off the shelf application or custom built technology solutions to meet business needs. Act as a subject matter expert for Application Software developers and Engineers. · Contribute to the entire implementation process including driving the definition of improvements based on business need and architectural improvements · Meet with business partners to understand business needs · Responsible for overall design of the....


Job description This position reports to the Director of Provider Contracting & Network Management to support the contracting activities of the Medical Group and Health Plan. Responsibilities include managing outside medical cost through contracting initiatives, analysis of financial reports and trends in the marketplace covering IPAs, PHOs, hospitals, and key specialty services. Contractual arrangements will be complex and comprehensive, needing a depth of understanding of managed care;....


Director, Provider Payment Innovation (Provider Network Management) Fantastic opportunity to join Fortune 100 leading healthcare enterprise experiencing incredible growth and market expansion. Design, implement and optimize innovative and value-based payment contracting strategies for the health plan to include the development of a broad vision, short and long-term objectives and execution of key business initiatives across all products. Collaborate with multiple functional health plan....


Nationwide Search for Vice President, Quality & Process Improvement (Health Plan) (RN, CPHQ) Position Purpose: As the senior leader, reporting to the Chief Medical Director, you will be responsible for developing and overseeing the quality improvement functions.. To be part of the leadership team to lead and direct process improvement activities, streamline the workflow for a more efficient process. To oversee business processes related to risk adjustment and quality improvement activities

- St. Louis Area, MO

Exclusive Search for Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit as part of a team of Medical Directors assisting the Chief Medical Director of Fortune 100 healthcare enterprise. 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....


Exclusive Nationwide Search for Senior Medical Director to Assist the Chief Medical Officer (CMO) to direct and coordinate the medical affairs functions for the business enterprise. Oversee the denials and appeals department. May manage other medical directors. Medical Leadership Provide medical leadership for all utilization management, pharmacy, case management, disease management, cost containment, and medical quality improvement activities. Perform medical review activities pertaining to....

- NW, SW, Central Ohio, OH

Exclusive Search for Manager, Provider Network to Manage the day-to-day operations of the network accounts department function of this Fortune 100 healthcare enterprise to ensure compliance with health plan, corporate and state policies, procedures, and guidelines to achieve healthy outcomes. *Candidate can reside in NW, SW or Central Ohio Manage the network accounts team to ensure goals and objectives are met through effective hiring, performance management, training, coaching, and career....

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