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Clinical Manager for Case Management | Care Coordination – MILWAUKEE Health Plan Manage and develop clinical team of licensed medical and behavioral health clinicians, ensuring quality of care for individuals with both behavioral health and medical conditions. This team has oversight for the Case Management and Care Coordination services and activities for members. Manage clinical services including oversight of clinical policies and procedures and daily activities of integrated care....


Sr VP Health Services | Medical Management - CA ___________________________________________________________________ Advance your career AND make a difference! Exceptional opportunity for someone who thrives on quantifiable results to drive improvement in quality, outcomes, and operational efficiency, enhancing care delivery and quality of life for the membership of this international, mission -driven MCO. GENEROUS relocation and compensation - AMAZING career potential SVP will be a key part of


Manager, Medical Management - Appleton, WI Provide leadership for experienced clinical team in growing satellite office (12 direct reports), Manager will be responsible for managing a complete program of medical management in accordance with the mission, philosophy, and objectives of plan. Oversight includes both UM and CM. Manager will implement changes to medical service functions and performance in relation to company mission, philosophy objectives and policies, as directed. Manage budgets....


Sr Director, Provider Contracting – Columbus, OHIO Great manager – highly motivated team –relocation offered. Growing health plan needs a strong communicator with a deep knowledge of value- based contracting and proven ability to build relationships with providers and senior leadership. Drive the development and implementation of network contracting and network development. · Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between


VP, Provider Contracting | Network | Strategy OREGON - Portland | Eugene STRONG leadership team - GREAT relo & benefits. Experienced strategist with exceptional relationship - building skills will direct the provider network and contracting activities across the OR market for multiple product lines. Responsible for analysis, network operations and supporting decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the....

- St Louis, MO

VP, QUALITY - MCO - St Louis EXCEPTIONAL leadership team - GENEROUS RelocationWorking closely with the Chief Medical Director and the CEO, VP will oversee all related activities for Quality Improvement functions. Lead and direct process improvement activities for more efficient and streamlined workflow. Oversee the business processes related to risk adjustment and quality improvement for assigned products and plans.Responsible for all activities related to National Committee for Quality....

- Indianapolis, IN

Director, UM - Indianapolis, IN Amazing growth continues with this national firm - award winning programs of care and a chance to TRULY make a difference for the medically underserved population in INDIANA. Benefits are excellent- career advancement opportunities are unlimited Director will join an already successful team and have oversight for referral management, telephonic utilization review, prior authorization functions, and case management programs and ensuring compliance government and....


Senior Director, Quality – FLORIDA _____________________________________________________________________ Incredible growth potential - generous relocation to SUNNY Florida! If you enjoy taking the lead in NCQA accreditation - this may be the new job for you! Sr Director will utilize proven success in moving the needle by directing process improvement activities to improve and streamline workflows across the Florida market. Responsible for NCQA and HEDIS performance. Ensure health plan is....


VP Medical Management | Health Services - South Carolina _____________________________________________________________________________________________ VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist in this market. Incredible growth opportunities and perks for this executive role GENEROUS relocation & competitive compensation. ** We are seeking an experienced leader with a proven background in an MCO/health plan/ACO. Direct and....


GROUP HEALTH | SALES EXECUTIVE | EXCLUSIVEWhat does every sales professional want? Something their prospects want to buy, something different, and something better than what the competition has to offer! What if you could have this and the backing of a large, national brand with a 50 year history of success? Now you can have both! Our client is a subsidiary of one of the largest employee benefits plans in the country. They offer ACA-Certified innovative group dental plans across multiple....


GROUP HEALTH | SALES EXECUTIVE | EXCLUSIVEWhat does every sales professional want? Something their prospects want to buy, something different, and something better than what the competition has to offer! What if you could have this and the backing of a large, national brand with a 50 year history of success? Now you can have both! Our client is a subsidiary of one of the largest employee benefits plans in the country. They offer ACA-Certified innovative group dental plans across multiple....


GROUP HEALTH | SALES EXECUTIVE | EXCLUSIVEWhat does every sales professional want? Something their prospects want to buy, something different, and something better than what the competition has to offer! What if you could have this and the backing of a large, national brand with a 50 year history of success? Now you can have both! Our client is a subsidiary of one of the largest employee benefits plans in the country. They offer ACA-Certified innovative group dental plans across multiple....

- Tarzana, CA

Full Time, Night Shift Registered Nurse for a 245-bed not-for-profit medical center that serves the San Fernando Valley, offering high quality specialty services, including: heart and vascular care, orthopedics, oncology and senior services in Tarzana, CA. The hospital specializes in pediatrics and has one of the largest neonatal intensive care units in the San Fernando Valley. It has a reputation for clinical excellence and sophisticated technology with a personal touch. They are continually....


Provides in-depth clinical expertise in a defined area of nursing practice (eg., pediatrics, oncology, adult medicine). Develops and ensures quality standards for nursing practice for a specific patient population. Provides advanced clinical practice education, consultation, research and administration. Salary up to $104,000, plus 7% bonus. Relocation available for candidates in the local area to help reduce commute time. No remote work or sponsorships are available. Basic Qualifications:....

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