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- Maitland or Sunrise, FL
new job!

Director, Case ManagementINNOVATIVE health plan truly values their nurses . The Director will be engaged in creating, defining and directing a complete Case Management Program across a diverse population.This will encompass needs analysis and planning; working with executive leadership to ensure targets are met for the annual operating plan; ensuring compliance with Corporate, State and NCQA standards. Director will be asked to develop and implement methods, policies and procedures to improve....

- Milwaukee, WI
new job!

Case Manager II - RN Innovative health plan truly values their nurses. This health plan has received numerous awards for their programs of care ! They offer generous benefits and PLENTY of opportunity to grow in your career RN will coordinate continuum of care for select members with complex medical and/or behavioral health conditions to ensure they receive the highest quality most effective care while maintaining cost effectiveness. Activity will include advanced review of admissions through....

- Atlanta, GA
new job!

Manager, Finance- AtlantaYou will be mentored by an exceptionally talented team of analytics and finance professionals as part of this growing healthcare enterprise in the Atlanta area. Career opportunity is unlimited here!Manager will focus on revenue optimization and risk adjustment activities, overseeing the development of various analytical reports and performing complex financial analysis. Supervision of 1-2 analysts. - Ensure that timely and accurate reports are generated - Produce and....

- Boston, MA
new job!

SUPERVISOR, CM Growing health plan is adding a “hands on” supervisor to engage and motivate the CM team. Running the daily operations of the CM department will include : - Ensure appropriate usage of resources in order to facilitate the CM process - Ensure compliance within applicable state program guidelines - Evaluate compliance policies and procedures and analyze/recommend enhancements - Assist with ensuring consistent data collection from CM staff that is used to assist the company in....

- Milwaukee, WI
new job!

VP, Health Plan Operations- MILWAUKEE Join this highly successful leadership team in a market that is continuing to expand and lead change in healthcare. UNLIMITED CAREER POTENTIAL – GENEROUS RELOCATION PACKAGE VP will partner with multiple stakeholders and senior leadership to establish and achieve strategic vision and operational objectives. This will include oversight for business operations, procurement opportunities, new product implementations and complex initiatives for business....

- Ft Lauderdale, FL
new job!

Director, Medicare STARS – FT LauderdaleNewly –created role will provide strategic leadership, guidance and manage the Medicare STARs for the Medicare Plans in the Florida market. RELOCATION package- great benefits- wonderful opportunities to grow! - Act as a leader and expert of Medicare Stars Program to ensure Healthcare Effectiveness Data and Information Set (HEDIS) and Stars objectives are met to support the overall goals - Develop, manage and coordinate clinical and non-clinical HEDIS and

- harrisburg, PA
new job!

Director, Contracting & NetworkWorking closely with the VP, Director drives daily activity of the provider contracting, network development and/or provider relations functions for this new market. GENEROUS relocation - UNLIMITED career growth! -Recruitment and contracting of provider networks in new and prospective markets, and existing market expansions. - Support new business launch in diverse markets by considering individual market circumstances, provider community, budgeting....

- Ft Lauderdale, FL
new job!

VP of Quality - Ft Lauderdale, FL Drive success in quality through process improvement activities for more efficient and streamlined workflow. VP is responsible for all activities related to NCQA Accreditation and HEDIS performance ensuring highest level of accreditation. STRONG GROWTH potential- multiple product lines- GREAT relocation! -Manage all aspects of HEDIS improvement activities, including outreach, incentives, data integrity and chart review - Review and implement new technological....


Director, Medical Management – Complex Care Open due to promotion! Strategic leadership role will provide direction and guidance in medical management and quality for the Medicare product line in this market. You will join a member-centric team of clinicians committed to quality care. Director will develop and implement market focused clinical programs to improve health and quality outcomes for Medicare member and assure utilization management best practices. Medicare is NOT required for this....

- central, PA
new job!

VP, Long Term Care Product - Health Plan- PA Design and own strategy and product for long term care for this new market. You will have an amazing mentor and an opportunity to build out your own team here. Highly visible role offers GENEROUS relocation- strong career potential. Develop and implement operational systems; research changes and updates to government regulations guidelines; create network development plan and integrate LTC and other network providers; participate in the integration....


Vice President, Network Development & Contracting – Central PA Incredible growth and new market expansion has created the need for an additional leader and strategist. This is THE opportunity to be with a leading healthcare enterprise. VP will lead all aspects of provider network strategy including access analysis and network operations. Engage with other decision makers for analysis related to reimbursement and unit cost management. · Develop, implement and maintain production and quality

- Central, PA
new job!

VP, Dual Eligible/Special Needs Plans - Harrisburg Build your own team as this innovative healthcare enterprise continues to expand. VP will oversee and direct Medicare operations, compliance and business strategy utilizing cross functional business units and corporate teams to meet strategic objectives. GENEROUS RELOCATION- strong opportunities for career growth. · Lead Medicare operations, planning, market strategy and compliance between various business units · Perform duties as chief....


Our client is a thriving company that believes in building beautiful, incredibly innovative and energy-efficient homes people adore.They are the first national top 10 homebuilder to have every home we build be 100% ENERGY STAR® certified. And with more than 90,000 homes built, their focus, since day one, has been to build incredible new homes and communities in prime locations for fantastic prices. But more than anything, they build energy-efficient homes and communities for people who....


Our client is a thriving company that believes in building beautiful, incredibly innovative and energy-efficient homes people adore.They are the first national top 10 homebuilder to have every home we build be 100% ENERGY STAR® certified. And with more than 90,000 homes built, their focus, since day one, has been to build incredible new homes and communities in prime locations for fantastic prices. But more than anything, they build energy-efficient homes and communities for people who....


Our client is looking for the best and brightest to take their Sales department to the next level. If you have passion and expertise in business development, account management, or business acumen, this is the company for you. The company seeks a Sales Manager for its Sales Office in New York City (Manhattan), New York. Experience a high-energy, fast-paced work environment that's both competitive and rewarding. Learn about our industry and soar with the support of great coaches and sales....

- Indianapolis, IN

Behavioral Health Case Manager INDIANAPOLIS, IN Isn't it time to join an organization that is leading the way in innovative government health care? Collaboration with providers, award-winning programs of care and INCREDIBLE opportunity to grow The behavioral case manager will play a critical role as part of the Integrated Case Management team working with members identified as high risk. -Identify needs and goals to achieve empowerment and improved quality of life for both behavioral and....


The Director of Accounting and Financial Reporting for National Medicare and Medicaid Finance (NMF) will report to the NMF Controller and will lead the overall accounting and financial reporting of the Program's Medicare revenue. He or she will direct the work of the NMF Accounting and NMF Payment Analysis and System teams. Duties will include engaging with NMF partners to ensure accurate Medicare revenue reporting, ensuring compliance with Sarbanes-Oxley (SOX) and Model Audit Rule (MAR),....


he Global Accounting & Performance team ((‘GAP’) provides accounting and performance measurement services to clients across the spectrum, from funds through to separate accounts, where a shadow accounting service is performed and outsourced financial accounting for insurance clients.This role is part of the Investment Accounting Group (‘IAG’), delivering outsourced financial accounting services to insurance companies who are clients of the company's Investment Accounting. We are currently....


The Investment Accounting Department provides accounting & reporting services to over 30 accounting clients. These services include the preparation of monthly accounting packages and quarterly footnote schedules, and the reconciliation of cash and asset positions. The Investment Accounting Analyst has direct interaction with the clients and ensures that all accounting and reporting is performed accurately and within the specified timeframes. 15% Bonus available. Local candidates only....


The Practitioner/First Assist provides outstanding care to the incoming patients by collecting personal information, accurate clinical assessments, diagnosis, treatment and evaluation. The Practitioner/First Assist provides safe clinical decisions and empathetic care to patients within the clinical area of practice. This position focuses on educating patients in a medical environment while working with team members to meet patient’s needs and incorporate the policies and procedures.....

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