QUALITY ASSURANCE MANAGER / QIDP (Qualified Intellectual Disabilites Professional). Analyzes processes and conducts root cause analysis related to operations; engages with team leads and department managers to gain complete picture of performance or process. Develops and/or monitors contract and per...
The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Th...
Bachelor's - Healthcare, Bachelor's - Nursing, Master's - Behavioral Health. Bachelors of Science in Nursing, Masters in Behavioral Health or like degree. Associates degree in Nursing, Behavioral Health or like degree with an additional 2 years of directly related experience may be considered. Proje...
Engage, motivate, and lead team in a positive manner that fosters teamwork and excellence, including planning and organizing work in a managerial role. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the...
The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Th...
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and res...
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health ...
Lead Project Managers and/or Program team in the development and maintenance of comprehensive plans for a defined program. Healthcare Insurance industry business and operational knowledge. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Ac...
Mindoula Specialty Population Health Management Program Managers lead a team of Care Extenders to implement one of our programs, serve members, and deliver outcomes to our health plan partners. Develop and coordinate the development of community resource guides with an emphasis on medical health, be...
Healthcare or Health Insurance Experience. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, relig...
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health ...
As a Digital Product Manager for My Highmark, a site for members to view claims, explore coverage, and find care, you'll play a pivotal role in representing the customer's voice throughout the product development lifecycle. Coordinate with other Product Managers to ensure cross-product alignment. Co...
Our Quality, Risk and Compliance teams focus on maintaining compliance and auditing to mitigate risk for our operations.This keeps the company in compliance with State, Federal and overall company requiremens, but most importantly to keep our clients safe and to help them live their best life.If you...
This position will require the skillset of an experienced project manager who has successfully delivered large scale, multi-phased system implementations with multiple work streams, numerous different types of stakeholders and the ability to comfortably deliver updates and relay information to vendo...
Specific training in Manager, Environmental, Health & Safety. Accountable for the generation, implementation, development, and management of systems to ensure facility compliance with all applicable Morton Salt, State, Federal, Local Health and Safety standards and regulations. Develop, implement an...
Bachelor's degree in Social Work or in health, human, or education services and 3 years of experience in long-term care, home health, hospice, public health, or assisted living. Master’s degree in Social Work or in health, human, or education services and 1 year of experience in long-term care, home...
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health ...
Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the business strategy and shaping Procurement strategic direction. Certified Purchasing Manager (CPM). Highmark Health and its affiliates prohibit discrimination against qualified individu...
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health ...
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientati...
The Nurse Manager is responsible and accountable for assessing, planning, implementing, evaluating and maintaining quality nursing care on the unit. Participates in hospital educational programs on health, safety, hazardous waste, etc. Employee Health Responsibilities. Assures coordination of the ho...
Highmark Health's Enterprise Data Office (EDO) is seeking a passionate and experienced Testing and Quality Manager to champion a culture of quality and continuous improvement. Bachelor's Degree in Computer Systems Analysis, Data Processing, Healthcare Informatics or Management Information Systems. M...
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health ...
Understanding of healthcare costs and the broader healthcare service delivery system. This job has primary ownership and oversight over a specified panel of oncology members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member...
The incumbent will play a key role with IT product managers and product owners planning in facilitating budget and resource requests and follow through. Salesforce Data Cloud, Marketing Cloud, Marketing Cloud Intelligence, Adobe Experience Manager, and Workfront). Highmark Health and its affiliates ...