Healthcare Operations Jobs in Portland

Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..

Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..

Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..

Job Information Humana Senior Strategy & Program Development Professional (Remote) in Portland Maine Description Responsibilities Humana's Corporate Marketing team is looking for a Senior Strategy & Program Development Professional to join ..

Powerback is a new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an empowered approach to achieving your full potential by providing integrated ..

... and execute strategic transformation. 'Strategy Operations' is one of a three ... Strategy Planning functions. The Strategy Operations team provides consulting services to ... the other teams in Strategy..

Job Information Humana Network Operations Lead - Behavioral Health/Medicaid in ... Portland Maine Description The Network Operations Lead maintains provider relations to ... claims data needed for service operations. The..

Job Description Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on ..

Job Information Humana Medicare/Medicaid Program Manager -- Remote in Portland Maine Description Humana's Enterprise Shared Services organization is seeking an outstanding cross-functional program leader to join its Business Management team. This ..

... guide and direct the clinical operations of the nursing units on ... transfers and terminations. Why Genesis?Genesis HealthCare is a leading provider of ... is a leading provider of..

Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..

... the advancement of Medicaid Clinical Operations and Programs. Responsibilities Responsibilities of ... a clinical environment or within healthcare operations 5 or more years Healthcare or Managed Care leadership experience,..

Job ID 21000KZ6Available Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..

Genesis is the nation's leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how care is ..

... guide and direct the overall operations, coordination and direction of nursing ... values and policies of Genesis HealthCare and in accordance with accepted ... action when necessary. Why Genesis?Genesis..

Description The Senior Compensation Professional develops, implements, and administers compensation programs. The Senior Compensation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

... Advisor - Medicaid Provider Service Operations in Portland Maine Description The ... Advisor - Medicaid Provider Service Operations provides support to assigned health ... to Medicaid Group product implementation,..

... in Portland Maine Description The Healthcare Quality Reporting & Improvement (HQRI) ... to Humana's national planning and operations for Risk Adjustment, Stars, and ... national provider education strategy and..

Job Information Humana Enterprise Risk Management Lead-US-Remote in Portland Maine Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..

Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical Management and PCO-IPU Operations teams. ..

Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Portland Maine Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... leadership and external exposure with healthcare providers in OH,..