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Results based on filters ( 68 jobs found )

Market CFO, CA Health Plan – Remote

Affinity Health Plan
California
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JOB DESCRIPTION Job Summary Looking for an individual ready for a fast-paced ...
Details
Summary
About the job:
environment. This individual will provide executive level strategy and leadership for market finance activities - specifically provision of financial analysis to support business decisions including profitability initiatives for medical management metrics, member growth/retention ventures, targeted business extensions/expansions, rate advocacy efforts and other activities involving the finance function. Provides subject matter expertise and collaboration on enterprise projects and priorities including standardization...
Location:
California
Job Type:
Full-Time
Permanent
Occupation:
Financial and Investment Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Processor, Coordination of Benefits 7:00 am-3:30 PM PST - Remote

Affinity Health Plan
Arizona
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Processor, Coordination of Benefits 7:00 am-3:30 PM PST - Remote AZ, United ...
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Summary
About the job:
States and 89 more Trending Job Description Job Description Job Summary Provides support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. Responsible for primarily coordinating benefits with other carriers responsible for payment. Facilitates administrative support, data entry, and accurate maintenance of other insurance records. Job Duties - Provides telephone, administrative and data entry support for the coordination of benefits (COB) team. - Phones or...
Location:
Arizona
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Affinity Health Plan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Facilitated Enroller - Benefit Sales Specialist (In Field - Flushing & Chinatown, NY)

Affinity Health Plan
Flushing, NY
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JOB DESCRIPTION Job Summary Provides support for member enrollment ...
Details
Summary
About the job:
activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentation accuracy and follow-up. Also develops and maintains relationships with local community agencies, health care organizations, and county/state agencies that refer potential eligible members, and represents at community-based outreach events to aid enrollment efforts. Essential Job Duties •...
Location:
Flushing, NY
Job Type:
Full-Time
Permanent
Occupation:
Insurance Sales Agents
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
Affinity Health Plan
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Auditor, Healthcare Services (RN)

Affinity Health Plan
Los Angeles, CA
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Auditor, Healthcare Services (RN) Los Angeles, CA, United States Be the ...
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First to Apply Job Description JOB DESCRIPTION Job Summary Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors...
Location:
Los Angeles, CA
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:
Certified Registered Nurse
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Risk & Quality Performance Manager (Remote)

Affinity Health Plan
Located in Ohio
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Job Description Job Summary The Sr Risk & Quality Performance Manager is a ...
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Summary
About the job:
tactical execution role that will lead specific projects to support Molina’s Risk & Quality Solutions (RQS) team and program outcomes. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS’s strategic objectives. Job Duties • Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting,...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:

Project Management Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Facilitated Enroller - Benefit Sales Specialist (In Field - Brentwood, NY)

Affinity Health Plan
Brentwood, NY
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JOB DESCRIPTION Job Summary Provides support for member enrollment ...
Details
Summary
About the job:
activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentation accuracy and follow-up. Also develops and maintains relationships with local community agencies, health care organizations, and county/state agencies that refer potential eligible members, and represents at community-based outreach events to aid enrollment efforts. Essential Job Duties •...
Location:
Brentwood, NY
Job Type:
Full-Time
Permanent
Occupation:
Insurance Sales Agents
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
Affinity Health Plan
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Specialist, Pharmacy Operations (Medicaid/ PBM experience)

Affinity Health Plan
Located in Ohio
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JOB DESCRIPTION Job SummaryProvides support for pharmacy delegated service ...
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Summary
About the job:
activities. Responsible for implementation of new products/services and existing business management. Contributes to overarching pharmacy strategy of optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties • Supports designated lines of business surveillance and oversight of delegated functions. • Analyzes and interprets data to identify erroneous execution of the pharmacy benefit by the Pharmacy Benefit Manager (PBM). • Reviews daily inventory of “outliers”...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Pharmacists
Career Level / Education:
Doctoral or professional degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead, Medicare Administration (Bids & Member Materials) (Remote)

Affinity Health Plan
Arizona
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Lead, Medicare Administration (Bids & Member Materials) (Remote) AZ, United ...
Details
Summary
About the job:
States and 90 more Job Description Molina Healthcare is hiring a Lead, Medicare Administration . This will be a remote position on our team that is responsible for our Medicare product- both Bids and Member Materials. Highly qualified candidates will have the following experience: - Medicare experience - Experience filing bids - In depth understanding of planning benefits - Experience with member materials - Product management, product development of the Medicare product - Experience supporting annual Medicare Product...
Location:
Arizona
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Director, Quality & Risk Adjustment (Utah Health Plan) - REMOTE

Affinity Health Plan
Utah
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Job Description Job Summary The Director, Quality & Risk Adjustment is ...
Details
Summary
About the job:
responsible for leading health plan execution for Risk and Quality ensuring alignment of strategy and activities with Enterprise and acting as the Risk and Quality subject matter expert for the health plan. Primary interface with state agencies, leadership of local Quality committees and oversight and execution of local intervention activities intended to improve quality measures and outcomes. Collaborates with MHI Quality leaders to conduct data collection, reporting and monitoring for key Quality performance measurement...
Location:
Utah
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

AVP, Quality & Risk Adjustment (Utah)

Affinity Health Plan
Utah
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Job Description Job Summary The AVP, Quality & Risk Adjustment is ...
Details
Summary
About the job:
responsible for leading health plan execution for Risk Adjustment and Quality for all lines of business, ensuring alignment of strategy and activities with Enterprise, acting as the Risk Adjustment and Quality subject matter expert for the health plan. The AVP leads a plan with a large membership base, large population, and multiple lines of business. The plan has complex state requirements. Job Duties - Serves as the primary contact to State agencies for all Risk and Quality matters. - Leads the local Quality committees. -...
Location:
Utah
Job Type:
Full-Time
Permanent
Occupation:
Compliance Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Affinity Health Plan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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