Category: MM Curator

 
 

Department Information


State Of Colorado Residency Required


NOTE: This announcement may be used to fill multiple openings.


The Department of Health Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado’s Medicaid Program), Child Health Plan Plus (CHP+), and other state public health programs for qualified Coloradans. Our mission is to improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado.


We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.


We are looking for a Project Manager I to join our Project Management Division in the Health Information Office!


As part of the State of Colorado, HCPF offers a competitive benefits package:

• PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
• Medical, Dental, and Vision insurance coverage
• Automatic Short-Term and Optional Long-Term Disability Coverage
• Life and AD&D Insurance
• Flexible Spending Accounts (FSAs)
• Family Medical Leave Act (FMLA) job protection and State of Colorado Paid Family Medical Leave (PFML)
• 10 Paid Holidays Annually and Accrued Annual and Sick Leave
• Accrued Sick Leave for State of Colorado Temporary Employees
• Flexplace and Flextime work arrangements
• Variety of discounts on services and products available through the State of Colorado’s Work-Life Employment Discount Program
• Discounted RTD EcoPass
• Reduced college tuition through CSU Global
• Credit Union of Colorado Membership Eligibility
  
  

The ongoing COVID-19 pandemic has impacted how and where we do our work. During this pandemic, we are onboarding new employees using a hybrid approach. The Department supports flexible work arrangements. Depending on the business need and description of the position, we have options that range from fully remote, hybrid, to full-time in the office. Specific discussions about the schedule will be discussed during the offer stage.


The Health Information Office develops, implements, and maintains the Department’s Health Information Technology (Health IT) and related Information Technology (IT) infrastructure, while coordinating with the Governor’s Office of Information Technology and other stakeholders on HIT and IT projects that impact the Department. Major responsibilities of the Health Information Office include enhancing and maintaining the Department’s health care claims payment system (Medicaid Management Information System or MMIS) and client eligibility system (Colorado Benefits Management System or CBMS) by developing requirements documentation, reviewing detailed system design approaches, proposing systems solutions to program staff and implementing systems solutions to support Department initiatives. In addition to aligning the Department’s infrastructure, this Office creates a foundation for emerging Health IT solutions that will be necessary to implement the Department’s transformational vision for the future of Medicaid.


Enterprise Project Management Office


This work unit of the Enterprise Project Management Office (EPMO) is responsible for the management of projects for the Medicaid Enterprise Systems (MES) and ensuring that project management standards and methodology are followed in line with the Project Management Body of Knowledge (PMBOK). The work unit is responsible for managing projects related to implementing and enhancing the MES. The EPMO project manager ensures processes are followed that are necessary for successfully project design, development, and implementation. The processes include activities such as developing effective and consistent requirements, detailed system design, identifying and resolving project risks and issues, and cost, schedule, and documentation management. The unit forms partnerships with policy staff, programmers, testing staff, as well as business and operations analysts to ensure the Health Information Office (HIO) meets internal and external (i.e., Fiscal Agent, CMS) project deadlines, creates project work plans to track activities, tasks, risks, issues, accomplishments, and schedules.


The work unit also oversees and coordinates projects related to Medicaid Management Information System (MMIS), Colorado Benefits Management System (CBMS), Program Eligibility Application Kit (PEAK), Shared Eligibility System (SES), and Health Information Technology (Health IT) initiatives at the Department of Health Care Policy and Financing (the Department). The work unit coordinates Heath IT initiatives with other State agencies, including coordination with the Governor’s Office, the Office of eHealth Innovation, the Office of Information Technology (OIT), the Department of Public Health and Environment (CDPHE), and the Department of Human Services (CDHS) to maintain a cohesive strategic approach among these agencies. Finally, the work unit is responsible for ensuring current compliance and strategic planning to achieve required compliance with federal regulations (I.e., HIPAA, Medicaid Information Technology Architecture (MITA), Medicaid Enterprise Certification Life Cycle (MECL), MEET), including Advanced Planning Documents (APDs). Description of Job


What You’ll Be Doing


The Project Manager manages and oversees all aspects of the development and implementation of large, highly complex, multi-platform technology initiatives. Typical job functions will include:

• Provides Strategic Project Management support, direction and training to ensure overall success of large, complex initiatives by following and promoting best practices and EPMO standards through the entire Project Lifecycle. Taking projects from original concept through final implementation by defining project scope and objectives, creating the budget, analyzing project requirements and determining best approach to complete project using existing and/or new approaches, developing detailed work plans, schedules, project estimates, resource plans, and status reports, managing the project risks, issues and budget, and developing plans for transition to operations
• Ensure alignment of projects to strategic business goals and project scope, in collaboration with management and project sponsors.
• Plans Resource Management, allocation and monitoring of tasks needed to achieve project goals. Influences and negotiates with Department managers, when necessary, regarding the support of required personnel to ensure project continuity through completion
• Conducts Project Budget planning and monitoring including collaborating on Advanced Planning Documents, budget proposals and providing subsequent budget change recommendations
• Communicates and collaborates to develop, and appropriately execute stakeholder analysis, communication, adoption plans and change strategy
• Coaches, mentors, and motivates project team members and vendors on best practices, processes and encourages positive action, communication and accountability for assigned work
• Proactively manage changes in project scope, identifies potential risks, and devises and executes response plans
• Manages issues and proactively escalate critical issues for immediate resolution effectively demonstrating decision making, issues management and resolution skills
• Collaborate, lead, and facilitate cross functional coordination of projects with teams from within the Department and vendors – managing and monitoring progress, quality, and cost
• Creates and delivers status reports from the project team, troubleshoots problem areas and delivers overall progress reports to senior management
• Conducts project lessons learned assessments and suggests improvements in process or procedures

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights


Minimum Qualifications


Education and Experience:


Bachelor’s degree from an accredited institution in Health Care Administration, Business Administration or a field of study related to the work assignment AND three years of professional experience in healthcare or IT related Project Management, managing complex cross-functional projects.


Substitutions

• A combination of work experience in the occupational field or specialized subject area of the work assigned to the job, which provided the same kind, amount, and level of knowledge acquired in the required education, may be substituted on a year-for-year basis for the bachelor’s degree.
• A master’s or doctorate degree from an accredited college or university in a field of study related to the work assignment may be substituted for the bachelor’s degree and at the agency’s discretion, one or two years of general experience respectively.
   

Preferred Qualifications

• PMP or equivalent Project Management Certification, or the ability to achieve this certification within one year of employment
• Experience in managing multiple large healthcare or IT projects through the full project lifecycle while adhering to challenging cost and schedule constraints
• Strong stakeholder management and communication skills at all levels, with the ability to maintain effective relationships and partnerships with a diverse group of stakeholders
• Strong planning and organizational skills, including the ability to manage multiple projects concurrently
• Vendor management experience
• Proficiency with the Microsoft Office Suite, Project (PWA), SharePoint
• Ability to set and prioritize workload, develop a work plan with tasks, time frames, milestones, resources, and dependencies
• Strong communication skills, verbal and written
• Ability to be self-motivated and self-directed, while possessing the ability to work in a team environment.
  
  

DEFINITION OF PROFESSIONAL EXPERIENCE: Work that involves exercising discretion, analytical skill, judgment, personal accountability, and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor’s or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods.


CONDITIONS OF EMPLOYMENT

• All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.
• Employees who have been disciplinary terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.
• Effective September 20, 2021, employees will be required to attest to and verify whether or not they are fully vaccinated for COVID-19. Employees who have not been fully vaccinated may be required to submit to serial testing in the future. Upon hire, new employees will have three (3) business days to provide attestation to their status with proof of vaccination. Vaccinated employees must provide proof of vaccination. Note: Fully Vaccinated means two (2) weeks after a second dose in a two-dose series of the COVID-19 vaccine, such as the Pfizer or Moderna vaccine, or two (2) weeks after the single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine, as defined by the most recent State of Colorado’s Public Health Order and current guidance issued by the Colorado Department of Public Health & Environment.
   

Appeal Rights


If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.


An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email (dpa_state.personnelboard@state.co.us), postmarked in US Mail or hand delivered (1525 Sherman Street, 4th Floor, Denver CO 80203), or faxed (303.866.5038) within ten (10) calendar days from your receipt of notice or acknowledgement of the department’s action.


For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board; go to spb.colorado.gov; contact the State Personnel Board for assistance at (303) 866-3300; or refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director’s Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules.


Supplemental Information


How to Apply
(PLEASE READ CAREFULLY)


Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process. Therefore, it is paramount that you clearly describe all your relevant experience on the application itself. Applications left blank or marked “SEE RESUME” will not be considered.


Your application will be reviewed against the minimum qualifications for the position. If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.


Comparative Analysis Process


The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates. Applicants will be notified of their status via email. Failure to submit properly completed documents by the closing date will result in your application being rejected.


ADAAA Accommodations: The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.


The Department of Health Care Policy & Financing is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Virginia Miller, at virginia.miller@state.co.us.


The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.

 
 

Clipped from: https://www.linkedin.com/jobs/view/medicaid-enterprise-systems-project-manager-at-state-of-colorado-3099853531/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Job Brief

Experience in a Provider Services position working directly with Providers in a Managed Care/Health Insurance industry and with Medicaid/Medicare background. Must have Claims, Presentation/Communications skills and solid proven Excel skills.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation’s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Must Live in Michigan to qualify. 

Responsibilities:

The AE I is responsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers.  Assigned provider accounts may include single or multiple practices in single or multiple locations, integrated delivery systems or other provider organizations.  AE I maintains in depth understanding of Plan’s contracts and provider performance and needs, identifying, developing and conducting relevant and tailored provider orientation sessions, making educational visits and working to resolve provider issues.  Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the Plan’s territory in keeping w/ State and Federal contact mandates for all products.   Identifies, contacts and actively solicits qualified providers to participate in Plan at new and existing service areas and products, assuring financial integrity of the Plan is maintained and contract management requirements are adhered to, including language, terms and reimbursement requirements.  Maintains complete understanding of Plan reports and metrics and uses them to evaluate the performance of assigned providers/practices/facilities, determining, communicating and implementing plans for providers to improve performance and measuring ongoing performance.  Uses data to develop and implement methods to improve relationship.  Assists in corrective actions required up to and including termination, following Plan policies and procedures.  Supports the Quality Management department with the credentialing and re-credentialing processes, investigation of member complains and any potential quality issues.  Maintains a functional working knowledge of Facets, including the provider database and routinely relays information about additions, deletions or corrections to the Provider Maintenance Department.  Maintains and delivers accurate, timely activity and metric reports as required.  Identifies and maintains strong partnerships with appropriate internal resources and stakeholders.  

 
 

Education/ Experience:

• Bachelors Degree or equivalent work related experience.
• 1 to 3 years experience in a Provider Services position working with directly with Providers.                    
• 3 to 5 years experience in the Managed Care/Health Insurance industry and with Medicaid/Medicare background.
• Excellent communications skills (written and verbal). Will be expected to present at meeting with executive level personnel.
• Must have Claims experience.
• Required Excel experience.
• Demonstrated strength in working independently, establishing influential relationships internally and externally, meeting and training facilitation skills. Priority setting and problem solving skills critical.

Note:  Presently all of our AmeriHealth Caritas Family of Companies associates are working remotely due to the Pandemic.  This role/department will be transitioning back to the Southfield, Michigan office when it is safe to return.

 
 

Clipped from: https://www.monster.com/job-openings/provider-network-account-executive-i-medicare-medicaid-experience-southfield-mi–4d747b92-8d77-4e6a-aa2b-56af9b0ec11e?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Company Description

CVS Health, the Woonsocket, Rhode Island-based healthcare company, offers clinical, retail pharmacy, specialty pharmacy, pharmacy benefit management, and prescription mail order services in the US, the District of Columbia, and Puerto Rico. CVS’ mission is to provide people assistance on their path to better health, making quality care more affordable, accessible, simple and seamless.The company seeks to attract individuals whose beliefs and behaviors are in alignment with CVS core values of collaboration, innovation, caring, integrity and accountability. The multi-award winning company (e.g. Military Friendly Employer, America’s Top Corporation for Women Business Enterprises) provides opportunities to a diverse work experience that empowers the team for career success. CVS offers a benefits package to its employees, including medical, prescription, dental and vision coverage, a company contribution to a health savings account (HSA), employee stock purchase plan, adoption benefits, life, accident and disability insurance, paid time off, tuition reimbursement, and colleague discount.

Job Description

Job Description

Only candidates that live in or are willing to move to Louisiana will be considered.The Manager of Operations is responsible for leading and managing all hands-on operational aspects and activities of various functional areas within the Plan which may include: Claims, Provider Services, Information Technology, Grievance and Appeals, Member Services, Medical Management and the Medicare and Long Term Care lines of business. Assists the Plan leader in the successful growth and performance of the Plan. The Manager of Operations also interfaces, collaborates and works cooperatively with corporate office functional leaders and centralized business departments.

Required Qualifications

Provides day-to-day leadership and management to a service organization that mirrors the mission and core values of the company. Interfaces with corporate office staff as required.* Responsible for driving the Plan toachieve and surpass performance metrics, profitability, and business goals and objectives.* Responsible for employee compliance with, and measurement and effectiveness of all Business Standards of Practiceincluding Project Management and other processes internal and external. Provides timely, accurate, and complete reports on the operating condition of the Plan. Develops policies and procedures for assigned areas. Ensuring that other impacted areas, as appropriate, review new and changedpolicies.* Assists the Plan leader in collaborative efforts related to the development, communication and implementation of effective growth strategies and processes. May be required to spearhead theimplementation of new programs, services, and preparation of bid and grant proposals.* Collaborates with the Plan management team and others to develop and implement action plans for the operational infrastructure ofsystems, processes, and personnel designed to accommodate the rapid growth objectives of the organization.* Assists in defining marketing andadvertising strategies within State guidelines. Participates in the development and implementation of marketing policies for the Plan, and ensures their compliance with program regulations.* Provides assistance inpreparation and review of budgets and variance reports for assigned areas.* Works cooperatively with Network Development team in the development of the provider network. Acts as “client-care officer” through direct contact with all stakeholders. Serves as a liaison with regulatory and other state administration agencies and communicates activity to CEO and reports back to Plan. * Communicates, Motivates and leads a high performance management team. Attract, recruit, train, develop, coach, and retain staff. Fosters a success-oriented, accountable environment within the Plan.* Ensures that performance evaluations and compensation decisions for employees are not influenced by the financial outcomes of claimsdecisions.* Assures compliance to and consistent application of law, rules and regulations, company policies and procedures for all assigned areas. * Prompt response with a sense of urgency/priority to customer requests.Documented follow through/closure. Assists as assigned or required in performing other duties, assignments and/or responsibilities. **Must have a managed care experience.

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications

10+ years work experience that reflects a proven track record of proficiency in the competencies noted.Ability to work collaboratively across many teams, prioritize demands from those team, synthesize information received, and generate meaningfulconclusions.Ability to conceive innovative ideas or solutions to meet clients requirements.Excellent communication and relationship management skills. Express thoughts in an organized and articulate manner. Listen very effectively and build a climate of trust and respect with prospective and existing clients andthe consulting communityAbility to work closely with client service, operations, and investment personnelProven leadership and negotiation skills.Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategicplanning and analysis, mergers and acquisitions, strategic planning, risk management.Recent and related managed health care experience.

Education

Bachelor’s degree required; Master’s degree preferred.

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

 This position is open. This job was posted on Wed Jun 01 2022 and expires on Fri Jul 01 2022.

Minimum $58,343

$102,897 average

Maximum $131,709

Tasks

• Direct or coordinate an organization’s financial or budget activities to fund operations, maximize investments, or increase efficiency.
• Appoint department heads or managers and assign or delegate responsibilities to them.
• Analyze operations to evaluate performance of a company or its staff in meeting objectives or to determine areas of potential cost reduction, program improvement, or policy change.
• Direct, plan, or implement policies, objectives, or activities of organizations or businesses to ensure continuing operations, to maximize returns on investments, or to increase productivity.
• Prepare budgets for approval, including those for funding or implementation of programs.
• Confer with board members, organization officials, or staff members to discuss issues, coordinate activities, or resolve problems.
• Implement corrective action plans to solve organizational or departmental problems.
• Direct human resources activities, including the approval of human resource plans or activities, the selection of directors or other high-level staff, or establishment or organization of major departments.
• Establish departmental responsibilities and coordinate functions among departments and sites.
• Preside over or serve on boards of directors, management committees, or other governing boards.
• Negotiate or approve contracts or agreements with suppliers, distributors, federal or state agencies, or other organizational entities.
• Coordinate the development or implementation of budgetary control systems, recordkeeping systems, or other administrative control processes.
• Review reports submitted by staff members to recommend approval or to suggest changes.
• Deliver speeches, write articles, or present information at meetings or conventions to promote services, exchange ideas, or accomplish objectives.
• Interpret and explain policies, rules, regulations, or laws to organizations, government or corporate officials, or individuals.
• Prepare or present reports concerning activities, expenses, budgets, government statutes or rulings, or other items affecting businesses or program services.
• Review and analyze legislation, laws, or public policy and recommend changes to promote or support interests of the general population or special groups.
• Administer programs for selection of sites, construction of buildings, or provision of equipment or supplies.
• Direct or conduct studies or research on issues affecting areas of responsibility.
• Direct or coordinate activities of businesses or departments concerned with production, pricing, sales, or distribution of products.
• Make presentations to legislative or other government committees regarding policies, programs, or budgets.
• Refer major policy matters to elected representatives for final decisions.
• Direct or coordinate activities of businesses involved with buying or selling investment products or financial services.
• Conduct or direct investigations or hearings to resolve complaints or violations of laws or testify at such hearings.
• Direct non-merchandising departments, such as advertising, purchasing, credit, or accounting.
• Prepare bylaws approved by elected officials and ensure that bylaws are enforced.
• Serve as liaisons between organizations, shareholders, and outside organizations.
• Attend and participate in meetings of municipal councils or council committees.
• Represent organizations or promote their objectives at official functions or delegate representatives to do so.
• Organize or approve promotional campaigns.
• Nominate citizens to boards or commissions.

Skills

• Reading Comprehension – Understanding written sentences and paragraphs in work related documents.
• Active Listening – Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
• Writing – Communicating effectively in writing as appropriate for the needs of the audience.
• Speaking – Talking to others to convey information effectively.
• Mathematics – Using mathematics to solve problems.
• Critical Thinking – Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Active Learning – Understanding the implications of new information for both current and future problem-solving and decision-making.
• Learning Strategies – Selecting and using training/instructional methods and procedures appropriate for the situation when learning or teaching new things.
• Monitoring – Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
• Social Perceptiveness – Being aware of others’ reactions and understanding why they react as they do.
• Coordination – Adjusting actions in relation to others’ actions.
• Persuasion – Persuading others to change their minds or behavior.
• Negotiation – Bringing others together and trying to reconcile differences.
• Instructing – Teaching others how to do something.
• Service Orientation – Actively looking for ways to help people.
• Complex Problem Solving – Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Operations Analysis – Analyzing needs and product requirements to create a design.
• Judgment and Decision Making – Considering the relative costs and benefits of potential actions to choose the most appropriate one.
• Systems Analysis – Determining how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
• Systems Evaluation – Identifying measures or indicators of system performance and the actions needed to improve or correct performance, relative to the goals of the system.
• Time Management – Managing one’s own time and the time of others.
• Management of Financial Resources – Determining how money will be spent to get the work done, and accounting for these expenditures.
• Management of Material Resources – Obtaining and seeing to the appropriate use of equipment, facilities, and materials needed to do certain work.
• Management of Personnel Resources – Motivating, developing, and directing people as they work, identifying the best people for the job.

Knowledge

• Administration and Management – Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
• Economics and Accounting – Knowledge of economic and accounting principles and practices, the financial markets, banking and the analysis and reporting of financial data.
• Sales and Marketing – Knowledge of principles and methods for showing, promoting, and selling products or services. This includes marketing strategy and tactics, product demonstration, sales techniques, and sales control systems.
• Customer and Personal Service – Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
• Personnel and Human Resources – Knowledge of principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
• Mathematics – Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
• Psychology – Knowledge of human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders.
• Education and Training – Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects.
• English Language – Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
• Public Safety and Security – Knowledge of relevant equipment, policies, procedures, and strategies to promote effective local, state, or national security operations for the protection of people, data, property, and institutions.
• Law and Government – Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.

CVS Health

Description

CVS Health, the Woonsocket, Rhode Island-based healthcare company, offers clinical, retail pharmacy, specialty pharmacy, pharmacy benefit management, and prescription mail order services in the US, the District of Columbia, and Puerto Rico. CVS’ mission is to provide people assistance on their path to better health, making quality care more affordable, accessible, simple and seamless.The company seeks to attract individuals whose beliefs and behaviors are in alignment with CVS core values of collaboration, innovation, caring, integrity and accountability. The multi-award winning company (e.g. Military Friendly Employer, America’s Top Corporation for Women Business Enterprises) provides opportunities to a diverse work experience that empowers the team for career success. CVS offers a benefits package to its employees, including medical, prescription, dental and vision coverage, a company contribution to a health savings account (HSA), employee stock purchase plan, adoption benefits, life, accident and disability insurance, paid time off, tuition reimbursement, and colleague discount.

Type

Company – Public

Size

Large

Revenue

Over $10B

Location

Baton Rouge, LA, and others

Industry

General Hospitals, Outpatient Care Centers

Founded

1963

CEO

Larry J. Merlo

Website

Visit Website

Total job postings in the past

Based on 130 job boards, duplications excluded

Current job openings

15%

6 months

1,504%

1 year

5 weeks

Average posting lifetime

Total job posting distribution in the past

Based on 130 job boards, duplications excluded

Job category Distribution 6 months 1 year

 
 

 
 

Clipped from: https://lensa.com/louisiana-medicaid-health-plan-coo-jobs/baton-rouge/jd/54c924bd4f16478bf305dcb2dfada4bf?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. 

Position Overview

Reporting to the Director of Reporting Systems within Analytics and Reporting Department, the Senior Data and Business Intelligent Developer provides business intelligence support to units within the organization. This individual is responsible for analysis of healthcare data, designing processes for data transformation in SQL Server environment, and developing data visualization in various BI reporting tools such as SSAS, Excel, Tableau, or Power BI.

Qualified candidates must be a self-motivated and technically strong individual with minimum 7 years of experience in SQL Server development and BI reporting tool. The candidate must be proficient in T-SQL, SSIS development and familiar with application development life cycle. Knowledge of Python, C# or R script is a plus. This candidate also must have strong analytical skill and problem-solving skills.

 
 

Clipped from: https://jobs.fox2now.com/jobs/medicaid-team-lead-new-york/609766513-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic