Health Plan Operations

Selected news for the healthcare topic - Health Plan Operations, collected since 11/2017. Recent stories appear in inyoregister.com and ask.com. This healthcare topic shares news with Medicaid, Medicare, Evolent Health, Passport Health Plan and dozens of others.

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Selected Headlines

Date Headline (link) Source Relevant Snippet
4/7/2021 Local health leaders team up with MDwise for COVID-19 vaccine webinar | Fox 59 fox59.com ... Department, Dr. Virginia Caine, who’s been advocating for those underserved. The chief medical officer for Eskenazi, Dr. David Crabb will also be on the panel, as well as vice president for MDwise’s health plan operations , Torriaun Everett.Everett says the point of the panel isn’t to change everyone’s mind.“It’s not about forcing the vaccine on anyone. But it’s about ensuring that we do ...
3/11/2021 Jeff Davis Named President of Healthy Blue in Missouri financialbuzz.com ... plan, a leading managed care provider of health benefits for Missouri’s MO HealthNet (Medicaid) program. (Photo: Business Wire)“Jeff is a trusted and highly respected senior leader who has extensive knowledge of Medicaid health plan operations as well as a passion for serving communities,” said Dr. Barsam Kasravi, President of Anthem’s Medicaid West Region. “He has been recognized as a strong, influential and dynamic leader who is ...
1/14/2021 Senior Solution Sales Executive, Payer-Telecommute - UnitedHealth Group - Phoenix, AZ insurancejobs.com ... work.(sm) The Sr. Solutions Sales Executive is a unique and highly interactive position within Health Plan Market. This critical role will be responsible for developing and closing product and service opportunities to increase Health Plan Operations and Administration Efficiencies (OAE). This position is responsible for providing all aspects of business development and support for health plan product development, new business sales, and risk optimization within the more heavily evolving ...
12/14/2020 Care at Heart Welcomes Marc Love, MBA to Advisory Board inyoregister.com ... their advisory board, Marc Love. Love is the State Chief Operating Officer for WellCare of Georgia, the largest Medicaid health plan in Georgia with a significant Medicare Advantage plan. He is primarily responsible for Health Plan Operations , Network Management, and Member Experience.He joins the Care at Heart advisory board as a health plan industry expert in anticipation of a changing hospice landscape with the future introduction of the Primary ...
12/14/2020 Care at Heart Welcomes Marc Love, MBA to Advisory Board ask.com ... their advisory board, Marc Love. Love is the State Chief Operating Officer for WellCare of Georgia, the largest Medicaid health plan in Georgia with a significant Medicare Advantage plan. He is primarily responsible for Health Plan Operations , Network Management, and Member Experience.He joins the Care at Heart advisory board as a health plan industry expert in anticipation of a changing hospice landscape with the future introduction of the Primary ...
9/23/2020 A New Approach to Health Plan Operations PR Newswire TAMPA, Fla. , Sept. 23, HealthAxis takes health plan claims administration software and services to the next level with the release of HxOne; an end-to-end, fully integrated healthcare operations solution. HxOne combines advanced claims system technology, flexible front and back-office services, and actionable analytics. The HxOne encompasses: (PRNewsfoto/HealthAxis) HxPro, a next-generation, claims administration platform that helps streamline healthcare claims processing and health plan management. HxOps, a ...
9/10/2020 ClarisHealth Launches A.I. Powered Healthcare Fraud Detection Solution for Health Plans aithority.com ClarisHealth, the company transforming health plan operations with its comprehensive payment integrity technology platform Pareo, launched an artificial intelligence-based (A.I.) solution for healthcare fraud detection. Pareo Fraud Detection works seamlessly with Pareo Fraud Case Management for an integrated, 360-degree approach to mitigating fraud, waste, and abuse (FWA). According to Mark Isbitts , vice president of program integrity for ClarisHealth, who led the project, Pareo Fraud Detection provides significant advantages ...
9/9/2020 ClarisHealth Launches A.I. Powered Healthcare Fraud Detection Solution for Health Plans PRWeb ... will get information on which providers to investigate first, why a provider is suspicious, and how valuable the investigation can be – in real-time. NASHVILLE, Tenn. (PRWEB) September 09, 2020 ClarisHealth, the company transforming health plan operations with its comprehensive payment integrity technology platform Pareo®, launched today an artificial intelligence-based (A.I.) solution for healthcare fraud detection. Pareo Fraud Detection works seamlessly with Pareo Fraud Case Management for an integrated ...
8/11/2020 DataLink’s Evoke360 Automates Data Extraction from Electronic Health Records to Continuity of Care Document files, Closes Care Gaps and Improves Payer and Provider Connectivity Business Wire ... payer and provider. Giarth adds, “Our nation’s healthcare systems need what Evoke360 offers: optimized care quality, reduced administrative burden, enhancements for value-based care and improved financial performance and communication, with visibility into all health plan operations in one point-of-care solution.” About DataLink Software DataLink Software (DataLink) is a healthcare technology company that empowers better health by enabling payers, providers and risk-bearing entities with real-time data ...
8/11/2020 DataLink’s Evoke360 Automates Data Extraction from Electronic Health Records to Continuity of Care Document files, Closes Care Gaps and Improves Payer and Provider Connectivity Business Wire ... payer and provider. Giarth adds, “Our nation’s healthcare systems need what Evoke360 offers: optimized care quality, reduced administrative burden, enhancements for value-based care and improved financial performance and communication, with visibility into all health plan operations in one point-of-care solution.” About DataLink Software DataLink Software (DataLink) is a healthcare technology company that empowers better health by enabling payers, providers and risk-bearing entities with real-time data ...
8/6/2020 VP, Employer Sales builtinaustin.com ... Develop broker marketing strategies and materials. Responsible for sales call center stand-up and execution as well as the broker service unit for Self-funded sales. Assist with product design, marketing, new technology products, health plan operations . This position has supervisory responsibilities for the Self-funded Distribution team. EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE Bachelor’s degree required, Graduate degree preferred or fifteen (15) years of experience in self-funded sales and ...
6/30/2020 Peter Janelle Joins Vital Data Technology as Director of Risk Adjustment Solutions PR Newswire ... has joined the company as Director of Risk Adjustment Solutions. Peter brings a decade of experience working with health plans as they developed and implemented their risk adjustment strategies and programs. His expertise in health plan operations and risk adjustment programs and extensive knowledge of Medicare Advantage finance, including risk adjustment, Star, value-based arrangements, and healthcare economics will drive value both for Vital Data Technology and its clients. "Vital ...
6/5/2020 Medicare Advantage plans face 'double whammy' of pent-up care demand and risk scores: experts FierceHealthcare ... then could be faced with higher healthcare costs due to pent-up demand from delayed care. “You see a double whammy with the impact of risk scores,” said David Weathington, senior vice president of health plan operations for Clover Health, during the virtual series. RELATED: Half of physicians now using telehealth as COVID-19 changes practice operations After the SARS epidemic in the early 2000s, over the next 6 to ...
3/31/2020 UCare: Business Reporting Analysis Senior - EDI Star Tribune ... limited to BusinessObjects and SQL • Other projects and duties as assigned. Education Bachelor's degree in business, IT or related field; demonstrated experience may be considered. Required Experience Seven years of business analysis experience within health plan Operations or IT. Five years of data analysis experience. Five years of experience in report development, including SQL queries. Experience working with business experts to evaluate complex data requirements. Preferred Experience Health Plan Operations ...
3/27/2020 Rvp Medicaid East Regional Ops - USA-FL-Fort Lauderdale employmentcrossing.com Profile RVP Medicaid East Regional OpsThe candidate will be responsible for leading and directing Regional Operations areas of a Medicaid Region in East Central or West. Oversight of the Health Plan operations strategies for the Region, as well as initiatives. Primary duties may include, but are not limited to: Oversees Health Plan Operational leads, as well as Regional Operations pillars, currently including: 1.Provider Oversight and Execution Team. 2.Escalated ...
3/15/2020 Health Plan Operations Transportation Coordinator - Metairie, LA - UnitedHealth Group - Metairie, LA insurancejobs.com ... of Transportation Vendor claims Possess strong attention to detail with the ability to think in a logical and structured manner to identify problems and present solutions for consideration Complete research as needed by the Health Plan Operations team analyzing and composing data into a useable format. Leverage strong communication skills (verbal, non-verbal, and written) with a demonstrated ability to communicate ideas clearly and concisely with peers, superiors, members, and ...
3/6/2020 Senior Analyst - RMHP/UHC C&S - Grand Junction, CO (telecommute option) - UnitedHealth Group - Grand Junction, CO insurancejobs.com ... anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Conduct research, statistical, and analytical studies as directed on health plan data to fulfill internal and external reporting requirements related to health plan operations and a variety of health plan related issues Interpret and analyze information, conduct cost benefit analyses, and financial assessments to be used in business planning. Provide pros and cons of various potential options ...
12/19/2019 (USA) VP & GM - Accountable Care (Health Plan Operations) ihs.jobs ... delivering the highest possible quality and value health care in partnership with the faculty of the School of Medicine and Stanford Children’s Health, Stanford Health Care. The Vice President (VP) is responsible for leading Health Plan Operations reporting to the Chief Financial Officer of Stanford Health Care. The VP will partner with colleagues in finance, clinical services, operations and corporate health care services to deliver health care offerings to the ...
12/16/2019 Kaiser Permanente mental health clinicians launch 5-day strike Becker's Hospital Review ... 11 to Nov. 15 but was rescheduled for Dec. 16 to Dec. 20 after the death of Kaiser Chairman and CEO Bernard J. Tyson. Michelle J. Gaskill-Hames, senior vice president of hospital and health plan operations for Kaiser Permanente Northern California, told The Sacramento Bee Kaiser has made proposals that would provide excellent benefits, keep Kaiser therapists among the highest paid in the state, and provide workers with more ...
12/16/2019 Kaiser mental health workers start five-day strike sfexaminer.com ... overwhelmed with unsustainable caseloads. Kaiser mental health workers previously went out on a five-day strike in December last year. In a statement Friday, Michelle J. Gaskill-Hames, senior vice president of hospital and health plan operations for Kaiser Permanente Northern California, said Kaiser has been working with an external, neutral mediator to help us reach a collective bargaining agreement with the NUHW. That mediator, Gaskill-Hames said, recently delivered ...