Managed Care Director Jobs

Lead the charge in shaping a comprehensive Medicare Advantage strategy by leveraging extensive expertise to enhance member experience and operational efficiencies, while collaborating with cross-funct...

Drive end-to-end operational excellence for stop-loss and funding processes. Oversee program administration, manage relationships with vendors, and enhance operational efficiency while leading high-pe...

Deliver clinical and administrative oversight for Medicare Advantage and Dual Eligible populations, ensuring compliance with regulations and optimizing care management processes to enhance member outc...

Drive compliance and operational excellence by overseeing charge audits and collaborating with clinical departments. Utilize your expertise in healthcare reimbursement to enhance billing accuracy and...

Shape impactful sales strategies in healthcare, driving revenue growth by establishing relationships with C-suite executives and delivering value through tailored solutions. Lead consultative sales an...

Join a dynamic team to enhance risk adjustment strategies and initiatives. Lead transformative projects, ensure compliance and optimize clinical documentation to support organizational growth and effi...

Lead a high-performing team of actuaries, overseeing key projects and strategies, while driving compliance and fostering relationships across business segments to ensure informed decision-making and c...

Lead a dynamic team of actuaries, driving strategy and project management while fostering relationships and ensuring compliance to support key business objectives in a fast-paced environment...

Lead and direct a team of actuaries, overseeing long-term projects while providing strategic insight and expert guidance in actuarial concepts that drive decision-making and enhance compliance with in...

Shape the actuarial landscape by leading a skilled team, steering strategic projects, and delivering insights for high-level decision making while fostering compliance and continuous improvement in ac...

Lead a team of actuaries to drive strategic initiatives and enhance decision-making through expert insights and compelling presentations. Ensure compliance with standards while developing key relation...

Transform healthcare delivery by leading strategic payer relationships, contract negotiations, and operational management. Collaborate with executives to optimize contract performance and enhance popu...

Transform managed care strategies and performance by leading contract negotiations and payer relations across diverse healthcare settings. Collaborate with cross-functional teams to optimize financial...

Drive strategic business development initiatives in the Medicare landscape, fostering key partnerships with national payers to enhance care access. Collaborate cross-functionally to accelerate growth...

Shape the future of healthcare by providing expert clinical oversight in utilization management, ensuring appropriate care delivery and regulatory compliance while leading initiatives to mitigate frau...

Transform the legislative landscape by steering health care policy advocacy. Engage with state and federal leaders to shape strategic initiatives, analyze impactful legislation, and drive coalition-bu...

Champion operational excellence by leading membership status determinations and reconciliations. Ensure accurate, compliant financial operations while optimizing workflows with AI tools to deliver sea...

Champion operational excellence by leading membership status determinations, ensuring accuracy and compliance while driving improvements and utilizing AI tools to optimize workflows in a fast-paced, i...

Pioneer innovative approaches in healthcare network management, leading initiatives in provider relations, quality outcomes, and strategic growth. Collaborate with diverse teams to enhance operational...

Optimize marketing strategy to elevate our presence in healthcare AI. Lead cross-functional initiatives to generate impactful content, drive revenue growth, and establish Qualified Health as the trust...

Shape the future of clinical policy by providing strategic oversight and leadership in developing and implementing evidence-based practices to enhance healthcare delivery, compliance, and operational...

Empower organizational excellence by leading strategic provider contracting initiatives to enhance network performance, drive compliance, and support operational goals in a collaborative environment f...

Support strategic leadership and operational oversight of Provider Contracting, driving complex negotiations and cross-departmental collaboration for a high-performing, compliant network that fosters...

Lead the charge in managing and optimizing partnerships with Community Health Centers. This strategic role focuses on enhancing collaboration, driving growth, and ensuring program success through effe...

Lead and optimize our global outsourcing strategy, managing multiple vendors across various functions to enhance operational effectiveness, align with corporate goals, and drive transformational outco...