Manager Health Resume Samples

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NH
N Hauck
Neva
Hauck
368 Brown Overpass
Dallas
TX
+1 (555) 709 2141
368 Brown Overpass
Dallas
TX
Phone
p +1 (555) 709 2141
Experience Experience
Detroit, MI
Manager Health
Detroit, MI
Ernser-Kihn
Detroit, MI
Manager Health
  • Select external training providers and/or develop in-house training courses best suited to advance E&T Americas organizational competence
  • Act as project manager in implementation of approved process improvements
  • Work with E&T Americas unit heads & group heads and divisional stakeholders to identify areas for improvement
  • Set and achieve annual strategic continuous improvement goals for E&T for talent development
  • Lead quarterly meetings with QM deputies to drive alignment across E&T Americas on QM topics and provide a platform for collaboration and improvement
  • Develops programs to ensure compliance with Provincial, Federal and local regulations
  • Be the Quality Management (QM) Process owner for Engineering &Technology (E&T) Americas
New York, NY
Manager Health Care
New York, NY
Tromp-Bins
New York, NY
Manager Health Care
  • Maintain / establish a “Reimbursement, Dispense and Taxation Network” within Inflammation and Immunology opinion leaders, insurance companies and policy makers
  • Open communication with peers, supervisors and other Regional Field Network Managers
  • Apply competitive intelligence, identify early opportunities and threats in the market and create solutions to benefit from opportunities and to disarm threats
  • Design, develop and implement process and execution expertise in reimbursement activities to Inflammation and Immunology products in Germany
  • Flexible, team member with positive attitude
  • In close cooperation with sales, marketing and medical department of InI and in line with the overall business plans, develop pharmaceutical options and models for business strategies in order to maximize the commercialization of the product portfolio
  • Good technical knowledge of all Microsoft programs
present
Detroit, MI
Manager, Health Care Claims
Detroit, MI
O'Connell, Jacobs and Zieme
present
Detroit, MI
Manager, Health Care Claims
present
  • Provide expertise to Provider Services/Relations in the identification of Medical Management authorization issues and trends
  • Manage the Claims Liaison department and staff and provide expertise to staff to assist in claims issue resolution and audits
  • Provide Corporate and Health Plan management with all necessary data to allow for expedient resolution of claims issues
  • Provide expertise and research providers’ claims inquiries from plan and corporate staff
  • Utilizing knowledge of provider billing and claims processing, directs Provider Services/Relations with the claims reprocessing notification
  • Track trends in claims processing issues and assist Claims Department in identifying and quantifying issues
  • Monitors daily and weekly production of claims by analyzing reports and manage the day-to-day operational duties of claims operations
Education Education
Bachelor’s Degree in Related Field
Bachelor’s Degree in Related Field
Brigham Young University
Bachelor’s Degree in Related Field
Skills Skills
  • Excellent written, oral, and organizational skills
  • Independent thinker, self-motivated, organized, flexible and dependable
  • Ability to manage a budget
  • Ability to perform strategic planning and all day-to-day operations of an administrative office
  • Ability to perform job responsibilities with accuracy, thoroughness and timeliness
  • Ability to react well under pressure
  • Ability to learn and apply new skills as they relate to computer systems and departmental/company initiatives
  • Ability to manage competing demands and adapt to changes in the work environment
  • Ability to accept criticism and apply to work-related duties
  • Expertise with proofreading and data analysis
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15 Manager Health resume templates

1

Senior Manager, Health Care Programs Resume Examples & Samples

  • Responsible for the ongoing management of Health Care programs
  • Manages day-to day activities of outsourced plan administrator, health care vendors and internal staff to ensure programs are administered according to our business strategy
  • Supervises / manage medical, pharmacy, behavioral health, employee assistance, health advocacy, and health account programs, vendor partner operations and relationships
  • Assists in researching, analyzing, and evaluating health care vendors. Applying best industry practices to ensure vendor contractual terms, conditions, and performance standards are established and fully met. Works to ensure integration of program operations with service delivery across multiple vendors. Maintains a constructive, productive, and professional working relationship with all business partners
  • Manages the implementation of complex health care program changes, vendor changes, and large special projects requiring extensive benefits subject matter and advanced project management expertise. Responsible for defining/refining the technical specifications needed to complete each project. Must be able to manage several large, complex projects concurrently
  • Directs and coordinates the activities of internal and external resources to implement benefits changes and process improvements. Fully responsible for time, resource, and cost management of all projects assigned. Confers with key stakeholders and customers, sets project priorities, and resolves any conflicts or challenges as they occur
  • Manages to ensure that health care programs are administered in accordance with federal and state regulations. Identifies and mitigates any compliance risks associated with plan administration. Establishes strong internal controls to prevent violations regarding private health information (PHI) or private information exposure, discrimination or other impropriety. Oversees internal or external audit activity
  • Plans and directs periodic, comprehensive operational reviews and compliance audits. Acts a departmental subject matter on federal and state health care regulations, including federal healthcare reform
  • People management. As a senior manager, individual directs and coordinates the work of up to 2 internal professionals. In addition, as part of the vendor management role, the position directs the work of more than 60 external resources from 8 to 10 vendors
  • Sets objectives, monitors performance, resolves conflicts, etc
  • 5 to 7 years experience working in health and wellness operations (internal or outsourced) or consulting position with large, complex organization. Demonstrated success collaborating on large teams
  • Certified Employee Benefits Specialist designation or equivalent. Insurance, actuarial underwriting or equivalent
  • Knowledge of health care federal and state regulations, administrative best practices, advanced project management and vendor management skills. Extremely well organized, excellent interpersonal and diplomacy skills. Excellent analytic skills
  • Familiarity in using data warehouse tools
  • HR, IT, Accounting or Finance
2

Senior Marketing Manager Health Resume Examples & Samples

  • Working with the Segment Head to build the value proposition, key messages and the medium to long-term marketing, product and services strategies for the Health segment
  • The delivery of the marketing plans
  • Developing a partnership approach to strategic marketing and gathering of market intelligence, through engagement with Sales and Product stakeholders. Ensuring regular and ongoing relationship with these and other key BFS stakeholders to ensure appropriate levels of engagement, consultation and communication
  • Market and competitor analysis and research to help in defining our point of difference in the market
  • Understanding of campaign and market analytics to ensure activities are being optimised and delivering business value
  • Ensuring appropriate evaluation, measuring and reporting of marketing activity results against business objectives and embedding learnings
  • Developing and overseeing the segment marketing budget and expenditure to maximise efficient growth in target segments
  • 10+ years marketing experience, of which 2+ in a similar Marketing leadership position
  • Health segment experience (Medical, Aged Care, Pharmaceutical, Medical supplies, industry associations)
  • Significant financial services and B2B Product marketing experience within Australia
  • Strong analytical Marketing background, with proven experience in bringing fact-based analysis to marketing decisions
  • Demonstrated ability to think strategically, laterally & creatively and to introduce industry leading ideas and practices
  • Proven ability to build strong working relationships and partnerships with other functional managers
3

IT Manager Health Information Services Hour Days Resume Examples & Samples

  • Researches application solutions working with various application support teams if needed
  • Test, document and apply certified patches when applicable
  • Develops work-around solutions and make recommendations
  • Develops, implements and maintains new interfaces
  • Develops 3rd party application interfaces to and from various applications
  • Develops system and user documentation when applicable
  • Deep experience in architectural development, design patterns and implementation of custom developed solutions (and/or product integration projects)
  • Knowledge and experience administering a Cloverleaf Interface Engine
  • Understanding of object oriented software development and technologies such as C#, .NET, Java, Visual Basic, relational databases (i.e. Oracle, MS SQL Server), Middleware Platforms (i.e. WebsPhere or .NET), and development methods such as Agile, RUP, UML
  • Knowledge of product and package selection methods
  • Proven leadership and managerial skills to manage tracks of work with up to 12 people, throughout the project lifecycle
4

Manager, Health Checks Resume Examples & Samples

  • Work with Senior Manager, PEO to prepare proposals for business sponsors, recognize constraints and scaling the depth/duration of the Health Check to maximize effectiveness
  • Present Health Check overview/approach to relevant team members
  • Develop a schedule and manage the Health Check engagement according to plan, providing regular progress reports to PEO leadership and the appropriate program executives
  • Gather required project documentation and review against the Health Check criteria
  • Conduct interviews with project stakeholders
  • Compile information and complete the complexity assessment
  • Oversee input of data to the analytical database
  • Augment the report outputs with fact based examples and observations, including inputs from other non-EPMO reviews (i.e. Technology Major Project Reviews, Finance reviews etc.) I
  • If control gaps exist, develop recommendations for remediation
  • Prepare summaries of Health Check results for senior executive audiences (i.e. SCOPE)
  • Track common themes emerging from Health Checks and feed them back to the EPMO & EES teams with observations and recommendations to support continuous improvement and address systemic issues (i.e. need for training, changes to methodology, governance, tools)
  • Create and track metrics to assess client satisfaction and impact of PEO services
5

Domain Knowledge Manager, Health Sector Resume Examples & Samples

  • Based on a deep understanding of the business agenda and emerging needs of the Health sector, propose knowledge initiatives and design solutions to the sector leadership that are relevant and commercially impactful
  • Prioritize and deliver against business agreed strategic objectives defined within the sector integrated knowledge plan, including insights on sub-sector knowledge needs as appropriate
  • Support implementation of the sector’s knowledge infrastructure, using firm standard architecture and technologies, to develop home sites and communities that align broader context of business priorities with content strategy (working closely with the assigned content advisor and community implementation lead)
  • Build a network of relationships in the sub-sector across different ranks and countries, including Knowledge Champions and key experts
  • Together with respective business leaders, help to convene the sector’s specialists to facilitate dialogue and to advance and extract relevant knowledge, ensuring that innovative ideas, good practices and lessons learned from pursuits and engagements are shared across and beyond the sector
  • Drive knowledge awareness and adoption activities within the community to engage and educate Health sector practitioners on available knowledge content and resources, help build a knowledge sharing culture
  • Drive the execution of the sector’s content strategy to ensure re-usable collateral is captured, co-created or curated, surfaced and proactively distributed to practitioners, including knowledge assets such as credentials, ‘Why EY’ decks, or account activity
  • Assign responsibilities and coordinate content and insight harvesting from engagements and pursuits
  • Lead the knowledge support for sector or SL-specific solutions aligned to market and regulatory developments (e.g. content curation, lessons learned transfer, awareness etc.)
  • Support the development of service line sector learning to support growth and sector specialization of our people integrating knowledge behaviors and core curriculum
  • Provide on-demand support for specific Health engagements or pursuits (first alerts), leveraging insights and information from multiple sources, including other engagements as well as third party sources
  • Ensure continuous improvement across key knowledge activities, and work with Analytics & Measurement team to support reporting and analysis on these activities as well as sharing and responding to feedback from customers and stakeholders
  • Ongoing evaluation of knowledge value to the Health sector
  • Objective maturity assessment of the sector to provide recommendations for additional enhancements
  • Engage key stakeholders and deliver effective change and progress the community’s knowledge culture
  • Identify opportunities to achieve a step change advancement of the community’s accessible knowledge
  • Demonstrated understanding and relevant experience in the Health sector
  • Robust understanding of knowledge management approaches and their application, paired with the ability to articulate the value they bring to the business and drive buy-in and sponsorship from the business
  • Good understanding of knowledge infrastructure and relevant sector-specific technology solutions to facilitate stakeholder discussions and identify expert resources to bring to discussions when needed
  • Consultative mindset and integrated teaming approach to service delivery
  • Ability to communicate and influence effectively to lead change with people on a global basis
  • Strong executive presence and demonstrated success in building relationships at a senior level
  • Professional, confident, credible and an enthusiastic team player able to work effectively across functional teams and domains
  • Strong project management skills and experience in leading complex programs and projects to achieve milestones and objectives
  • Experienced people manager, able to lead teams in a complex environment
  • 5 – 7 years of knowledge management or equivalent experience
  • Two or more relevant experience in the Health or related sectors
  • Experience with key knowledge management concepts, tools and techniques (e.g. community facilitation, after action reviews) and or comparable experience
  • Professional service industry experience or client-serving experience strongly preferred
6

Manager, Health Promotions Resume Examples & Samples

  • Manages the department, providing employees with leadership, coaching, mentoring, training and performance management to ensure departmental effectiveness and productivity
  • Leads staff within the department, providing training and mentoring to ensure employee productivity
  • Designs, develops, implements, evaluates outcomes and supervises health and Wellness programs for employees. Provide planning expertise including managing cost/benefit analysis, preparation/presentation of detailed proposals and business cases for approval
  • Establishes and implements short and long-term goals, objectives, policies and operating procedures to meet employee needs related to Wellness programming
  • Ensure programs are innovative, and delivered within consideration of needs, cost-efficiency, competitive positioning, and emerging industry trends
  • Plans, implements and evaluates educational materials and promotional activities for the Wellness program
  • Collaborates with and maintains effective relationships with various business leaders, relationship management teams, corporate communications and human resources to develop and implement a communications plan to further employee wellness offerings
  • Provides guidance and direction based on ongoing analysis of employee health status in order to meet corporate health and Wellness program goals and objectives and improve the health and wellbeing of employees
  • Collects, analyzes and reports data relative to health related baselines, outcomes and return on investment for employee Wellness programs and develops targeted interventions based on results
  • Serves as a health and wellness resource, presenting lectures and discussion on health-related topics to employees
  • Completion of a university degree
  • Requires knowledge of advanced principles
  • Computer proficiency (Microsoft Office Suite/Outlook)
  • Conducts advanced analysis
  • 3 to less than 5 years of work related experience
  • Some supervisory experience, an asset
  • Leadership skills in building and motivation teams
  • Supervises others to complete tasks
  • Advanced presentation skills
  • Solicits and considers the points of view of others and participates in reaching agreement
  • Provides data on financial matters
  • Prioritizes multiple tasks
7

Portfolio Manager Health Professions & Brady Resume Examples & Samples

  • Assess global market demand for both print and digital opportunities across the portfolio
  • Establish portfolio business case and deliver portfolio/product mix and related KPI’s including financial performance, gross profit contribution, and learner outcomes
  • Create strong author relationships working closely with them to outline a vision for each product
  • Scout for and sign new authors and talent to build strong future product pipeline
  • Manage revisions and new product development
  • Collaborate with Product Management to recommend discipline relevant technology roadmap improvements
  • Participate in cross-functional teams to define learner outcomes and align author content and product features to those outcomes
  • Travel as needed for focus groups, conferences, events, and campus visits to develop market insights, strengthen educator community network and drive revenue performance
  • Undergraduate degree required
  • At least 3-5 years of relevant sales, marketing or product development experience. Higher education experience preferred
  • Highly analytical with the ability to synthesize multiple viewpoints into actionable plans
  • Excellent written and oral communication and presentation skills, with ability to communicate effectively for diverse audiences
  • Intellectually curious with a passion for education and a keen focus on the learner
  • Creative problem solver who uses data to inform decisions
  • Ability to work in a fast paced, highly collaborative environment
  • Proficient in Microsoft Office (Excel, Word, PowerPoint)
8

Manager Health Services Metrics Resume Examples & Samples

  • Long term planning, including initiatives geared toward operational excellence
  • Firm understanding and background in electronic medical records with an ability to interface and problem solve system issues with medical professionals. Responsible as the primary point of contact with HRIS and IT on all issue identification and resolution for the clinic EMR
  • Responsible for developing the requirements for system enhancements and/or system requirements for current system or future replacements
  • Responsible for all metrics and dashboard development across Walt Disney Parks and Resorts (WDPR) Health Services. Provide analytics, metrics and tracking to support business growth and effectiveness. Works with the physician, nursing and clinic leadership to provide insight on current quality and time to tasks and helps evaluate process improvement opportunities to provide best value services across WDPR
  • Evaluates metrics for Walt Disney World Guest First Aid and coordinates with Disneyland Resort Guest First Aid to ensure best practice on both coasts
  • Understanding of population health and biostatistics with an ability to look at interventions and outcomes in the health and wellbeing area
  • Problem solving device interface issues with the electronic medical record, with collaboration from nursing and medical team
  • Leadership guidance for domestic accommodation and case management team with appropriate leader feedback on functional improvements, ensure compliance with all federal and state laws. Achieve optimal placement of Cast members with disabilities
  • Coordinates with clinical practice leaders and other segment stakeholders such as Employee Relations, Legal and Labor Relations on all escalated issues regarding medical accommodations
  • Works with procurement and IT to negotiate and coordinate vendor contracts across the segment for the health management system, as well as procurement and management of medical assets that coordinate with the system, including audiometers, EKG’s, etc
  • Collaboration with strategic business partners including risk management, safety, Enterprise benefits, Global HR Operations, Casting, etc
  • Provide analytics, metrics and tracking to support business growth and effectiveness
  • Superior project management skills
  • Performance planning and appraisal, coaching and recruitment
  • Must have at least 7 -10 years experience in related roles
  • Background in working with electronic medical records, medical management system, metrics or other relevant experience demonstrated
  • Certified disability management professional
9

RN Consulting Manager, Health Advisory Resume Examples & Samples

  • Financial operations, including the financial close, planning and forecasting processes
  • Documentation and the identification of key controls within the transaction lifecycle
  • Trends of global organizations utilizing pragmatic approaches to achieve sustainable financial functions and
  • Building, maintaining, and utilizing networks of client relationships and community involvement
  • Communicating value propositions,
  • Managing resource requirements, project workflows, budgets, billing and collections
  • Preparing and/or coordinating complex written and verbal materials
  • Supervising teams to create an atmosphere of trust and seeking diverse views to encourage improvement and innovation
  • Answering questions and providing direction to less experienced staff
  • Coaching staff including providing timely meaningful written and verbal feedback
10

Manager, Health & Human Services Resume Examples & Samples

  • Review business process and information security controls to help provide effective, efficient, and secure access to information within applications
  • Develop and maintain relationships with a large number of senior management at state/local government agencies, positioning self and the firm for opportunities to generate new business
  • Eight years of experience during the system and/or user acceptance testing planning or execution of a health and human services engagement in a team environment
  • Demonstrated experience with application development, system evaluations and support for health and human services, including unemployment, Temporary Assistance for Needy Families, Medicaid Management Information Systems, and child services Statewide Automated Child Welfare Information Systems
  • Demonstrated ability to identify business opportunities, lead project engagements, attract new business, and build lasting professional relationships with senior client executives; relevant skills in project management with hands-on experience in the full life-cycle of a project
  • Applied experience assisting other organizations in reviewing or implementing Information Technology Infrastructure Library standards
11

Senior Manager Health &welfare / Wellbeing Resume Examples & Samples

  • Acquires and applies technical knowledge, skills, and experience to accomplish results and serve customers better. Possesses up-to-date knowledge about the function they are in and is regarded as an expert in the technical/functional discipline area. Shows understanding of the issues relevant to the confectionary industry, related industries and competitors. Demonstrates proficiency with technology required to complete assigned tasks and looks for new applications of technology to streamline current work and re-design processes
  • The ability to operate both strategically and tactically, as well as provide vision and leadership
  • Effective project manager, who defines a project, develops the overall project plan with clear deliverables and timeline and manages the project team
  • A technical specialist with demonstrated global integration and change management experience
  • Analyzes and designs business processes to achieve objectives; includes designing structures, roles and supporting systems
  • A detail-oriented, logical, and methodological approach to problem solving. Understands the underlying issues and components of a problem or opportunity and perceives complex cause-and-effect patterns. Identifies patterns and trends from past experiences that relate to a current situation and uses that knowledge to come up with creative solutions and new ideas
  • Superior communication skills, written and verbal, able to effectively address all levels within the organization
  • Works cooperatively as a member of a team and is committed to the overall team objectives rather than own interests
  • Uses available technology to improve personal performance and ability to contribute to the business ie) MS Office, SAP, etc
  • Minimum of 6-8 years of experience required with at least 3 years in an HR role with benefits and wellness focus leading an HR team inside a growing business
  • Previous experience with multi-site, multi-geographic, multi-functional organizations is a plus. Global benefits experience is preferred
  • Demonstrated ability to interact effectively with and influence the decision making of senior management
  • Successful track record of implementing large scale/systemic change efforts across a global organization
  • Proficient with systems reporting and data analysis
12

Manager Health Care Configuration Resume Examples & Samples

  • Responsible for the performance management processes for direct reports including coaching, counseling, providing feedback, career planning, goal setting, and performance assessment
  • Manages process improvement initiatives, seeking root cause and developing appropriate corrective action
  • Serves as primary contact for complex configuration issues
  • Advanced Other Knowledge of provider data management and provider contract configuration
  • Intermediate Other Develop successful working relationships with key functional areas (ie.Provider Relations, Claims, Credentialing, etc..)
13

Success Manager, Health & Life Sciences Resume Examples & Samples

  • Ultimate responsibility for the customer's renewal and for expansion of the platform. You promote maximum value from their investment in Salesforce, utilize all their licenses, identify new opportunities, and collaborate with sales teams to ensure growth attainment and increased footprint
  • Coach customers to ensure they are leveraging all available Salesforce Success Resources e.g. Help & Training, Communities, User Groups, webinars etc
  • Working within an account team matrix, lead C-level stakeholders towards identifying their vision by evangelizing the capabilities of Salesforce in the areas of: sales productivity, service optimization, platform (Communities, Data.com , Marketing Cloud, Heroku)
  • Where appropriate, partner with the customer to establish a transformational Business Roadmap/Blueprint to ensure achievement of business goals
  • Effectively network within accounts from the C-Level down in order to achieve successful execution of the customer's Blueprint, where appropriate
  • Play a fundamental part in coaching customers to establish and manage their Change Management/Governance/Centre of Excellence programs
  • Identify risks to the customer achieving their stated business goals and work with the virtual team to build a risk mitigation plan
  • Develop and maintain long-term relationships with stakeholders in your account portfolio, where appropriate, by networking between customers, partners, and Salesforce
  • Deliver successful customers to the contract renewal cycle and, where necessary, support the renewals process to minimize customer attrition
  • As part of building your personal brand you will be given the opportunity to
  • Minimum 10 years relevant work experience
  • Ability to prioritize, multi-task, and perform effectively under pressure
  • Knowledge of Salesforce product and platform features, capabilities, and best use
  • CRM or IT experience and knowledge of Salesforce competitive landscape and technical ecosystem
  • Proven effectiveness at leading and facilitating executive meetings and workshops
  • Familiarity with the database, application and network technologies used in Cloud Computing (e.g. knowledge of network topologies and devices, database concepts and SQL, multi-tenancy)
  • Working knowledge of the software development process and of software design
  • Flexibility for travel (approx. 20%)
  • Highly beneficial to have any Salesforce product certifications prior to joining. It is expected that you will gain the following certifications as part of the role requirement and onboarding process in the first 6 months
14

Manager, Health Policy & Market Access Resume Examples & Samples

  • Develop and implement reimbursement, health economics and market access strategies to promote growth in the GYN Surgical, Breast Health and Skeletal Imaging businesses
  • Collaborate with Marketing, Commercial Analytics and Health Economics field teams to anticipate market needs and develop customer-facing tools, economic models and other tactical elements of reimbursement to maximize patient access to Hologic technologies
  • Lead creation, cross-functional alignment, approval and implementation of new tools and programs that drive utilization of Hologic technologies
  • The successful candidate will possess a deep knowledge of U.S. health policy with hands-on experience proactively impacting coverage, coding and reimbursement changes with federal, state, and private payers. Experience with medical devices, including imaging and surgical products, is a strong advantage. Experience with legislation preferred
  • The Manager, Health Policy & Market Access will need to interface closely with the Health Economics, Commercial Analytics, Sales and Marketing teams
  • Demonstrated responsiveness and sense of urgency when pursuing goals and completing tasks
  • In-depth knowledge and understanding of the health care industry
  • Demonstrated ability to set and manage priorities, manage multiple projects
  • Ability to work with ambiguity and continuously adapt in a rapidly changing atmosphere
  • Experience and comfort with complex concept sales involving changes in customer behavior or care-pathway in response to clinical unmet needs
  • The desire and capability to personally do heavy lifting – this role is ideal for candidates who enjoy both strategy and execution
  • 3+ years reimbursement/market access management experience including a proven track record of interpreting and assessing the reimbursement environment for medical devices
15

Key Accounts Manager Health Plans Resume Examples & Samples

  • Bachelor degree in Economics, Engineering, Business Administration or related field
  • 8+ yrs. of proven experience working on health plan or Negotiating or contracting with health plans in Puerto Rico or US
  • Fully bilingual (English / Spanish) (reading, writing and speaking)
  • Understanding of US and/or Puerto Rico health system
  • Understanding of local economy
  • Must be sales oriented with strong interpersonal skills
16

Manager, Health Tech Resume Examples & Samples

  • Serve as a day-to-day client contact and manage work streams and teams on program implementation, often times supervising the work of junior account staff
  • Work with account leaders to set strategic direction for accounts, facilitating planning, strategy development, drafting of communications plan and managing execution
  • Drive story idea development for wide range of clients including the ability to track industry trends and identify opportunities to insert our clients into current news cycles
  • Develop content including plans, competitive analysis’, executive and corporate thought leadership documents, event recommendations, media strategy and the like
  • Ability to generate ideas and think creatively
  • Ability to organize and prioritize work under pressure
  • Maintains clear and consistent communication between the Client and account team, manages workflow of projects
  • Contributes to program development for the Client and new business proposals. Must see that these are grounded in the principles of Perception Management
  • Contributes to the Health Tech group at Burson-Marsteller by identifying and pursuing new business opportunities with Health Tech companies
  • Supervise junior team members on both client-work and career development
  • Work across disciplines in an integrated approach
  • 7 -10 years’ experience working in public relations
  • Experience within the technology industry required, health-technology industry preferred (wearables, telemedicine, EMR’s, etc.)
  • Strong work and moral ethic with the innate ability to do what’s right for the team and business, beyond achieving personal accolades
  • Ability to be nimble, organized and prioritize pressure driven situations
  • Ability to work both within a team, and one who can also work who can work independently when necessary
  • Strong communication, both verbal and written and excellent analytical skills
  • Skilled to think creatively and bring new ideas to clients and prospects
  • Ability to develop trust and engagement with clients, supervisors, team members and external influencers
  • Ability to manage multiple accounts with 4-5 team members each with success Strong project and people management skills
  • Expertise in media relations and established relationships with trade, top-tier, business media
  • Advanced presentation skills, demonstrates ability to manage and gain confidence of client and Burson-Marsteller management
  • Bachelor’s degree in communications, public relations, journalism, English, marketing, business or related field
17

Senior Manager, Health Systems Marketing Resume Examples & Samples

  • Coordinate assigned HS therapeutic area tactical business plans by: developing critical initiative timelines, directing marketing programs, and controlling the prioritization of project and process workload. Initial focus will be to support HS marketing activities to support KAM team tactical and data analytics support
  • Lead/administer the development and review of marketing/sales resources through all appropriate internal processes (including, but not limited to, MAP, etc.)
  • Contribute project metrics to gain insight for future action
  • Contribute to the HS business planning process, ensuring that tactical plans are developed to achieve franchise market access and sales performance goals
  • Review changes in the healthcare environment that may require the inclusion of data and brand HS-related consequences in the strategic decision process
  • Collaborate with cross functional departments (including sales, CL&D, marketing and operations) to identify new trends within the payer, integrated system, and large group practice settings in order to deliver unbranded programs and resources to support TA business objectives
  • Manage outside agencies and consultants -- projects and budgets
  • Manages the development of appropriate training materials and programs to support the delivery of HS-related materials to field colleagues engaging market access stakeholders (i.e. HS Account Management, Channel Management Accounts Team, and Sales Teams as appropriate)
  • Implement other support functions as assigned by supervisor
  • This level requires 8 plus years of related, relevant marketing experience (i.e., sales, sales training, market research, marketing operations, managed care, etc.) and/or equivalent education
  • Proficient in power-point and excel
  • Proven analytical and quantitative skills
  • Proven oral and written communication skills
  • Demonstrated ability to be a high level contributor or leader of multiple projects, processes or functions
  • Should have knowledge of the disease states to which assigned, demonstrated by the ability to converse with professionals about the disease state and related products
  • Ability to present complex issues to higher level management is a must
  • Willingness to travel (20% to 40%)
18

Manager, Health Coaching Resume Examples & Samples

  • BA/BS Degree or equivalent experience
  • 3+ years of experience in a leadership role
  • Excellent phone/communication skills
  • Ability to interact and motivate a wide range of staff
  • Superior people management and leadership skills
  • Demonstrated career progression in the wellness call center space
  • Solid experience managing metrics (Quality, Productivity, Customer Service) according to wellness key metric scorecard
  • Strong PC skills
  • Familiarity with an inbound call center focus
  • Ability to manage time in a fast past environment
  • Strong meeting and group facilitation skills
  • Experience working through the change management process
  • Demonstrated critical thinking/problem solving skills
  • Ability to multitask and manage multiple priorities
  • Attention to detail and organizational skills
19

Manager Health & Productivity Resume Examples & Samples

  • 20% Act as a medical partner for Environmental Health and Safety in the field
  • 20% Work collaboratively with Worker's Compensation
  • 15% Disability Management process/Change Management process/Case Management
  • 10% HIPPA Compliance
  • 10% OSHA Regulations
  • 10% Vendor Management
  • 10% Medical and Health Management evidence-based programs (ex. Building Better Health); Return to Work Programs
  • 5% First Aid/First Responder where appropriate
  • Must be eighteen years of age or older
  • Bachelor of Science in Nursing; Registered Nurse
  • Ability to handle confidential information
  • Ability to translate medical outcomes to business benefits
  • Excellent communications and interpersonal skills (form internal and external partnerships)
  • Highly motivated; providing evidence based results
  • Customer focused 5 plus years in Occupational Health Nurse role
20

Manager, Health & Productivity Resume Examples & Samples

  • Effectively managing vendors and consultants to ensure superior service levels
  • Participate in benefit & absence program strategy, design, administration, and compliance
  • Ensuring all benefit programs are consistent with the company’s focus and competitive in the marketplace
  • Manage annual events such as annual enrollment, plan renewals, non-discrimination testing, plan/financial audits, government filings, and vendor claims audits
  • Manage the performance of staff members by providing opportunities for growth and development, by fostering an environment of open, honest communication, teamwork, creativity, high involvement, productivity, and efficiency
  • Streamlining business strategies, structures, and processes; apply technology and process improvements to enhance capabilities and competitiveness
  • Overseeing development and implementation of effective communication plans regarding benefit programs
  • Analyzing plan performance and providing performance reports to Senior Management
  • Acquisition integration
  • Limited travel as required
  • Demonstrated knowledge and management of benefits, leave of absence, and Workers Compensation concepts, legislation, administration, compliance and project management
  • Technical expertise in the design, operation and administration of a broad spectrum of health and welfare programs including medical, prescription, dental, life/AD&D, STD/LTD, FSA, HSA, COBRA, and other mandated and voluntary employee benefits (self-funded and fully insured)
  • Proven track record proactively driving benefit design, strategy, implementation and administration from a large employer perspective (10,000+)
  • Technical expertise in the operation and administration of leaves of absence and Workers Compensation
  • Advanced skills in Microsoft office products including Word, Excel, and PowerPoint
  • Advanced skills in reporting and analytics; data warehouse experience preferred
  • Superior customer service skills; promotes, embodies and expects customer service excellence
  • Excellent organizational and time-management skills, ability to meet deadlines and manage multiple projects
  • Ability to excel in a collaborative work environment with internal stakeholders and external partners
  • Communicate proactively and effectively with all levels of employees throughout the organization
  • Ability to convert strategic goals and objectives into implementable plans and programs; extremely results- and resolution-oriented
  • Superior verbal and written communication skills
  • Effective leadership and supervisory skills
  • General knowledge and experience with design and implementation of HRIS systems
  • 7-10 years of increasing responsibility in employee benefits with a large multi-state organization
  • Bachelor’s degree in Business, Human Resources, Insurance, or a related field preferred, or combination of experience and training
  • Supervisory/managerial experience required
  • PHR, SPHR, CEBS, PHIAS, Life and Health agent or other designation/certification preferred
  • Experience with corporate mergers and acquisitions a plus
21

Manager, Health Care Claims Resume Examples & Samples

  • Manage the Claims Liaison department and staff and provide expertise to staff to assist in claims issue resolution and audits
  • Provide Corporate and Health Plan management with all necessary data to allow for expedient resolution of claims issues
  • Coordinate documentation, tracking and resolution of all plan providers’ billing and payment issues
  • Provide expertise and research providers’ claims inquiries from plan and corporate staff
  • Provide expertise to Provider Services/Relations in the identification of Medical Management authorization issues and trends
  • Utilizing knowledge of provider billing and claims processing, directs Provider Services/Relations with the claims reprocessing notification
  • Track trends in claims processing issues and assist Claims Department in identifying and quantifying issues
  • Review, audit and ensure accuracy of Claims Department work
  • Prioritize work volumes on a daily basis
  • Responsible for the management of all suspended/pended claims
  • Responsible for ensuring that the review and manual pricing of claims is complete and accurate
  • Monitors daily and weekly production of claims by analyzing reports and manage the day-to-day operational duties of claims operations
  • Ensure claim processing edits align with corporate, health plan, contractual obligations and state regulations
  • Ensure all claims are processed accurately and within service level agreements
  • Address escalated claim disputes and make recommendations to health plan leadership on adjustments and exceptions that meet business, provider, and auditing requirements
  • Manage claim payment data analysis and reporting and inter-departmental research of claims adjudication issues
  • Maintain standardized reporting of KPIs, metrics, inventories, priorities and other issues
  • Knowledge of industry standards and practices related to provider billing and claim adjudication including Comprehensive knowledge of physician and hospital billing practices and CPT-4, ICD-CM, and HCPCS coding conventions
  • Ability to analyze data and determine the applicability of data, to draw conclusions and make appropriate recommendations
22

Senior Manager, Health Plan Operations Resume Examples & Samples

  • Understanding and educating the C&S Functional Leaders and UHC Shared Services Partners
  • Learning the State Contractual / Market / Member Benefit Requirements in partnership with Compliance to assure understanding and accountability
  • Build strong relationships with matrix partners (including Claims, Member/Provider Call, Provider Operations, Appeals & Grievances, Enrollment/Eligibility, Encounters, IT, Provider / Member Experience, Clinical, Quality) by fostering and leveraging an “account team” structure that is involved in key Health Plan strategic initiatives, goals and activities
  • Ensuring matrix partner processes meet State / Market requirements by assuring that we are working within UHG and State guardrails / requirements
  • Facilitate resolution of concerns with established guardrails / requirements trying to ensure a win for both UHG and the State
  • Analyze metrics and trends to ensure contractual / market requirements are met
  • Work with matrix partners to improve performance when not met
  • Drive performance excellence and accountability by developing relationships with and working across our matrix partners to eliminate identified barriers to creating new and maintaining existing reference accounts
  • Perform special projects as assigned by Leader or Health Plan
  • Bachelor's Degree or equivalent experience
  • 3+ years in-depth managed care health plan operations experience to include, but not limited to claims, member / provider call center, enrollment and/or eligibility, and provider operations
  • 3+ years demonstrated experience working in a highly matrixed environment
  • 3+ years experience managing multiple projects / tasks to meet contractual deadlines or other time sensitive commitments
  • Intermediate to advanced level proficiency in MS Office Suite: Outlook, Excel, Word, PowerPoint, Project and Visio
  • Live within a commutable distance to Sugar Land, TX
23

Senior Manager Health Care Inflammation & Immunology Resume Examples & Samples

  • Close cooperation with Director Market Access & Public Affairs as well as with Market Access Central and Governmental & Public Affairs about current and upcoming AMNOG InI projects and political activities and developments
  • Development of Local Access Strategies in terms of pricing and reimbursement, e.g. concepts and contracts for pharmaceutical negotiations with sickness funds and other potential contract partners, e.g. in MVZs, Integrative Care, Competence Centres, Pharmaceutical Compounding Networks etc
  • Close cooperation and alignment of all InI Local Access related activities with Business Unit (BU Head InI, National Director Sales, Marketing Lead, Product Managers, Regional Business Managers) and Medical Functions in order to align local access related strategies and tactics and support all customer related functions with local access business support
  • Exchange and alignment with internal international InI access functions and decision making committees, in terms of for suggesting local access business cases (e.g. local rebate contracts with sick funds) incl. obtaining approval
  • Participation and support of in-field teams in national projects/events with important customers (coordination, planning and execution)
  • Open communication with peers and active encouragement of regular exchange of ideas and experiences with peers, Regional Field Network Managers and Regional Business Managers
  • Coaching and development of team members based on their individual needs and capabilities to their next level
  • Stakeholder Management: Maintains / establishes a “Reimbursement, Dispense and Taxation Network” within inflammation/immunology opinion leaders, insurance companies and policy makers
  • Identifies needs of prescribers, pharmacists and health stakeholders and develops (with support and in cooperation with agencies) tailored pharmaceutical solutions and services
  • Applies competitive intelligence, identifies early pharmaceutical opportunities and threats in the market and creates solutions to benefit from opportunities and to disarm threats
  • Responsible for compliance with all laws and regulations as well as Celgene’s Policies in all activities
  • Strong identification with Celgene’s values
  • Has a University degree or post graduate diploma. A PhD would be an asset in this position
  • Extensive experience in responsible position within pharmaceutical industry. Optimal would be an additive inflammation/immunological background and several years of experience in a health political department of pharmaceutical industry and experience in working with statutory health insurances, pharmaceutical stakeholders etc
  • Has deep knowledge about the German pharmaceutical Health Care system (legal pricing, dispense, taxation and reimbursement framework, e.g., German drug law, Law on Pharmacies, Social Code Book, Regulation on Pharmaceutical Prices, Decree on Management of Pharmacies, regional and federal contracts of dispense of pharmaceuticals), interactions of relevant pharmaceutical stakeholders within German self governing body
  • Tact, diplomacy and discretion - excellence in ´anticipation, innovation and execution‘
  • Ability to lead and motivate a team of home based Health Care Managers, set clear objectives and expectations, demonstrating and applying situative leadership and empathy
  • Strong analytical, financial and communication skills
  • Excellent written, verbal and interpersonal communication skills, acts as good internal and external communicator, a representative appearance are essential
24

Manager, Health Outcomes Insights & Solutions Resume Examples & Samples

  • M.P.H., M.S. or equivalent education
  • 5+ years of experience working with US payers or health system customers (directly or indirectly) in a research, medical information or communications role
  • Pharm.D, PhD
  • 5+ years of experience communicating and translating medical and pharmacoeconomic evidence to population based decision makers in a pharmaceutical, US payer (managed care) or health system setting
  • Direct experience with and knowledge of population- based decision makers: US payers, health systems, retail pharmacies or federal (CDC, CMS, VA) customers
  • Clear understanding of observational research methodologies and economic models, with a demonstrated ability to translate real-world evidence, including comparative effectiveness research (CER), observational research studies, and economic model results in a compelling and credible manner
  • Ability to independently evaluate the scientific literature regarding observational research, health economics and health policy
  • Proven ability to develop relevant population based decision maker- focused medical resources: reimbursement dossiers, medical information responses, scientific presentations
  • Experience influencing internal research teams and communicating population based decision maker priorities and needs to both medical and commercial internal matrix team partners
  • Understanding of US vaccine approval, CDC/ ACIP recommendation, purchasing and reimbursement processes
  • Understanding of health information technology/ electronic medical record platforms, systems, and observational insurance claims databases
  • Ability to maintain a command of a large amount of scientific information across multiple therapeutic areas
  • Ability work to proactively and independently; ability to develop and maintain strong trusted relationships with internal partners
  • Experience working with third party vendors and managing projects/budgets
  • Residency and/or post-doctoral training in a pharmaceutical industry/health system/payer setting
25

Account Manager, Health Management Services Resume Examples & Samples

  • Client reports
  • Presentations
  • Arranging onsite health screenings
  • Client-specific enhancements of basic WebMD web sites
  • On site coordination of health fairs and medical screenings
  • Ability to quickly develop relationships of trust and confidence with a variety of people
  • Ability to manage complex employee health programs
  • Ability to deliver results to clients through coordinating the efforts of others
  • Ability to present complex issues/data with a high level of clarity and impact
  • Excellent relationship building and listening skills
  • Excellent project management and follow up skills
  • Must be proficient in the use of a personal computer and supporting software in a Windows based environment including, MS Office products (Word, Excel, Outlook, PowerPoint), Adobe Acrobat, Desirable: Graphics experience, report development, vendor management experience
  • HTML experience a plus
  • BA/BS Degree or equivalent work experience
  • 3 years experience in employee benefits with relevant background in client management, sales, corporate benefit administration or insurance brokerage. Health care or claims experience would be ideal
26

Manager, Health Outcomes Resume Examples & Samples

  • Minimum a MPH, MS, or MA (PhD strongly preferred) - any advanced degree in economics, psychology, outcomes research, public health, or a related discipline
  • Advanced ability to analyze data using SAS, SPSS, Stata, Mplus, and/or R
  • Strong quantitative background including knowledge of multivariate modeling techniques
  • Strong interest in learning new methodological approaches and new statistical analyses while having the superior ability to describe complex scientific data and results to a non-technical audience
  • Ability to work well in a collaborative research environment, as well as the ability to work independently with limited supervision
  • Ability to multitask several projects in a fast-paced environment
  • Proficiency in MS PowerPoint, MS Excel, MS Word and familiarity with SQL is desirable but not required
  • Be willing to travel in support of all of the above responsibilities (~30-40%)
27

Manager, Health Plan Analysis Resume Examples & Samples

  • Maintains a solid working knowledge of all health plan contracts and their assignment to various client entities
  • Directs the development of effective controls to monitor health plan financial performance and assures adherence to all contract financial provisions
  • Serves as a liaison with health plan representatives regarding implementation of contract financial terms
  • Directs the development of models to predict health plan performance
  • Oversees health plan reporting including enrollment, capitation, pharmacy, hospital fund and other factors
  • Develops additional health plan reporting as dictated by current needs of client organizations
  • Ensures accuracy of information provided by the department
  • Ensures supportability of health plan revenue accruals and consistency to GL entries
  • Oversees the analysis of health plan performance by product line to provide benchmarks
  • Recommends revenue enhancement and cost reduction strategies in relation to health plan management and contracting
  • Develops models and systems that assure parity in allocations among the various entities. Oversees all reinsurance and stop loss policies. Develops procedures that maximize recovery under such policies
  • Develops audit procedures and systems for health plan capitation and hospital fund activities that identify discrepancies and maximize recovery
  • Develops departmental and individual goals
  • Maintains a departmental structure that is conducive to productivity and quality
  • Assures that staff has the information and tools necessary to perform their functions including notification of all contract changes
  • Develops, monitors and reports departmental budget
28

Manager Health Resume Examples & Samples

  • Develops programs to ensure compliance with Provincial, Federal and local regulations
  • Implements HSE&F standards, provides technical assistance on HSE&F issues, and partners with the business and sites on compliance, project management, and HSE&F management issues
  • Utilizes a MOS (Management Operating System) to ensure the organization is achieving/exceeding AOP targets and uses the Tier Accountability escalation process to mitigate potential misses as necessary
  • Directs the Site’s HSE&F AOP, STRAP, and Corporate governance processes including, the assurance letter, compliance initiatives, governmental reporting, and best practice exchanges
  • Is a strong advocate of the Honeywell Operating System (HOS) behaviours and tools and adopts them as part of the HSE&F enterprise’s MOS. Provides guidance and support to assure site HOS phase gate exits are successful and gaps are identified and corrective actions are implemented
  • Participates in the development of Aerospace and Corporate initiatives, and enhances maturity of the management systems including leadership standards, risk assessment, and risk management processes
  • Directs organizational initiative to achieve external HS&E certifications as necessary
  • Partners with businesses and site leaders to integrate the culture of HSE&F ownership, performance and compliance across the sites (Cambridge and Ottawa)
  • Deploys safety, industrial hygiene, and environmental processes which demonstrate continuous improvement in HSE&F stewardship directed toward preventing accidents, eliminating safety hazards, waste minimization and pollution prevention
  • Champions continuous improvement efforts to enhance HSE&F processes/programs at the site. Leads efforts to continuously improve HSE&F performance and operations, including environmental/ sustainability projects, conservation activities, and projects focused on improving facility efficiency, preventive maintenance program and energy reduction efforts
  • Ensures compliance with all applicable Health, Safety and Environmental regulations and Corporate/Aerospace policies, procedures and programs
  • Coordinates the execution of actions within the organization necessary for successful deployment of the Health Safety and Environmental Management System, and integration with the Honeywell Operating System. Utilizes the HSE Management System (HSEMS) standards and overall approach to drive organization-wide improvements and effectively integrate all aspects of the HSEMS into the operating system (HOS)
  • Develops and executes the AOP and has direct responsibility for departmental spend and managing the sites HSE&F budget. Provides strategic direction for site HSE&F operations and assist in developing the ISC (integrated supply chain) Strategic Plan and Annual Operating Plan (AOP)
  • Develops and articulates a clear vision, mission, and structure for the HSE&F team, including the ownership of an effective goal deployment process
  • Interfaces with government agencies to maintain regulatory compliance (audits, annual reports, applications for permits, etc)
  • Manages talent strategies including succession planning, Management Resource Review (MRR), and career development processes. Actively coaches, develops and provides performance feedback/actions to employees, as well as provides consistent supplier / contractor performance feedback to drive expectations / improvement actions
  • Bachelor’s degree in Occupational Health & Safety, Environment, Engineering or related field required
  • Seven or more years of experience leading the implementation of HSE programs in a manufacturing environment
  • 5 years of progressive experience managing HSE&F programs and personnel
  • Thorough knowledge and experience in managing compliance with all HSE disciplines and regulations
  • Canadian Registered Safety Professional (CRSP) or Certified Health and Safety Consultant (CHSC) preferred
  • Experienced in preparation, development & implementation of health, safety and environmental management systems & procedures that comply with ISO 14001 & OHSAS 18001 requirements
  • Lead Auditor certification/experience with ISO 14001 and/or OHSAS 18001
  • Has completed training in relevant HSE specialties, e.g. Behaviour Based Programs, Root Cause Analysis etc
  • Black Belt / TPM Expert / Lean Expert certification desired
  • Demonstrated ability to articulate and drive strategic ideas and issues to senior management
  • Excellent interpersonal, strategic decision making, written and verbal communication skills
  • Demonstrated experience leading the implementation of HSE management systems
  • Demonstrated experience managing 3rd party contractors
29

Manager, Health Care QM Resume Examples & Samples

  • 6 or more years progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management
  • Working knowledge of credentialing accreditation and regulatory requirements
  • Ability to work autonomously with minimal supervision; proactive and self-directed
  • Working knowledge of MS Office Suite
30

Program Manager, Health Disparities Resume Examples & Samples

  • Manages the day-to-day operations of the program under the direction of the faculty leader of the program. Works both strategically and tactically to plan, coordinate, and implement programmatic activities, resources and services
  • Administratively reports to a senior member of the Catalyst management team and works collaboratively with the Executive Director, Director of Operations, and Director of Finance and Administration
  • Responsible for developing and maintaining systems that track and monitor program activities/progress and provide reports for internal and external evaluation as required/requested
  • Identifies issues/problems/barriers that impede program objectives and propose strategies to overcome challenges
  • Develops and implements communications and marketing strategies to promote awareness and access to program and resources
  • Represent Harvard Catalyst to the faculty and staff of Harvard and other external stakeholders as needed
  • Works collaboratively with the team of Catalyst program staff to integrate activities and resources across Harvard Catalyst and the Harvard Community
31

Manager, Health Management Consulting Resume Examples & Samples

  • Provide onsite wellness consultations to key customers to help design and develop population health management strategies
  • Collaborate with medical informatics, account management, sales, product strategy and all other stakeholders as needed to provide value added service to BCBST’s customers
  • Work in collaboration with customer to measure program effectiveness
  • Work in collaboration with sales and account management to assist in driving incremental product sales
  • Conduct physical site reviews for customers and make specific recommendations for improving organizational health
  • Conduct HR functional reviews for customers to identify existing policy improvements, training opportunities, benefit strategies and reward and recognition programs to improve organizational health
  • Review current population health management strategy and make recommendations for improvements
  • Review clinical insights data to proactively make recommendations to customers on population health management strategies
  • Perform background research, develop projects, and write program descriptions and customized program materials based on evidenced base care
  • Respond to requests for information and proposals regarding Blue Health Solutions products
  • Collaborate with product development, marketing and sales regarding the wellness programs alignment with needs and expectations of the market and our members
  • Assist with strategy development for BCBST’s employee wellness program
  • Minimum 5 years experience in Wellness programming
  • 5 - 7 years of progressive management experience
  • Requires an in-depth knowledge of management and operational processes
  • Extensive working knowledge of all aspects of Wellness Programs
  • Experience with wellness program design and implementation required
  • Experience with vendor management required
  • Experience with HR and benefit plan design highly desirable
  • Wellness Certifications (ie WELCOA Well Workplace Practitioner) preferred
  • PHR or SPHR certified preferred
  • Proven track record of project design and implementation
  • Demonstration of independence, leadership, excellent organizational, interpersonal, written and verbal communication skills, business writing, interpersonal, problem solving and analytical skills required
  • Demonstration of a positive health and wellness influence and role model to members, colleagues and staff
  • Proven ability to research, plan, organize, and coordinate multiple projects related to operational workflow
  • Project management experience preferred. Advanced computers skills, including Microsoft Word, Power Point and Excel. Microsoft Project experience preferred
  • Ability to lead and work with multiple team members on major health management projects within and outside of BCBST
  • Proven ability to manage time efficiently is required
  • Valid Driver’s License required
  • 50% plus travel required
32

Manager Health Care Mgmt-idd Population Resume Examples & Samples

  • Provides direct oversight for the team of Support Coordinators responsible for the development and management of person-centered Individual Support Plans for Individuals with I/DD, which includes supervising the work of RN’s, in coordinating services for Individuals with I/DD ensuring contractual requirements are met
  • Directs and collaborates with functional managers to develop and implement the steps necessary to manage the Virginia Statewide program operations
  • Evaluates program operations to include medical, mental health and substance abuse services to improve efficiency of operations, financial return, customer service, and provider engagement
  • Coordinates with the lead trainer regarding ongoing support coordination needs and activities
  • Manages resource utilization to include member assessment of physical and psychological factors to ensure appropriate delivery of care to members and adequate coverage for departmental tasks and job responsibilities
  • Ensure appropriate tracking and monitoring systems are in place to support fulfillment of all contracted support coordination requirements
  • Interfaces with providers to support the development of ISPs and assists in problem solving claims and contracting issues, as necessary
  • Hires, trains, coaches, counsels and evaluates performance of direct reports
  • Supports quality initiatives and activities, including adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting
33

Sales Origination Senior Manager Health Payer Resume Examples & Samples

  • Minimum of 5 years selling and originating large, multi-tower, complex IT services projects for a global or national consulting or technology services firm
  • Minimum of 5 years selling complex solutions for a global or national consulting firms in the Health Provider space
  • Minimum of 5 years in broad based, cross Growth Platform door opening expert who can drive deals with little to no hand holding
  • From a Domain expertise standpoint, candidate needs experience in Transformational Consulting (MC & Strategy) and Outsourcing
  • Digital expertise is highly desirable
  • Candidate will have skills that enable him/her to originate larger, complex deals
  • Deep understanding of and ability to sell services based upon a global delivery system
  • Advanced sales and marketing skills, including proven ability to carry and sell to personal sales quota
  • Proven track record against multiple million dollar sales targets
  • Deep understanding of transformational consulting & outsourcing
  • Executive level presence and influence with client organizations
  • International/Global expertise and perspective
  • Exceptional relationship building skills and currently networked into the relevant business communities
  • Highly self-motivated, individually driven, self-discipline, organized, and focused in conducting sales tasks
  • Excellent negotiation, mediation, and conflict management skills
  • Ability to guide others through complexity, ambiguity, and uncertainty
  • Strong verbal and written communications skills
  • Ability to apply out-of-box thinking
34

Program Manager, Health Care Resume Examples & Samples

  • Responsible for planning, execution and evaluation of large and complex program initiatives to improve quality performance
  • Develops and monitors measurement strategies for large change and improvement initiatives
  • Manages program(s) from initiation/pilot phase through delivery/spread and monitors for continuous improvement
  • As part of a broader QI team, influences the business unit, strategies and objectives
  • Becomes an expert in company quality initiatives, as well as the products, functions, marketing and/or service policies and procedures that support those initiatives
  • Serves as a quality expert with internal constituents to drive successful improvement initiatives in the organization
  • Educates and works with external partners and participating practices as needed to identify innovation opportunities and adopt improvement actions
  • Exercises independent judgment in developing methods, techniques and evaluation criterion for obtaining results
  • May assist in the planning and direction of budgets
  • Bachelor’s degree required in public health or similar discipline, Master’s preferred
  • At least two years of experience in direct patient care setting
  • At least two years of healthcare experience in quality improvement and quality management
  • Knowledge of HEDIS and accrediting body requirements (i.e.; NCQA or URAC) desired
  • High integrity/ethics/trust
  • Strong facilitator with demonstrated excellence in driving multi-disciplinary and cross-functional teams to consensus
  • Seasoned critical thinking
  • Ability to manage large, complex projects
  • Analytical skills—the ability to summarize complex information succinctly, using QI methodology as a guide
  • Experienced in Change Management Processes, including improvements and redesign
  • Skilled at facilitating and growing collaboration and motivation amongst geographically disperse teams
  • Strong interpersonal skills and demonstrated ability to build relationships in fast-paced environments
  • Financial/Quantitative acumen
35

Manager, Health Tech Programs Resume Examples & Samples

  • Define/document overall Agile sprints
  • Plan for assist in workshop facilitation
  • Produce workshop materials, collate workshop outputs and publish final products
  • Set up and track Kanban items (e.g. Trello boards), action items. Execute on project management follow-ups
  • Prepare impactful communication materials
  • A minimum of 5 years of hands-on technology project management is required
  • Experience in Agile, scrum methods
  • Design background
  • Strong organizational and effective communication skills (excellent written, verbal and presentation skills)
  • Proven ability to plan for and facilitate workshops
  • Self-starter and able to work in a dynamic, fast-paced environment independently
  • Technical skills and strong technology product sensibilities is preferred8886170501
36

Manager, Health Plan Applications Resume Examples & Samples

  • Bachelor's degree with five years work experience in a IT management supervisor level position; or Bachelor's degree with one to two years work experience in a management supervisor level plus five years experience in Information Technology; or Eight years experience in Information Technology
  • Demonstrated ability to work in a team environment. Must have excellent interpersonal and communication skills
  • Experience in contract negotiations and vendor management a plus
  • Healthcare application support experience strongly desired
  • ITIL foundation certification is a plus
  • Candidates will need to take and pass an Epic pre-certification exam in order to be considered
37

Hcs Him Operations Manager Health Information Manager Resume Examples & Samples

  • Previous acute care HIM operational management experience required
  • Strong knowledge of JC/DNV & CMS COP standards and HIPAA, with excellent analytical and data mining skills
  • Ability to effectively manage and direct various levels of staff as well as manage vendor relationships and expectations
  • Exhibits effective organizational skills, time management, management of multiple priorities and strong project management skills
  • Ability to interpret federal and state regulations, as well as accreditation standards relative to Health Information Management
  • Ability to successfully manage remote staff/sites
38

Sales Account Manager, Health Care Resume Examples & Samples

  • Bachelor's Degree in Marketing, Business, Nursing or related field
  • A minimum of three (3) years recent sales or liaison experience in the health care industry, preferably in home health care
  • Demonstrated success in achieving referral goals within the market
  • Excellent oral/written communication and interpersonal skills
39

Account Manager Health Informatics Resume Examples & Samples

  • Minimum of 6 + years of industry or sales experience involving complex bundled deals
  • Experience with Health Informatics
  • Consistent and successful sales track record & results: over quota performance, forecast accuracy, balanced portfolio, and competitive wins
  • Demonstrates superior industry knowledge on market trends, products and current Philips product portfolios and uses this knowledge to his/her advantage
  • BS/BA in Business, Engineering, Associates, RT certification or equivalent experience
  • Ability to effectively manage assigned territory
  • Medical capital equipment sales experience or work experience in the Healthcare field
  • Strong leadership and team building skills and ability to effectively leverage other people
  • Strong executive level selling, negotiation and facilitation skills
  • Financial analysis skills for doing ROI, NPV, ROA, etc
40

Development Manager, Health Organization Resume Examples & Samples

  • Coordination of special events including, but not limited to: event mailings, vendor contracts/coordination, volunteer coordination, guest registration and follow-up. Also working with outside organizations holding fundraising events on CCP’s behalf, to ensure that the CCP brand and message is consistent and clear through the events, and that appropriate donor follow-up and appreciation occur. Familiarity with Event software, like Greater Giving desired
  • Ensure that individual event objectives are achieved, and assist the organization in meeting financial goals. Track performance to goals and objectives. Perform assessments, and recommend improvements and new ideas
  • Work with the CCP team to generate material for and maintain social media and internal communication platforms including Facebook, e-news, website and e-blasts
  • Assist with the creation, production and mailing of direct mail appeals, newsletters, annual reports and other correspondence. Coordinates with office manager to work with in-house mail services on timing of jobs, purchase postage, coordination of volunteers to prepare for special mailing
  • Responsible for assisting in administration of Raiser’s Edge donor database including data entry, maintaining accurate data for event mailings and electronic mailings, timely donor acknowledgements, reporting and tracking of gifts
  • B.A. degree and at least two to three years of experience working in development/fundraising for nonprofit organizations, business development, or marketing or an approved equivalent combination of education and experience
  • Experience in organizing and planning special fundraising events
  • Impeccable customer services skills and ability to work well with diverse groups of stakeholders, funders, volunteers, staff, clients and community members
  • Database knowledge required and experience in Raiser’s Edge preferred
  • Design skills (PhotoShop) and HTML Scripting desired
  • Proficiency with MS Office, primarily Microsoft Word, Excel, Outlook
  • Proficiency with social media—Facebook, Twitter, Linked In
  • Proficiency with email platforms, like Constant Contact or MailChimp
  • Personable, professional, organized, and energetic
  • Ability and experience to develop and track to individual goals and follow through with them
41

Clinical RN Integrated Care Manager Health Services Resume Examples & Samples

  • Carries out responsibilities in accordance with the organization's policies and regulatory requirements
  • Serve as a liaison between Health Services Unit and the Business Partners
  • Perform Case Management activities to include: assessment planning, service implementation, care coordination, monitoring and evaluation and plan of care development
  • Track and report member milestones monthly and provide status updates quarterly
  • Review, Analyze and Prepare assigned regulatory reports as required
  • Provide education and training for business partners and team members
  • Represents the department in assigned Plan committees / meetings
  • Drive continuous program improvement projects
  • Assist with the development and updates of policies and procedures
  • Problem solve skills: the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
  • Excellent verbal communication and business technical writing skills; ability to speak clearly and concisely, convey complex or technical information in a manner that others can understand
  • Current, unrestricted RN license in the State of Arizona
  • 5+ years clinical, pediatric / adult and case management experience
  • Ability to prepare written responses for regulatory submissions
  • Experience presenting to groups and key stakeholders
  • Experience in project management
42

Manager, Health Provider Data Quality Resume Examples & Samples

  • BA/BS in Computer Science, Information Technology or rated field
  • 3 yrs+ leadership or any combination of education and experience, which would provide an equivalent background
  • Strong solution design and development experience is required
  • Hands-on experience developing and supporting RDBMS data structures and database systems such as (but not including) MSSQL, DB2, Oracle 12c
  • Experience with different technology skills required including
43

Manager, Health Partner Contracting & Service Resume Examples & Samples

  • Execution of the contracting strategy, develop provisions based on cost, quality/analysis and monitor key metrics for the Market
  • Conduct annual effectiveness review of contracting strategies; ensure corporate compliance with all contracting
  • Ensure an ongoing high level of staff engagement, empowerment and development
  • Responsible for provider recruitment and implementation of contracts
  • Responsible for contracts and testing, initiating set-up, post configuration testing, maintenance and audit of claims system
  • Create contract language and review with legal to develop approved contract templates specific to the Market and within the established corporate guardrails
  • Administer provider contracts, terms, reimbursement rates, etc., in a manner that complies with corporate policies
  • Implement an efficient and effective process to on-board new providers; ensure network is adequate (access for members), cost-effective, competitive and stable, and meets corporate & regulatory requirements
  • Responsible for ensuring all regulatory requirements for provider network are met
  • Perform gap analysis to ensure no gaps and/or sanctions occur; identify & implement solutions that mitigate risk; development of corrective action plans as needed
  • Coordinate the account strategy and provide account support with the goal of driving the overall satisfaction and engagement of Health Partner network
  • Resolve routine issues with the Health Partners in the market in accordance with the department’s service level agreements/expectations
  • Coordinate the PR Customer Relationship Management (CRM) tool and assignment of tasks for the Health Partner Consultant when appropriate
  • Responsible for grievance intake, analysis and performance improvement initiatives
  • Participate in training sessions for providers and staff as appropriate
  • Support the contracting requirements of the corporation for geographic regions and products
  • Assist with development and review of payment policies and provider notifications
  • Perform any other job related instruction as requested
  • Bachelor’s degree in a healthcare related field, or equivalent years of relevant work experience is required
  • Master’s Degree or equivalent work experience is preferred
  • Minimum three (3) years of contract negotiation experience is required
  • Minimum three (3) years of management experience is required
  • Managed care experience is highly preferred
  • Intermediate proficiency level with Microsoft Outlook Word, and Excel
  • Knowledge of Network Management Processes & Services
  • Ability to manage and prioritize multiple tasks, promote teamwork and fact-based decision making
44

Care Manager, Health & Recovery Plan Resume Examples & Samples

  • Adhere to clinical standards of care through collaboration with providers in order to ensure appropriate outcomes
  • Communicate with members, family and other medical personnel as necessary to facilitate a desired outcome
  • Manage electronic files in order to document patient records, treatments and progress
45

Credentialing Manager, Health Plan Resume Examples & Samples

  • Responsible for the management of a credentialing service bureau, which meets the needs of multiple internal and external customers. The service bureau supports the credentialing and re-credentialing processes for the health plan, dental plan, medical and dental groups
  • Maintain an effective, efficient service bureau, which meets or exceeds the customer’s expectations
  • Develop, maintain, and routinely update internal policies and procedures for the various processes provided by the service bureau
  • Evaluate process and systems work flow, identify inefficiencies, recommend and implement strategies for improvement
  • Effectively maintain the integration of peer review findings within the re-credentialing and privileging processes and maintain appropriate safeguards to ensure confidentiality
  • Actively participate in appropriate departmental and organizational meetings related to credentialing
  • Assist director in coordinating activities of the HealthPartners Credentials Committee
  • Attend committee meetings on behalf of the CSB department and makes recommendations based on current knowledge of credentialing issues
  • Provide expertise regarding credentialing system needs
  • Responsible for compliance with regulatory, accreditation and other external customer requirements regarding the service bureau processes, including but not limited to NCQA, CMS, MDH, DHS etc
  • Assist Director in developing and implementing changes needed to demonstrate compliance
  • Works with Director to ensure compliance with Medicare products requirements and regulations
  • Assists Director in the coordination and communication for external audits and review activities as needed for both planned and unplanned visits
  • Represents the Director of the CSB in his/her absence when regulatory agencies (Department of Health, NCQA, and CMS) conduct visits at the health plan
  • Ensure compliance with the organization’s credentialing plan
  • Responsible for process and system controls to ensure data integrity of practitioner reporting for day to day operational monitoring and for periodic report requests
  • Collects and reports data necessary to monitor the CSB credentialing activities
  • Provides administrative leadership to the CSB staff in the Director’s absence. This includes providing direction, making appropriate judgment decisions, assuring that there is appropriate staffing in the CSB, coordinating and facilitating staff meetings, etc
  • Responsible for the supervision, recruitment, orientation, training, development, and day-to-day management of assigned staff
  • Works collaboratively with CSB Quality Assurance Coordinators to ensure the highest standards of quality and accuracy of the credentialing process
  • Participates in the creation and updating of Business Continuity and Disaster Recovery plans
  • Other projects/responsibilities as assigned by Director
  • Bachelor’s degree in health care field with minimum of three years’ experience in hospital or health plan credentialing OR Professional with CPCS or CPMSM credentials with a minimum of five years’ experience in hospital or health plan credentialing
  • Minimum of three years supervisory experience
  • Knowledge of regulatory-based credentialing requirements for health plans and hospitals, including NCQA and CMS
  • Demonstrated project management experience, leadership and facilitation skills, and cross-functional problem resolution skills
  • Effective professional verbal and written communication skills
  • Must exercise initiative, adaptability, flexibility, and willingness to work within teams and multiple organizations
  • Ability to work effectively with multiple departments and organizations to deliver results
  • Experience with provider databases and reporting
46

Digital Marketing Manager, Health Care Resume Examples & Samples

  • 5-10 Years professional work experience in direct to consumer/e-commerce marketing with at least 5 years of experience in digital strategy and execution of campaigns and programs with measured success
  • Excellent written and verbal communication skills with ability to present ideas and information clearly
  • Strong project and time management skills, able to be self-directed and proactively manage and direct multiple projects simultaneously
  • Basic understanding of website development, content management systems, SEM, Social Media and mobile apps
  • Experience running and scaling paid search campaigns (Google/Bing) with large daily budgets
  • Experience with Online Analytics (Google Analytics, Omiture, Optimizely, Test & Target) with ability to turn insights into recommendations
  • Experience creating and executing targeted customer email campaigns utilizing an email service provider (Hubspot, Mail Chimp, or Exact Target)
  • Knowledge of SEO best practices and their implementation
  • Demonstrated understanding of marketing concepts and consumer behavior
  • Highly organized and detail oriented
  • Proven track record to achieve goals
  • Upbeat, personable, positive, can-do attitude
  • General computer skills, must have solid working knowledge of Microsoft Office
  • External agency management oversight experience preferred
47

Senior Manager, Health Innovation Resume Examples & Samples

  • Strategic Planning
  • Develop and recommend digital therapeutic and clinical innovation roadmap to VP, Wellbeing, including, but not limited to, market analysis, technology assessment, and clinical validation
  • Provide quarterly reviews and updates on progress to plan and metrics
  • Prioritize clinical program innovations
  • Technology Assessment
  • Act as subject matter expert for digital therapeutics, including applicable technologies, companies, devices, software, etc
  • Develop build/buy analysis recommendations, including vendor selection process where applicable
  • Ability/knowledge to integrate recommendations and deployments with existing/planned Blue Shield technology platforms
  • Clinical Innovation
  • Review of lifestyle medicine clinical trial results, relationships with academic researchers and advocacy groups
  • Provide periodic clinical innovation updates
  • Translate clinical findings to program innovation recommendations and deployments
  • Forge working relationships with, and manage communication and influence to, key internal/external stakeholder groups
  • Manage and develop a team and maintain full budget responsibility
  • Minimum Bachelor’s degree required
  • Minimum 7 years relevant experience working in healthcare
  • Minimum 3 – 5 years of experience in digital innovation
  • In-depth expertise of digital therapeutics and applicable technologies
  • Ability to work cross-functionally and collaboratively across Blue Shield leadership teams
  • Experience leading, managing, coaching and developing teams
48

Manager, Health Promotions Resume Examples & Samples

  • Delivers programming to employees when necessary
  • Prepares and maintains budgets and provides reporting as necessary
  • 3 to 5 years of work related experience
49

Care Manager, Health & Recovery Plan Quality Resume Examples & Samples

  • Utilize expertise of best practice standards to render medical and social necessity determinations
  • In collaboration with Physician Advisor, assess appropriateness and effectiveness of medications in order to determine a medication's use, dosage and side effect as applied to different disease states
  • 3+ years clinical and/or managed health care experience required
50

Evaluation Senior Manager, Health Professions Resume Examples & Samples

  • Lead efforts to enable student success through accurate, fair, helpful and timely evaluations
  • Ensure Evaluation Faculty Managers are working with Evaluators to meet or exceed turnaround goals
  • Ensure that Evaluation Faculty Managers are implementing and monitoring requisite scoring quality policies and practices
  • Ensure that Evaluation Faculty Managers are implementing procedures, as set forth by the Evaluation Faculty Director, to attain appropriate levels of inter-rater reliability
  • Provide guidance to Evaluation Faculty Managers as they work with assigned Evaluators to provide helpful feedback for students on each scoring event
  • Monitor email communications involving Evaluation Faculty Managers and/or Team Leads as appropriate, including but not limited to resolution of appeals, counseling Evaluators, and communicating with others in the University
  • Lead efforts of Evaluation Faculty Managers to assess work performance of each assigned Evaluator to comply with formal HR and division requirements
  • Formally supervise all direct reports
  • Collaborate with the Evaluation Staffing Manager to determine staffing needs including hiring, team placement, and enrollment needs
  • Lead efforts to understand and improve evaluation efficiencies
  • Provides oversight to evaluator certification/licensure and other qualifications,as needed
  • Represent the Evaluation Department, as requested by the Evaluation Faculty Director, in collaborative efforts with other University personnel
  • Abide by policies established by the WGU Human Resources department
  • Satisfactorily perform other duties as assigned
  • Understanding and appreciation of competency-based education model
  • Fluent with performance based measurement practices and procedures
  • Familiarity with higher education assessment policies, issues, and practices
  • Well-developed task analysis, time management and problem solving skills
  • Proficient use of educational technological platforms and common office software packages
  • Excellent verbal, writing and presentation skills
  • Able to spend significant time working at a computer and on the telephone
  • Minimum earned Master’s Degree
  • A minimum of three years experience in educational measurement or a related field
  • A minimum of 3-5 years supervisory and/or management experience
51

Senior Manager, Health Systems Marketing Resume Examples & Samples

  • Lead the training and communication efforts with Market Access Field Teams to ensure alignment and execution of brand strategies
  • Track and trend ROI, targeting, formulary status and pull-through program effectiveness through various IT and data resources to further refine payor strategy
  • Coordinate Market Access presence for assigned products at select payer conferences
  • Attend various Market Access and relevant therapeutic association meetings to stay current on market trends, clinical developments and treatment guidelines
  • 7-10 Years in the pharmaceutical industry
52

Manager Health Care Resume Examples & Samples

  • Acquire essential information about developments of German Health Care System, especially for the regions assigned, at the earliest stage ("Horizon Scanning") and deliver specified information to Senior Health Care Manager / Market Access Local InI in an efficient way (monitoring and identifying opportunities and threats for terms of dispense of Celgene`s pharmaceuticals, specific terms of pricing (set rate and terms of formulars) and reimbursement, storing information, enlargement of contact network and establishing firm relationships with sickness funds and regional associations of SHI physicians, specific health care decision makers, concerned physician health politicians, budget stakeholders, other stakeholders in the pharmaceutical field)
  • Design, develop and implement process and execution expertise in reimbursement activities to Inflammation and Immunology products in Germany
  • In close cooperation with sales, marketing and medical department of InI and in line with the overall business plans, develop pharmaceutical options and models for business strategies in order to maximize the commercialization of the product portfolio
  • Identify needs of prescribers and health stakeholders and develop (with support and in cooperation with agencies) tailored solutions and services
  • Apply competitive intelligence, identify early opportunities and threats in the market and create solutions to benefit from opportunities and to disarm threats
  • Position and represent pharmaceutically Celgene and its products in the best possible way in all relevant health care bodies in the relevant territory
  • Support sales forces in all reimbursement matters provide health economic argumentations to support the applicable use of Celgene’s drugs
  • Open communication with peers, supervisors and other Regional Field Network Managers
  • Has deep knowledge about the German Health Care system (legal pricing, dispense, taxation and reimbursement framework, e.g., German drug law, Law on Pharmacies, Social Code Book, Regulation on Pharmaceutical Prices)
  • Ability to set right priorities and to work to tight deadlines (flexible in working time)
  • Flexible, team member with positive attitude
  • Good knowledge of English language
53

Account Manager Health Systems National Accounts Resume Examples & Samples

  • Day-to-day management of all activities in support of GPO(s) customer base relationship. Meet or exceed defined customer service levels that directly influence the department's achievement of targeted customer satisfaction goals
  • Team with Director of National Accounts, Vice President of Support Services and Vice President to Sales to develop goals, objectives and measurements for department performance, to ensure alignment with the Pharmaceutical strategic business goals
  • Responsible for providing strategic national account management and ensure contractual compliance for GPO(s) customer base, with a goal of world class customer satisfaction, sales goal achievement and streamlining cost to service through planning, process development and team work across all functional areas
  • Develop and execute implementation strategies to ensure successfully implemented and stable relationships are established
  • Conduct quarterly business reviews
  • Conduct audits to ensure profit/contract compliance and evaluate business opportunities
  • Liaison between GPO(s) and all MCK functional areas to develop and execute strategic initiatives
  • Champion the development of internal and external partnerships to enhance responsiveness to customers' needs, ensures internal/external customer understanding, develops and leads cross-functional process improvement teams
  • Coach and develop staff to maintain a productive and motivated workforce. Champion new initiatives and act as a catalyst for change
  • Coordinate development and roll out of new or updated MCK policies as needed
  • Customer Satisfaction targets are met or exceeded
  • Contract Compliance Audits performed to schedule and within compliance results
  • GPO(s) plan (sales and expense) is met or bettered
  • Customer relationships are maintained or strengthened
  • Employees performance and satisfaction expectations are met or exceed
54

Manager Health Care Mgmt-medicaid Resume Examples & Samples

  • Manages and oversees team responsible for ensuring contractual requirements
  • Coordinates service delivery to include member assessment of physical and psychological factors
  • Reviews benefit systems and cost benefit analysis
  • Evaluates medical, mental health and substance abuse service for cost containment
  • Supports program compliance and assists in identifying opportunities to improve the customer service and quality outcomes
55

Senior Account Manager, Health Plans Division Resume Examples & Samples

  • Day to day contact with complex clients for issue resolution
  • Provides input into the strategic planning for assigned clients. Knowledge and understanding of assigned corporate financial impacts of clients
  • Responsible for tracking operational performance versus guarantees. Compiles documentation for regular client reviews
  • Responsible for the operational needs of complex clients
  • Acts as a mentor for other team members and assist with training
  • Handles ad-hoc inquiries and other client requests
  • Bachelor’s degree in relevant discipline or equivalent work experience
  • 8-12 years relevant work experience or Master’s degree with 5-10 years relevant experience
  • Excellent PC skills including Microsoft Office and Internet experience
  • Strong focus on book of business client satisfaction and client retention results
  • Demonstrated ability managing projects utilizing proven project management processes
  • Ability to work cross-functionally to proactively communicate and to resolve issues with the highest sense of urgency
  • Ability to work cross-functionally to resolve complex client issues
  • Ability to travel overnight up to 25%
56

Regional Manager Health Services West Resume Examples & Samples

  • Monitors and evaluatesall third party service contracts and ensures compliance by routinely performing on site evaluations of medical care rendered
  • Works closely with Regional Director and third party contractors and GEO facility health services staff to resolve discrepancies and deficiencies
  • Ensures compliance of policies and procedures, a variety of accreditation standards and applicable federal, state, and municipal laws
  • Ensures compliance of applicable accreditation standards and keeps abreast of any current and changing trends
  • Advises Director of Health Services of changes and needs with recommendations to ensure compliance and continuous improvement in health and safety issues for employees and detainees at the institutional level
  • Works with facility Health Service Administrators in developing effective and organized medical units that are in compliance with client and regulatory agency standards
  • Evaluate system workload and levels of productivity within health services units
  • Monitors services rendered by contract and professional staff in relation to contractual requirements, Contract Compliance, and accreditation standards
  • Ensures all credentials files at the institution are up-to-date and in compliance with Company policies and procedures
  • Meets regularly with the Directors of Health Services to create plans of actions addressing client concerns and audit findings
  • Assists the Health Services Administrators in developing and implementing Corrective Action Plans (CAP) as results of audits
  • Completes and submits narrative, summary and/or operational reports as required
  • Monitors and ensures staff compliance with all applicable pharmacy laws especially those covering controlled substances and audits pharmacy use
  • Reviews Profit and Loss (P&L) reports and identifies over-utilization or excessive expenditures on a monthly basis. Assists the Health Services Administrators creating action plans to eliminate over-utilization impacting their cost centers
  • Assists and trains Health Service Administrators in preparing for accreditations or reaccreditations requirements
  • Provides comprehensive training to Health Service Administrators during initial appointment to the position and on an annual basis
  • Develops and maintains effective communication with outside hospital contractors, consultants and agency administrators to ensure a positive working relationship
  • Ensures standardization of current system components-forms, services, policies, standards, responses to address client concerns
  • Assists Health Administrators with challenges affecting their daily operations
  • Fills in as needed during the absence of the Director of Health Services
  • Attends seminars, workshops, and conferences as required
57

Manager, Health Partnerships Resume Examples & Samples

  • Oversee and encourage the collaboration with key Health Partners in the development of specific strategies for enhanced engagement. Health Partner engagement shall be measured by confidence in CareSource’s ability to fulfill promises, integrity to make things right when problems occur, pride in working with CareSource and their passion about CareSource being a vital member of the care team
  • Assists with the development and evolution of the team’s strategic direction, annual goals and objectives, recommends new processes and changes for increased department productivity
  • Provide proactive, high-level account development and support in order to drive the overall satisfaction and engagement of key Health Partners
  • Develop and implement the team business plan objectives, both in creating new plans and in identifying and responding to customer needs
  • Establish and maintain strong working relationships with key internal business partners
  • Ensure Provider Engagement team members are resolving complex or non-routine questions, issues, and problems within 30 days or less and provide direction as needed
  • Develop and report on key accomplishments and issues to upper management
  • Oversee the achievement of customer specific performance guarantees to include operations, clinical, pharmacy, behavioral
  • Set targets and priorities in order to contribute towards meeting overall CareSource Network Strategy
  • Implement local strategic plans in order to effectively influence providers, provider affairs and service centers
  • Ensure that retention rates and positive negotiations meet and regularly exceed network targets
  • Contribute to the training and development of associates in provider engagement
  • Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary
  • Outwardly support and be able to communicate the CareSource mission, goals of senior leadership and other stakeholders to the Health Partner community as well to the Provider Engagement team
  • Ensure appropriate documentation of interactions and projects by all team members
  • Perform any other job related instructions as requested
  • Bachelor’s Degree in Business Administration, or related field or equivalent years of relevant experience is required
  • Master’s degree is preferred
  • Seven (7) years of progressive experience in health care, account management, sales, customer service or related field is required
  • Three to five (3 to 5) years of experience in provider relations or related field/position is required
  • Proficient with Microsoft Office to include Word, Excel and PowerPoint
  • Strong interpersonal skills and high level of professionalism
  • Effective problem solving skills with attention to detail
  • Ability to work independently and within a team
  • Strong negotiation skills
  • Ability to create and maintain excellent working relationships
58

Manager Health Resume Examples & Samples

  • Be the Quality Management (QM) Process owner for Engineering &Technology (E&T) Americas
  • Ensure that the integrated management system is introduced, implemented and maintained in the Americas
  • Develop the management system with regard to defined E&T goals, together with the global E&T Health, Safety, Environment & Quality (HSEQ) Officers and the region head
  • Ensure that the management system meets all divisional (customer) requirements and relevant standards
  • Evaluate internal audits on the regional level and draw up the annual quality report for E&T-HSEQ (management review)
  • Ensure that the relevant legal and official regulations are made known in the region and that corresponding training is provided
  • Report to the global E&T HSEQ Officer and to the region head
  • Train local QM deputies and lead regular meetings with QM deputies to ensure global and regional requirements are driven to the country/ site/local level
  • Ensure compliance with the International Organization for Standardization (ISO) 9001 requirements and lead efforts to obtain new and/or maintain existing QM certifications
  • Be the subject matter expert on requirements for certification
  • Train QM deputies and key stakeholders on certification requirements
  • Work with global E&T HSEQ officer, region head, local QM Deputies, and divisional/corporate stakeholders to identify and close gaps to meet requirements for certification
  • Serve as Bayer lead and key contact for external QM certification audits
  • Ensure measures are in place and up-to-date in order to maintain certification in the form of training, documentation, and procedures
  • Lead QM community for E&T Americas and guide QM Deputies at major E&T sites
  • Serve as key QM contact to the global QM community and ensure global initiatives are communicated and implemented in the Americas
  • Lead quarterly meetings with QM deputies to drive alignment across E&T Americas on QM topics and provide a platform for collaboration and improvement
  • Set and achieve annual strategic continuous improvement goals for E&T for talent development
  • Set annual talent development strategy based on E&T strategic goals and divisional demand
  • Determine training focus areas
  • Develop personnel training roadmap for E&T Americas to optimize organizational competence in line with divisional demand
  • Select external training providers and/or develop in-house training courses best suited to advance E&T Americas organizational competence
  • Identify and drive implementation of process improvements in the areas of efficiency and quality
  • Work with E&T Americas unit heads & group heads and divisional stakeholders to identify areas for improvement
  • Analyze opportunities and recommend most value-added opportunities to E&T Americas leadership team
  • Act as project manager in implementation of approved process improvements
  • Coordinate E&T Americas efforts related to Bayer strategic initiatives on culture and people development (e.g. LIFE, Focus Behaviors)
  • Be responsible for Health, Safety, and Environment (HSE) within E&T Americas
  • Be a standing member and key contributor to the E&T Americas safety committee
  • Bachelor’s degree in either engineering, business, or HSEQ related field with at least ten (10) years of related experience
  • Relevant work experience, especially quality management experience
  • Experience in Project Management or in the Engineering industry
  • Certification(s) in QM or ISO
59

Office Manager, Health Services Resume Examples & Samples

  • Assist Supervisor(s) in establishing positive employee relations programs and practices
  • Schedules and provides support for monthly and quarterly meetings
  • Responsible for maintaining overall function, supplies and equipment of office; submits work orders as needed
  • Establishes and maintains filing systems for the department
  • Distributes departmental mail, confidential intercompany and external correspondence, and resident correspondence (hard copy and email). Prepares FedEx shipping labels, as assigned
  • Covers the RG front desk as needed
  • Serves as contributor and editor of monthly RG Newsletter, The Garden Gazette
  • Provides confidential administrative support for supervisor, including but not limited to: telephone screening, assistance with written correspondence, and maintenance of calendar(s)
  • Responsible for printing and distributing financial reports to appropriate supervisors and managers within established timeframes
  • Manages budgetary responsibilities as assigned
  • Prepares and codes invoices and other bills for supervisors’ approval and forwards to AP within established timeframes
  • Actively participates in Survey Team per established guidelines
  • Maintains binder of vendor contracts and accompanying documentation
  • Coordinates Information Services needs for new management
  • Schedules and coordinates travel arrangements as needed
  • Excellent written, oral, and organizational skills
  • Demonstrated proficiency with current computer software applications required
  • Independent thinker, self-motivated, organized, flexible and dependable
  • Ability to manage a budget
  • Ability to perform strategic planning and all day-to-day operations of an administrative office
  • Ability to perform job responsibilities with accuracy, thoroughness and timeliness
  • Ability to accept criticism and apply to work-related duties
  • Sound and accurate judgment
  • Ability to manage competing demands and adapt to changes in the work environment
  • Ability to react well under pressure
  • Expertise with proofreading and data analysis
  • Ability to learn and apply new skills as they relate to computer systems and departmental/company initiatives
  • High school or GED required; some college preferred
  • Minimum of 2-5 years of progressive, practical experience in administration required
  • Health care background preferred
  • Regularly required to talk and hear
  • Frequently required to stand, walk, use hands to finger/handle objects, and reach with hands and arms
  • Must occasionally lift and/or move up to 50 lbs
  • May provide input into policies
60

Manager, Health Care Administration Resume Examples & Samples

  • Formal training in a dental position, such as dental assistant or dental hygienist
  • Two years of working experience in a dental position, such as dental assistant or dental hygienist
  • Experience dealing with acquiring, distributing, and tracking dental instruments
  • Experience dealing with purchasing systems, vendors, and accounting procedures
  • Experience working with computers and electronic applications
61

Senior Manager Health Business Analytics Resume Examples & Samples

  • 8+ years of related experience or equivalent combination of transferrable experience and education
  • 3 or more years of successful formal leadership or management experience
  • Experience working with pricing and other key financial departments
  • Experience working with statistical methodologies and risk adjusters
  • Experience using algorithms and inferential statistics
  • Advanced level experience writing SQL /SAS or related code
  • Expert consulting, negotiating, communicating , consensus building, presentation and facilitation skills
  • In-depth business process knowledge of several key business functional areas
  • Expert-level ability communicating highly complex information clearly and articulately for all levels and audiences
  • Demonstrated leadership abilities including effective knowledge sharing and conflict resolution
  • Experience using SQL or SAS in performing quantitative healthcare cost analysis
  • Experience communicating and presenting detailed business and financial information
  • Ability to build trust and strategic partnerships with assigned business area contacts, project teams and leadership to facilitate two-way communication
  • Ability to understand overall Analytics strategy and apply/implement the strategy in assigned projects/initiatives
  • Experience oversight of data exchanges to aligned providers and/or third party vendors required to support the agreements
  • Experience managing risk and/or value based models of care reconciliation
  • Bachelors degree in Business Analytics, Health Economics or similar program is preferred
62

Manager Health Analytics Resume Examples & Samples

  • Analyze data to provide meaningful insight into key business challenges of clients or internal business users, as appropriate
  • Perform quantitative data analytics
  • Communicate analytic based findings to senior level audiences (internal and external)
  • Perform analytics on a relational dataset to identify root causes, patterns, trends and recommend priorities
  • Develop predictive models to project health care measurement performance and intervention strategies to influence future performance
  • Translate business requirements into actionable analytics requests
  • Perform defined analyses to assess proper outcome metrics for quality improvement product
  • Execute client implementation related data analytics outputs
  • Oversee ongoing review of health plan client data integrity and data coding issues and their impact on product quality
  • Develop and refine specifications for core features of quality improvement product to generate key performance indicators
  • Support business development opportunities in the expansion of products and services
  • Manage progress, flow and timing of various deliverables
  • Work on/assist with development of software and other tools to enable work of group
  • Provide insight into and develop new analytics and tools that will add value to the business
  • Ability to consistently exercise good judgment while making decisions
  • Proven ability to work independently as well as a cooperative team member
  • Exceptional organizational skills to establish priorities and manage multiple activities to meet deadlines
  • Proven ability to exercise discretion and judgment in dealing with confidential and sensitive information
63

Manager Health Outcomes RRP Resume Examples & Samples

  • Coordinate and support PMI R&D’s ongoing post-market assessment studies in Japan with a collaboration with CROs (clinical research organization)
  • Drive locally-initiated diseases risk reduction (health outcome) studies in Japan with a collaboration with PMI R&D and CROs
  • Explore opportunities of new assessment study for IQOS by utilizing different sources (consultants, KSOL engagements, etc). Engage effectively with potential study collaborators to realize the study in a collaboration with PMI R&D
  • Identify, analyze and assess political and regulatory trends that affect the industry and our business, particularly from scientific and health aspects
  • Strategic planning, driving and managing advocacy engagements with political, bureaucratic, scientific stakeholders, and other relevant opinion leaders to build allies/coalitions in support of tobacco harm reduction and the creation of a welcoming RRP environment in Japan
  • Educating internal stakeholders on scientific regulatory affairs and science behind PMI's RRP efforts. Educating internal stakeholders on regulatory/ business environment and science behind PMI's RRP efforts
  • Drive locally-initiated Diseases Risk Reduction (Health Outcome) Studies in Japan with a collaboration with PMI R&D and CROs
  • Educating internal stakeholders on scientific regulatory affairs and science behind PMI's RRP efforts