Showe and Associates LLC
Executive Recruiting Services for the Managed Healthcare Industry
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Director, Provider Payment Innovation (Provider Network Management) Fantastic opportunity to join Fortune 100 leading healthcare enterprise experiencing incredible growth and market expansion. Design, implement and optimize innovative and value-based payment contracting strategies for the health plan to include the development of a broad vision, short and long-term objectives and execution of key business initiatives across all products. Collaborate with multiple functional health plan....

- Fort Lauderdale, FL

Job descriptionPosition Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective


This dynamic department is looking for an HEOR professional (AD Level) he/she will be responsible and accountable for project execution and strategic support for Company’ products throughout their lifecycle. He/she will help to develop and implement US economics and outcomes strategy for one or multiple therapeutic area(s). This is a strategic as well as a technical position with project-specific responsibilities. This individual will ensure that rigorous health economics and outcomes research


Responsible for defining and directing a complete Case Management Program in conjunction with corporate goals and objectivesDirect the overall operational leadership of case management functions, including utilization management and staffPerform and oversee needs analysis and planningWork with executive leadership to ensure targets are met for the annual operating plan/financial managementEnsure compliance with Corporate, State and NCQA standardsDevelop and implement methods, policies, and....


Director, Case Management Fantastic opportunity to join Fortune 100 leading healthcare enterprise experiencing incredible growth and market expansion. Responsible for defining and directing a complete Case Management Program in conjunction with corporate goals and objectivesDirect the overall operational leadership of case management functions and staffPerform and oversee needs analysis and planningWork with executive leadership to ensure targets are met for the annual operating plan/financial


Senior Director, Contracting & Network Development Fantastic opportunity to join our Fortune 100 leading healthcare enterprise experiencing incredible growth and market expansion! Senior Director will oversee the development and implementation of contracting activities in network development and enhancement.Work with Business Development and Providers to develop a strategy for developing new networks including plans to meet network access and unit cost objectives.Determine necessary....


Our firm is in search of a Director of Case Management who has at least 3-5 years experience leading other Case Managers in a health plan work setting. This is a NEWLY CREATED POSITION. We need someone who can step right into the role and be a “trail-blazer”. This role reports to the Vice President of Complex Care Programs. What is great about this role and company? : Here you would be part of an exciting, highly credible managed care organization that offers growth opportunity. Our client is....


Vice President Network Development & Contracting Seeking a Change Agent motivated to get things done with a strong background in value-based contracting and knowledge of public policy for this leading healthcare enterprise! Reporting directly to the SVP Operations, the VP Network Development & Contracting will Direct the provider network and contracting activities, Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers....


Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance....


Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures. Reports to the VP New Business Contracting Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulationsImplement development activities for the recruitment and contracting of provider networks in new and....


Medical Director - Behavioral HealthProvide Psychiatric Medical Support for the Health Plan Focused Areas: Provides psychiatric medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members Assists the Chief Medical....


Medical Director (Psychiatrist) Utilization ManagementPosition Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or....


Vice President, Compliance (WA, NM, FL)Ensure regulatory compliance with state and other government agencies related to the health insurance industry, and its business subsidiaries. Report directly to the COO. Develop and implement a strategic vision for compliance and ethics culture within the business unit ensuring alignment with CorporateEnsure business unit is in compliance with state and federal program regulations, insurance regulations, regulatory requirements for business entities and....


Vice President Network Development & Contracting Seeking a Change Agent motivated to get things done with a strong background in value-based contracting and knowledge of public policy for this leading healthcare enterprise! Reporting directly to the COO, the VP Network Development & Contracting will Direct the provider network and contracting activities, Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with....


Vice President Network Development & Contracting Seeking a Change Agent motivated to get things done with a strong background in value-based contracting and knowledge of public policy for this leading healthcare enterprise! Reporting directly to the SVP Operations, the VP Network Development & Contracting will Direct the provider network and contracting activities, Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers....

- Santa Clarita, CA

The Home Health Clinical Supervisor is responsible for ensuring that patient care is coordinated and managed appropriately. The Clinical Supervisor is responsible for the clinical activities of the field staff. The clinical supervisor plans, implements and evaluates patient's plan of care for appropriateness to the individual patients needs. Great promote from with in opportunity too!Assesses and supervises the delivery of nursing servicesPerforms home supervisory visits of nursing services....


We are in search of a RN or Healthcare Administrator to manage the Medicare STARs across our client company’s Medicare Plans. To be considered you should be currently involved in leading a STARS program. Here is what our qualified candidate looks like:Experience in STARS and leading STARS Program.7+ years of managed care experience – MedicareKnowledge of Center for Medicare/Medicaid Services, requirements for Special Needs Plans (SNP), Medicare Medicaid Plans (MMP) and NCQA oversight....


Manufacturing Engineer IIOur client is a publicly traded leading contract design and manufacturing company with a specialization in electronic and electro-mechanical assemblies. Our customers include, Military, Medical, Biotechnology and Aerospace companies that are highly regulated with specialized needs. Basic Purpose of Position: Responsible for the technical support of customer products and the overall ownership of quality and accuracy in building customer products. Primary technical....

- Manhattan, NY

As a Study Leader Team Lead/Assistant Director, you will manage and mentor a group of approximately 10 study leaders and associates in order to maximize their capabilities to deliver high quality clinical studies. People Management · Coach and develop global staff to maximize their contribution to the delivery of studies across various therapeutic areas · Manage performance of direct reports through regular dialog and throughout the year in accordance with the Roche performance management....

- Victorville, CA

The Clinical Supervisor is responsible for ensuring that patient care is coordinated and managed appropriately. The Clinical Supervisor is responsible for the clinical activities of the field staff. The clinical supervisor plans, implements and evaluates patient's plan of care for appropriateness to the individual patients needs. Great promote from with in opportunity too!Assesses and supervises the delivery of nursing servicesPerforms home supervisory visits of nursing services delivered by....

21-40 of 45 results