- Bachelor's degree in health administration or a related field required. Advanced coursework and/or Master's degree preferred. Minimum 3-5 years of managed care experience, specifically in government programs, is required years in Strategic Planning, years in Operational Excellence, Vendor Management, years in Medicare, Medicaid and Commercial;
- TRICARE/TRICARE PRIME experience a plus
- Minimum of 8- 10 years of healthcare experience with thorough knowledge of healthcare quality improvement, industry standard performance measures, healthcare reimbursement including valued based purchasing methodology and management, managed care, and tactics that result in member and provider engagement. Prefer 3-5 year supervisory experience and experience with government contracts related to healthcare deliverables
-
Johns Hopkins Health System Hanover, United StatesJob Summary · Under the direction of the Associate Chief Medical Officer, Quality & Transformation, this execution-focused position of the Quality Performance Director, for Medicaid, USFHP & EHP will support quality performance management for the Medicaid line of business, Priori ...
-
Operator
1 week ago
Ring Container Technologies Hanover, United States3rd Shift Sunday through Thursday 9:45pm-6:00am · Starting Rate $20.50/hr · Clean, climate controlled work environment · Excellent Benefits after 30 days · Vacation Time after 90 days · Job Purpose · To operate production machinery safely and efficiently; maintain appropriate doc ...
-
Squire
1 week ago
Medieval Times Dinner & Tournament Hanover, United StatesMedieval Times is looking for PERFORMERS (Squires) for our live action dinner show. Squires assist all of His Majestys Brave Knights. **Successful training and performance as a Squire is a prerequisite for advancement into the role of Knight** · **WHAT DOES A SQUIRE DO?** · The S ...
-
Production Associate
1 week ago
AquaPhoenix Scientific LLC Hanover, United StatesAquaPhoenix Scientific, located in Hanover, PA, has immediate openings for production associates as a result of expanding business needs. Responsibilities include accurately selecting, mixing, staging, and packaging various components in support of the production/manufacturing pr ...
-
Digital Sheetfed Press Operator
1 week ago
Sheridan Press Hanover, United States**Job Summary**: · Responsible for the efficient operation and quality of the Digital Sheetfed Presses for Sheridan Digital products. · **Duties/Responsibilities**: · - Analyze and interpret job jackets to thoroughly understand job specs, workflow and/or customer instructions. · ...
-
Bw Scheduling Coordinator
1 week ago
University of Maryland Medical System Hanover, United States**Company Description** · Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021 As part of the acclaimed Universit ...
-
Cmo
2 weeks ago
Johns Hopkins Health Plans Hanover, United StatesJohns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3.2B business serving nearly 500,000 members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investmen ...
-
Sit Down Forklift
2 weeks ago
Hanover Foods Corporation Hanover, United StatesHanover Foods Corporation located in Hanover PA is currently seeking a **Checker** position on 2nd shift. This position is primarily responsible for performing BPCS, distribution and audit functions to ensure accurate reporting of inventory movement. · **Primary responsibilities* ...
-
Manager, Operations
5 days ago
Knorr-Bremse Hanover, United States**LOCATION**:Hanover / Pennsylvania (US-PA), United States | **BRAND**: Sheppard | **REQUISITION ID**:5981 |** JOB GRADE**: 19 · |** ON-SITE/REMOTE**: On-site · Founded in 1937, R.H. Sheppard Co. Inc. has a rich history of innovative design and American manufacturing excellence. ...
-
Central Sterile Processing Technician
5 days ago
UPMC Hanover, United StatesTo perform those duties necessary for the proper decontamination, cleaning, inspection, assembly, packaging, sterilization, storage, distribution and documentation of reusable surgical instrumentation and equipment according to established procedures. · **Responsibilities**: · - ...
-
Quality Improvement Business Analyst
2 weeks ago
Johns Hopkins Health Plans Hanover, United States Full time**_Who you are:_** · As a Business Analyst in Quality Improvement for Johns Hopkins Health Plans, you will work with a team to improve HEDIS measure performance across three lines of business including one Medicaid and two commercial plans. You are detail-oriented and able to mai ...
-
Associate Director Drug Supply
6 days ago
Novartis East Hanover, United States**Summary**: · About the Role: This position is directly accountable for Raw Material Planning, Purchasing, Clinical Warehouse Operations, Compliance, Budget, and Staffing. Major responsibilities include being responsible for and leading materials management and cGMP Warehouse Op ...
-
Warehouse Operations Supervisor
2 weeks ago
Owens and Minor Hanover, United States**Summary** · Directs Operations activities and teammates within the Distribution Center (DC). · **Core Responsibilities** · - Manages teammate time, attendance, and schedules (work shift, vacation) for assigned functional area(s). · - Provides proactive performance feedback to t ...
-
Warranty Clerk
2 weeks ago
Knorr-Bremse Hanover, United States**LOCATION**:Hanover / Pennsylvania (US-PA), United States | **BRAND**: Sheppard | **REQUISITION ID**:6072 |** JOB GRADE**: 11 · |** ON-SITE/REMOTE**: On-site · Founded in 1937, R.H. Sheppard Co. Inc. has a rich history of innovative design and American manufacturing excellence. ...
-
U Heavy Laborer
2 weeks ago
Hanover Foods Corporation Hanover, United StatesHanover Foods Corporation located in Hanover PA is currently seeking a **Heavy Laborer**. This position is primarily responsible for performing general, non-mechanical laborer duties throughout the Plant. · **Primary responsibilities** · 1. Sight inspects and removes defects or a ...
-
General Production Worker
2 weeks ago
Weiss-Aug Group - East Hanover, NJ East Hanover, United States: · Weiss-Aug Group is an internationally recognized leader in precision metal stamping, injection molding, value-added assembly solutions and tooling. · At our Corporate Headquarters we have served the medical device industry, automotive industry, and industrial sector for over ...
-
Assembly Technician
1 week ago
Johnson Health Tech North America Inc Hanover Township, United States: · **Pay**:$19.00 per hour · **Hours**:6am-2:30pm Mon-Fri. If there is OT the schedule will be 6am-4:30pm Mon-Fri with Saturdays as needed. · **Location**:175 Logistics Suite #200 Drive Hanover Township, PA 18706 · **Position Overview**: · Under the direction of the Assembly Sup ...
-
Associate Director, Supplier Management Lead
1 week ago
Novartis East Hanover, United States**Summary**: · The purpose of the Supplier Management Lead role is to establish and maintain a standardized supplier framework, monitor supplier performance against KPIs, conduct business reviews, and collaborate with procurement to select and manage suppliers. Additionally, they ...
-
Breakfast Attendant
1 week ago
Residence Inn Arundel Mills Hanover, United StatesJob Summary: · The Complimentary AM Attendant is responsible for providing the highest quality of service possible to guests in an efficient and courteous manner within the complimentary breakfast area of a hotel. In addition this individual shall be well-versed on the hotel-bran ...
-
Mixer Extruder
1 week ago
UTZ Brands, Inc Hanover, United StatesUtz Quality Foods is looking to grow our loyal, career driven, and customer focused team, and are currently recruiting for a **Mixer Extruder **to join our team of manufacturing professionals in **Hanover, PA** on our **Week Day Shift.** · This position works **Monday-Thursday 5: ...
Director of Medicaid and Commercial Quality Performance - Hanover, United States - Johns Hopkins Health Plans
Description
Job Summary
Under the direction of the Associate Chief Medical Officer, Quality & Transformation, this execution-focused position of the Quality Performance Director, for Medicaid, USFHP & EHP will support quality performance management for the Medicaid line of business, Priority Partners Managed Care organization (PPMCO), TRICARE Prime (USFHP), and Commercial (Employer Health Program) lines of business for JHHP.
Responsible for developing and driving the enterprise-wide Medicaid VBP, USFHP, and EHP performance improvement and implementation through evaluating strategies, external capabilities and vendors to help drive best-in-industry performance. Responsible for identifying innovative strategies to set market leading performance for PPMCO VBP, USFHP, and EHP measures and initiatives. Must have deep industry connections to cutting edge strategies and external partners that can accelerate and maintain as an industry leader. Works collaboratively with PPMCO, USFHP, and EHP, enterprise leaders, and internal leadership to establish baseline capabilities and develop strategies for capability enhancement. Extensive market knowledge and research capability is necessary to best be able to evaluate opportunities. Collaborates and coordinates work with peers, other departments within matrix/shared service partners (including but not limited to Provider Relations, Pharmacy, Care Management, Utilization Management, Compliance, Appeals, Marketing and Communications, and IT).
This position will be responsible for the planning, development and execution of activities that support the Maryland Department of Health (MDH) or External Quality Review Organization (EQRO), Qlarant required deliverables such as audits, corrective actions, performance improvement plans (PIPs) as well as VBP strategies. In addition, this position will serve as quality lead for USFHP and EHP deliverables related to quality improvement.
Qualifications