Martin’s Point Health Care

Marketing Production Specialist - Remote

Martin’s Point Health Care · Full Time · 6 days ago

Martin’s Point Health Care

🌎 United States ⭐ 5-10 yrs exp 💼 Marketing

The Marketing Production Specialist manages the workflow of all marketing projects, ensuring they meet deadlines, quality standards, and budget requirements. This role serves as the primary contact for print and mail vendors and maintains the project management system to optimize production efficiency.

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Remote HEDIS Nurse Reviewer – New England Region

Martin’s Point Health Care · Full Time · 14 days ago

Martin’s Point Health Care

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Perform clinical chart reviews and audits to ensure compliance with HEDIS measures and identify care gaps. Collaborate with providers and cross-functional teams to improve healthcare outcomes and maintain quality benchmarks.

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Senior Network Representative (remote) - Pittsburg or Cleveland territory

Martin’s Point Health Care · Full Time · 20 days ago

Martin’s Point Health Care

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Responsible for contracting, educating, and maintaining provider networks to deliver clinical and financial value. This includes recruiting new providers, managing high-level renegotiations, and ensuring compliance with HEDIS/NCQA and CMS requirements.

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REMOTE - Vice President Medical Director of Clinical Programs

Martin’s Point Health Care · Full Time · 21 days ago

Martin’s Point Health Care

🌎 United States ⭐ 10+ yrs exp 💼 Healthcare

The VP Medical Director manages Health Plan Medical Directors to provide clinical support for utilization, care, and quality management teams. They drive the development of evidence-based programs to manage medical expenses, quality outcomes, and utilization trends.

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Senior Director, Claims & Payment Integrity - Remote

Martin’s Point Health Care · Full Time · a month ago

Martin’s Point Health Care

🌎 United States ⭐ 10+ yrs exp 💼 Legal

Oversee health plan claims administration and payment integrity functions to ensure payment accuracy and regulatory compliance. Manage vendor relationships, optimize system processing, and develop provider payment methodologies and fee schedules.

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Senior Finance Business Partner - Remote

Martin’s Point Health Care · Full Time · 2 months ago

Martin’s Point Health Care

🌎 United States ⭐ 5-10 yrs exp 💼 Finance

Perform in-depth financial analyses, including ROI and business case evaluations, to support strategic organizational decisions. Collaborate with leadership to develop forecasting tools and monitor monthly financial performance to drive margin improvements.

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Utilization Review Nurse - Remote

Martin’s Point Health Care · Full Time · 9 months ago

Martin’s Point Health Care

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Utilization Review Nurse ensures high-quality, cost-efficient medical outcomes for enrollees needing inpatient/outpatient authorizations. Responsibilities include reviewing prior authorization requests, coordinating transitions of care, and managing health care within compliance regulations.

insurance medical communication microsoft-office documentation organization compliance

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