GEHA, Inc.

Summary Responsible for supervising the daily operations of the Care Management Department clinical programs and processes. Serves as the primary contact for staff, assigned to internal and external programs, and escalated care management issues. Assists Administrator/Manager with developing Care Management and utilization policies and procedures. Monitors internal and external policies and ...read more

Summary The Nurse Consultant II provides professional nursing care to our members through the execution of key duties within the discipline of the Clinical Operations division. Incumbents at level II support members through assessment, evaluation, planning, and evidence-based research that promotes optimum health care and service delivery. Key responsibilities may include assessment of open gaps ...read more

Summary The Clinical Operations Analyst (Non IT) plays a pivotal role in GEHA and is responsible for the analysis, development, and delivery of comprehensive clinical reports that provide actionable insights to senior leadership. This position requires a strong background in healthcare data analysis, a deep understanding of clinical operations, and the ability to translate complex data into ...read more

Summary The Medicare Part D Performance Management Specialist will report to the Director of Pharmacy and will be responsible for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP lines of business.    Duties Serves as a subject matter expert to Centers for Medicare & Medicaid Services (CMS) Part D / EGWP regulatory requirements.Able to ...read more

Summary The Director - Procurement and Vendor Management COE and Performance Management, reporting to the VP, Vendor Management Office, will own three distinct functions – VMO Center of Excellence, TPRM & Critical Contract oversight (non-UMR). Responsible for driving operational excellence and function as the senior executive for vendor contracts oversight. Provide leadership in the ...read more

Summary The Senior Clinical Business Process Analyst role is critical to GEHA, responsible for overseeing the large-scale integration of clinical platforms across multiple departments, including Population Health, Health & Wellbeing, Clinical Quality, Pharmacy, Medical Management, and Dental. This role ensures that all internal stakeholders are aligned with a new vendor's processes, facilitates ...read more