- Humana (Columbia, SC)
- …a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence ... Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing … more
- Humana (Nashville, TN)
- …caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical ... effectiveness within the Medicaid segment. This function integrates Medical Economics, Clinical Insights, and Quality to deliver improved health outcomes, optimized… more
- MyFlorida (Tallahassee, FL)
- MEDICAID WAIVER LIAISON - 67016101 Date: Jan 6, 2026 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 864789 Agency: Agency for Persons with Disabilities Working Title: MEDICAID WAIVER LIAISON - 67016101 Pay Plan: Career Service Position Number:… more
- State of Minnesota (St. Paul, MN)
- **Working Title: School-Based Medicaid Specialist** **Job Class: Human Services Program Representative 2** **Agency: Human Services Dept** + **Job ID** : 88770 + ... approval._** This position exists to provide comprehensive support regarding Medicaid policy for school-based services, focusing on infrastructure, billing,… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States of America) Range: UR ... high risk self pay acute care patients for the purpose of securing Medicaid eligibility. Shares Medicaid knowledge by providing consultation to Physicians,… more
- Humana (Austin, TX)
- …help us put health first** The National Dental Contracting Professional - Medicaid is responsible for identifying, engaging, and contracting with qualified dentists ... to join the insurance carrier's Medicaid dental network. This role ensures the network meets...meets accessibility, quality, and compliance standards as required by Medicaid regulations and company policies. The recruiter develops relationships… more
- General Dynamics Information Technology (Fairfax, VA)
- …**Public Trust/Other Required:** Other **Job Family:** Software Engineering **Skills:** Medicaid , Medicaid Claims, Medicaid Management Information System ... team is dedicated to improving the efficiency and effectiveness of Medicaid Management Information Systems (MMIS). We are seeking talented technical professionals… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Jan 2, 2026 Location: Parsippany, United States, 07054 Company: Teva Pharmaceuticals Job Id: 64915 **Who we are** Together, we're on a ... people to make a difference with. **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid ...The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing… more
- PruittHealth (Norcross, GA)
- …the Elderly and Disabled Waiver Program (EDWP) clients who do not have active Medicaid eligibility [Potential Medicaid Assistance Only (PMAO) or Medicaid ... eligibility or continued eligibility status 3. Assists EDWP clients with the Medicaid Application process and renewals 4. Collects copies of financial documents from… more
- CareFirst (Baltimore, MD)
- …for directing all aspects related to the monitoring of performance under the Medicaid contract and regulatory requirements and the overall state of compliance for ... Medicaid and Medicaid products. Reporting to the CEO, Plan Board of Directors, and Corporate Compliance Officer, the incumbent works closely with operational… more
- PruittHealth (Charlotte Hall, MD)
- **JOB PURPOSE:** The Business Office Medicaid Specialist plays a crucial role in supporting the financial operations of the organization, specifically focusing on ... Medicaid and compliance. This position is responsible for assisting...the business office, ensuring accurate and timely processing of Medicaid applications, managing resident accounts, and maintaining compliance with… more
- Humana (Madison, WI)
- …of our caring community and help us put health first** The Wisconsin Medicaid Market CFO provides strategic financial leadership for Humana's Medicaid operations ... and serving as the primary financial liaison to the Wisconsin Medicaid agency. **Key Responsibilities** **Provide market-specific financial leadership, developing a… more
- City of New York (New York, NY)
- …an area called the Office of Quality Assurance & Fiscal Integrity, the Medicaid Quality Control Unit (MAQC). They conduct complex internal audits and quality control ... need for corrective action plans and/or training. MAQC also ensures the Medicaid programs' continuous adherence to state and federal regulations. State and Federal… more
- CVS Health (Annapolis, MD)
- …The Manager of Claims Management is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and compliance monitoring. ... This role ensures timely and accurate processing of Medicaid claims in accordance with state and federal regulations, contractual requirements, and organizational… more
- DATAMAXIS (Springfield, IL)
- …Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations. * With the specialized ... knowledge of the Medicaid and Children's Health Insurance Programs, lead and guide...and third-party liability. * Proactively identify and understand state Medicaid agency data needs and determines the recommended solution… more
- HCA Healthcare (Asheville, NC)
- …of each individual is recognized. Submit your application for the opportunity below: ** Medicaid Specialist with our PACE (Program of All Inclusive Care for the ... benefits may vary by location._** We are seeking a ** Medicaid Specialist with our PACE Program** for our team...to apply! **Job Summary and Qualifications** Role Summary: The Medicaid Specialist plays a critical role in supporting the… more
- Commonwealth Care Alliance (Boston, MA)
- …that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and ... as necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Indiana Medicaid Market CFO analyzes and forecasts financial, economic, and other data to provide ... of financial operations for Indiana's Pathway's Plan with a focus on Medicaid and state partnership, oversees the budget, financial reporting, and all audit… more
- Prime Therapeutics (Frankfort, KY)
- …we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government Programs - Medicare & ... Managed Medicaid is responsible for the development, administration, and execution...+ Provide leadership and oversight to the Medicare and Medicaid teams and ensure the development and execution of… more
- Genesis Healthcare (NH)
- …we serve. Responsibilities Do you have a knack for navigating the complexities of Medicaid eligibility? Then join us as a Regional Floating Medicaid Application ... geography, you will improve the quality of all revenue cycle management Medicaid Eligibility related functions, from patient pre-admission to discharge, to optimize… more