- Teva Pharmaceuticals (Parsippany, NJ)
- Director Medicaid - Remote Date: Oct 30, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 58940 **Who we ... market access strategies to maximize profitability and success across Medicaid accounts. The Director will lead efforts to ensure Teva stakeholders are abreast… more
- Highmark Health (Columbus, OH)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic… more
- Humana (Columbus, OH)
- …help us put health first** Humana Healthy Horizons is seeking an Associate Director , Medicaid Implementation (Business Project Management) to lead within a ... management are best suited for this role. The Associate Director , Medicaid Implementation (Business Project Management) will...Up to 25% to Humana office locations. + **Workstyle:** Remote , must work hours within the eastern time zone.… more
- Elevance Health (Buffalo, NY)
- ** Medicaid Quality Management Director ** Location: This position will work a hybrid model ( remote and office). The candidate must live within 50 miles of the ... and reports quality measures per state, Centers for Medicare and Medicaid Services (CMS), and accrediting requirements. **Minimum Requirements:** + Requires BA/BS… more
- Motion Recruitment Partners (Canton, MA)
- Project Manager - Medicaid Canton, Massachusetts **Open to Remote ** Contract $65/hr - $65/hr Our client is looking for a contract Project Manager - Medicaid . ... to Canton, MA. However, the client is amenable to remote work as long as the candidate resides in...in CST or EST. As the Project Manager - Medicaid , you will be the driving force behind the… more
- Elevance Health (Overland Park, KS)
- **Nurse Appeals Lead- Medicaid Appeals** Location: This position will work a hybrid model ( remote and in office). The ideal candidate will live within 50 miles of ... medical necessity. + Extrapolates and summarizes medical information for medical director , consultants and other external review. + Prepares recommendations to… more
- Molina Healthcare (Louisville, KY)
- …into business requirements. In partnership with Plan Growth Leaders, the Director , Customer Experience is responsible for developing, implementing and monitoring a ... successful strategy to achieve Molina's Medicaid membership retention goals & objectives across the enterprise...retention goals & objectives across the enterprise for the Medicaid lines of business (TANF, ABD, Expansion, CHIP) including… more
- Magellan Health Services (San Diego, CA)
- …MMUM). After Hours coverage may be required. General Job Information Title Medical Director , Behavioral Health (Part Time, Remote ), Licensed/Reside in CA Grade ... This position is remote in California, candidates must be licensed and...for the health plan(s) for all lines of business ( Medicaid , Medicare, and Commercial) and implements programs to support… more
- Conviva (Columbus, OH)
- …of our caring community and help us put health first** The Associate Director , Security Architecture will play a key role in implementing security architecture, ... ensure the enterprise can achieve the enterprise security strategy. The Associate Director , Security Architecture will play a key role in implementing security… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Sr. Director , Pharmacy Network Management - Remote **Job Description** The Senior ... Qualifications** + MBA,othergraduatework,orequivalenttrainingand/orexperience + IntimateknowledgeofandexperiencewithinthePBMindustry, Medicaid ,Medicare,andhealthplans + Familiaritywithcontractlanguageandriskmitigationconcepts +… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description ... (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA-National Committee for Quality Assurance, and ERISA-Employee… more
- Walgreens (Deerfield, IL)
- …disability/veterans". $159-215-271K \#LI-TO1 **Job ID:** 1414700BR **Title:** National Director , Healthcare Consultant Relations Remote **Company Indicator:** ... various other providers, etc), the various lines of business (Commerical, Medicare, Medicaid , etc) and the various healthcare services provided in the overall… more
- Public Partnerships LLC (Alpharetta, GA)
- …and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and ... experience, including a minimum of 5 years working with Medicaid programs. + A minimum of 5 years working...state government and health plan clients. **Working Conditions:** + Remote Office Setting. + Local, statewide, and national travel… more
- Kepro (NC)
- Acentra is looking for a Software Quality Assurance Director to join our growing team. Job Summary: As the Software Quality Assurance Director at Acentra Health, ... and execute project plans. + Strong domain knowledge of Medicare, Medicaid , or healthcare verticals. + Excellent problem-solving, analytical, and evaluative skills,… more
- The Cigna Group (Bloomfield, CT)
- …**_Evernorth Workplace Care - Personalized Care Where You Are_** ** Director , Occupational Health Services** Provides strategic thought leadership and directs ... privacy standards, regulatory compliance (OSHA, CDC, Centers for Medicare and Medicaid , HIPAA, and management of reputational issues. * Represents Occupational… more
- Amneal Pharmaceuticals (Washington, DC)
- Description: The Director , State Government Business plays a pivotal role in leading and managing State Government partnerships in collaboration with Government ... Children & Families, Department of Emergency Management, Department of Justice, and Medicaid . This position reports directly to Amneal's VP of Government Business… more
- Public Partnerships LLC (Columbus, OH)
- …and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and ... **15+ years of engineering experience in the Healthcare Space working with CMS, Medicaid Agencies, HIEs and Commercial Health Plans, with deep experience working on… more
- Molina Healthcare (Starkville, MS)
- …Committees. * Manages and reports network adequacy for Medicare, Marketplace, and Medicaid services. * In conjunction with direct management and senior leadership, ... of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to;… more
- Molina Healthcare (Louisville, KY)
- …**Health Plan Performance metrics.** + **Health Plan operations experience - Medicaid & Medicare.** + **Process documentation experience.** + **Management consulting ... experience.** **Preferred License, Certification, Association** CPHQ To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and… more
- CVS Health (Sacramento, CA)
- …Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Double Board Certified Oncologist/Internal Medicine ... for this opportunity. This is a remote based from from home role. The Medical Affairs...Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director (Medical Affairs) will report into the Medical Affairs… more