• Director Medicaid - Remote

    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
    Teva Pharmaceuticals (10/31/24)
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  • Medical Director , Medicaid

    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
    Highmark Health (08/23/24)
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  • The Associate Director , Medicaid

    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
    Humana (10/29/24)
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  • Medicaid Quality Management Director

    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
    Elevance Health (10/25/24)
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  • Project Manager - Medicaid

    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
    Motion Recruitment Partners (09/19/24)
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  • Nurse Appeals Lead- Medicaid Appeals

    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
    Elevance Health (10/11/24)
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  • Director , Customer Experience (IT…

    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
    Molina Healthcare (10/17/24)
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  • Medical Director , Behavioral Health (Part…

    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
    Magellan Health Services (10/27/24)
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  • Associate Director , Security Architecture(…

    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
    Conviva (10/30/24)
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  • Sr. Director , Pharmacy Network Management…

    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 (10/24/24)
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  • Director , Specialty Clinical Solutions-…

    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
    Prime Therapeutics (08/23/24)
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  • National Director , Healthcare Consultant…

    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
    Walgreens (09/24/24)
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  • Sr Regional Director - Remote USA

    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
    Public Partnerships LLC (09/21/24)
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  • Director of Software Quality Assurance -…

    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
    Kepro (10/21/24)
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  • Director - Occupational Health Services…

    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
    The Cigna Group (10/19/24)
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  • Director , State Government Business…

    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
    Amneal Pharmaceuticals (09/04/24)
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  • Director of Engineering - Remote US

    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
    Public Partnerships LLC (10/19/24)
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  • Director , Provider Contracts / Health Plan…

    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 (10/13/24)
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  • Program Director (Health Plan Performance)…

    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
    Molina Healthcare (10/24/24)
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  • Medical Director - Medical Affairs…

    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
    CVS Health (08/23/24)
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