- ABBTECH Professional Resources, Inc. (Charlotte Amalie, VI)
- …Analyst (preferred), Salesforce Certified Administrator, or Salesforce Experince Cloud Consultant - SalesforceEducation: certification will be verified on ... to remotely to support the Centers for Medicare & Medicaid Services (CMS) activities. As a Salesforce Business Analyst...work independently Preferred Skills: - Possess a valid SAFe certification , such as SAFe Product Owner or SAFe Agilist.… more
- Elevance Health (Indianapolis, IN)
- **Behavioral Health Medical Director - Psychiatrist - Indiana Medicaid ** **Location:** This role enables associates to work virtually full-time, with the exception ... Medical Director** is responsible for reviewing cases for IN Medicaid members including child and substance use disorders, and...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- MyFlorida (Tallahassee, FL)
- 68053422 - GOVERNMENT OPERATIONS CONSULTANT II Date: Dec 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... for Health Care Administration Working Title: 68053422 - GOVERNMENT OPERATIONS CONSULTANT II Pay Plan: Career Service Position Number: 68053422 Salary: $2,125.08… more
- MyFlorida (Fort Lauderdale, FL)
- 68048394 - GOVERNMENT OPERATIONS CONSULTANT II Date: Dec 11, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... for Health Care Administration Working Title: 68048394 - GOVERNMENT OPERATIONS CONSULTANT II Pay Plan: Career Service Position Number: 68048394 Salary: $1,864.08… more
- Highmark Health (Buffalo, NY)
- …job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support ... to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control… more
- CVS Health (Madison, WI)
- …, and predetermination of covered benefits in the commercial, Medicare, and Medicaid environment. This Wheelchair DME consultant provides subject matter ... Summary:** Aetna, a CVS Health company has an outstanding opportunity for a Wheelchair DME consultant . Ready to take your career to the next level with a Fortune 4… more
- Nuvance Health (Rhinebeck, NY)
- …* * Active registered nurse license * Active international board-certified lactation consultant (IBCLC) certification * Must be eligible to be credentialed ... environment of open communication and unwavering compassion. *Title: *Lactation Consultant - NHMP Northern Ob/Gyn - Rhinebeck, NY. Full...with Medicaid /Medicare * Basic computer literacy * Excellent interpersonal, communication,… more
- Public Consulting Group (Trenton, NJ)
- …+ Business Enablement + Business Solutions + Project Assurance An OCM consultant will provide expert support and guidance to clients ensuring projects meet ... objectives by increasing stakeholder adoption and usage. This consultant will focus on the people side of change,...training activities related to MEMS Modules, MMIS Core Solutions, Medicaid DSS/DW and SI. * Prepare change impact assessments,… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical insight ... delivery of the product, interacting with customer end users and managers. The Consultant will be responsible for ensuring that the complexity of our AI technology… more
- MyFlorida (Tallahassee, FL)
- 68063625 - INFO TECH BUSINESS CONSULTANT MGR - SES Date: Dec 15, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Care Administration Working Title: 68063625 - INFO TECH BUSINESS CONSULTANT MGR - SES Pay Plan: SES Position Number:...entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000… more
- Cardinal Health (Baton Rouge, LA)
- …the specialty pharma ecosystem. We're looking for a Senior Change & Transformation Consultant who's not just experienced but energized by the opportunity to shape ... to the Director of Business Transformation and Change Management. This consultant will be responsible for driving adoption, inspiring stakeholders, and embedding… more
- CVS Health (Baton Rouge, LA)
- …each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts high-acuity, timely, and ... determinations align with contractual, regulatory, and accreditation standards (eg, Medicaid , CMS, NCQA). * Communicate clinical decisions to providers, member… more
- WellSense (NH)
- …for our members, no matter their circumstances. **Job Summary:** The Provider Relations Consultant - NH will act as the primary liaison between Provider Relations ... or healthcare environment is preferred + Experience with Medicare and Medicaid Reimbursement Methodologies + Understanding of provider coding and billing practices… more
- State of Georgia (Fulton County, GA)
- Healthcare Program Clinical Fraud, Waste, and Abuse Consultant 3 (00151424) Georgia - Fulton - Atlanta ... job posting and apply: If interested, please apply to: https://www.governmentjobs.com/careers/dchga/jobs/5169683/healthcare-program-clinical-fraud-waste-and-abuse- consultant -3-00151424 Applicants who do not apply using the DCH… more
- WellSense (MA)
- …activities and events** + **Ensures quality and compliance with state Medicaid regulations and NCQA requirements** + **Other responsibilities as assigned** ... + **Experience in the Medicare provider healthcare insurance industry preferred** ** Certification or Conditions of Employment:** + **Must have valid driver's license… more
- IQVIA (New Providence, NJ)
- …within one or more specific functional or technical workstreams (eg, Medicaid , Master Data Management, Chargebacks, Government Pricing, Testing, Managed Care ... Bachelor's Degree Req * Master's Degree (MBA) Pref, PMP certification a plus * 4-7 years of experience in...along with knowledge of others in this list: * Medicaid * Master Data Management * Chargebacks * Government… more
- Penn Medicine (Lancaster, PA)
- …to nursing practice. + Fosters individual nurses professional development and growth. ** Consultant :** + Collaborates with all members of the health care team ... member, in a chair co-chair role, or as a consultant . + Partners with other regional and system CNS...issued by the PA Board of Nursing License + Certification as a Clinical Nurse Specialist from a National… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- …for case presentations; + May supervise and participate in hospital Medicare and Medicaid reimbursement programs; + May testify in court; + May coordinate review and ... review of cases and case referral to a physician consultant for final disposition; + Perform related duties as...date or by visiting your JobAps Personal Status Board ( Certification Questionnaires section). + Prepare For An Interview: Interviews… more
- NHS Management, LLC (Tuscaloosa, AL)
- …Regional Administrator, Director of Medicare and Rehabilitation and MDS/Clinical Information Consultant . + Conducts audits to ensure accurate completion of all MDS ... Regional Administrator, Director of Medicare and Rehabilitation, and MDS/Clinical Information Consultant . + Conducts an observation of the resident when an MDS… more
- Erie 2-Chautauqua-Cattaraugus BOCES (Williamsville, NY)
- …+ Current licensure (with the exception of CFY) within NY State + ASHA certification required + Applicants working in a school program must have a teaching ... agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare, insurance companies, municipalities, Department of Health, school districts,… more
