- Conduent (Richmond, VA)
- …managing complex, matrixed teams to ensure project success?** We are seeking a ** Medicaid Management Systems Implementation Leader** to spearhead projects ... that involve the successful implementation of Medicaid Management Systems....Managing and overseeing a team of Project Managers, ensuring contract implementation is completed efficiently and in… more
- Prime Therapeutics (Columbus, OH)
- …+ Experience with analyzing state and federal regulations + Experience using Contract Management software including maintaining and managing databases **Minimum ... fuels our passion and drives every decision we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior … more
- Humana (Columbus, OH)
- …us put health first** Humana Healthy Horizons is seeking a Senior Medicaid Provider Education Professional who is responsible for provider education materials for ... Humana's Medicaid segment to drive best in class provider experience....ensure aligned segment strategy and approach. + Support provider implementation education team members on the creation of new… more
- Humana (Columbus, OH)
- …support to assigned health plan and/or specialty companies relative to Medicare/ Medicaid /TRICARE/Employer Group product implementation , operations, contract ... of diverse scope and complexity ranging from moderate to substantial. The Medicaid Market Development Advisor serves as the primary resource on regulations for… more
- CareFirst (Baltimore, MD)
- …assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, ... the group or for an individual. + Participates in the creation and implementation of new methods, processes and/or products + Prepares reports and submits them… more
- WellSense (Boston, MA)
- …The Senior Contract Manager is responsible for the development, implementation and management of a cost-effective provider network, maintaining complex ... Senior Contract Manager WellSense Health Plan is a nonprofit...implementation ; . Knowledge of federal and state Medicare, Medicaid , and relevant guidelines, regulations and standards; . Effective… more
- WellSense (Manchester, NH)
- …their circumstances. **Job Summary:** The Contract Manager facilitates development; implementation and management of new and current cost-effective provider ... Contract Manager WellSense Health Plan is a nonprofit...implementation ; + Knowledge of federal and state Medicare, Medicaid , and relevant guidelines, regulations and standards; + Effective… more
- CVS Health (Olympia, WA)
- …and group Behavioral Health providers within a defined market. You will manage contract performance and support the development and implementation of strategic, ... network management unit. + Assists with the design, development, management , and or implementation of strategic network configurations, including integration… more
- CVS Health (Sacramento, CA)
- …auditing, building, and loading contracts, agreements, amendments and/or fee schedules in contract management systems per Aetna's established policies + Conducts ... data, contract integrity and performance + Manages contract performance and supports the development and implementation...that may include, but are not limited to, database management and contract coordination + Organizing and… more
- Abbott (Livermore, CA)
- …Commercial payor contract review experience + Managed Medicare and managed Medicaid contract experience + Experience working for healthcare providers + ... Well developed, advanced knowledge and skills for assisting in the commercial contract review process, including the implementation of contractual arrangements.… more
- CVS Health (Columbus, OH)
- …Medicare and/or Medicaid Delegation + Delegation / capitation and associated contract and performance oversight + PMP Certification + Key concepts (high level) ... (clinical, operations, Medicare segment). **Required Qualifications** + Successful project management experience in health operations or similar disciplines with… more
- State of Minnesota (St. Paul, MN)
- …qualitative and quantitative analysis. + Understanding of grant and/or contract management . + Understanding of the Medicaid rules and regulations. + ... 2) Track and identify all training necessary for new implementation of programming for all Medicaid services....guide, solicit and explore diverse perspectives. + Knowledge of contract management along with basic public budget… more
- MyFlorida (Tallahassee, FL)
- …required. - Knowledge of and ability to apply state procurement laws and contract management policies/procedures. - Knowledge of the methods of data collection ... Policy is responsible for the development, coordination, and implementation of Florida Medicaid Program policies, including:...as the lead point of contact for their assigned Medicaid contracts and maintains active agency contract … more
- MyFlorida (Tallahassee, FL)
- …The incumbent will be responsible for leading procurement activities as well as contract development and management activities related to the assigned ... and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities,… more
- State of Colorado (CO)
- …policy development and implementation , grant oversight, contract management and performance, program administration and overall Medicaid program ... purposes of 1115 waiver administration. + Lead procurement and contract management for vendors hired to support implementation , reporting, and evaluation of… more
- MyFlorida (Tallahassee, FL)
- …Policy. Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including: all Medicaid ... development of policy language for: Medicaid contracts and amendments, Medicaid managed care report guides, contract interpretations, policy transmittals,… more
- MyFlorida (Tallahassee, FL)
- …Policy. Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including: all Medicaid ... development of policy language for: Medicaid contracts and amendments, Medicaid managed care report guides, contract interpretations, policy transmittals,… more
- Molina Healthcare (Atlanta, GA)
- …and strategic planning for the health plans. + Provides contracts and relationship management for State and Federal partners ( Medicaid , Medicare, Insurance) and ... legislation and policy requirements. + Oversees and monitors the implementation of new Medicaid and Medicare contractual...10+ years experience in government programs and 2+ years management experience. + Extensive knowledge of Medicaid ,… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …opportunities for improvement in payment terms, methodologies, and network participation. + Contract Implementation and Monitoring: Ensure timely and accurate ... aptitude in MS Office products (including Excel, PowerPoint, Outlook and Word) and contract management software. + Ability to travel to various locations (payer… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …the youth and families in Louisiana. Coordinate with MCOs on their care management of Medicaid -funded Specialized Behavioral Health Services (SBHS) for youth, ... resource mapping and assessment of system flow. Establishes and directs the implementation of data-driven utilization management procedures that maximize use of… more