- Daiichi Sankyo, Inc. (Boston, MA)
- …areas centered around rare diseases and immune disorders. Summary: The Associate Director Field Reimbursement (ADFR) is a critical front-line member of the DSI ... appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes and the… more
- Daiichi Sankyo, Inc. (Seattle, WA)
- …areas centered around rare diseases and immune disorders. Summary: The Associate Director , Field Reimbursement (ADFR) is a critical front-line member of the DSI ... appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes and the… more
- CVS Health (Princeton, NJ)
- …health care more personal, convenient and affordable. **Position Summary** The NJ Medicaid Lead Director , Network Management is accountable for designing ... conceptual models, initiative planning, and negotiating Medicaid value based agreements with New Jersey providers, including health systems, clinically integrated… more
- CVS Health (Hartford, CT)
- …new and exciting ways every day. Aetna is recruiting for an Executive Director , Medicaid Provider Experience Standardization who is responsible for ensuring the ... variations that currently exist across multiple Medicaid Health plans specific to provider contracting, credentialing, provider...and transparency with the Network Operations Team and the Medicaid Health Plans. This leader will develop and define… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Health, Department of Title Director of Medicaid Long Term Care Policy (Health Program Director 1) Occupational Category Health Care, ... Description The incumbent of this position will serve as the director of the Bureau of Medicaid Long-Term Care Policy (BMLTCP). This position will serve as the… more
- Elevance Health (Indianapolis, IN)
- **Medical Director -Indiana Medicaid ** **Location: This is a hybrid position. Candidates must live within 50 miles of an Elevance Health location. Prefer ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. **How you will… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …Deputy Commissioner & Chief Strategy Officer and have tight alignment to the State Medicaid Director within DSS. + Leadership, Planning & Execution. + Manage the ... Director of Technology Modernization, Medicaid Programs Durational Project Manager Recruitment # 240801-0415VR-001 Location Hartford, CT Date Opened 8/7/2024… more
- The Cigna Group (Bloomfield, CT)
- **Job Purpose/Description** The Legal Compliance Senior Director - Express Scripts Medicaid and Commercial is responsible for the development, implementation, ... to identify and mitigate compliance risks. The Legal Compliance Senior Director - Express Scripts Medicaid and Commercial will serve as the Express Scripts … more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range ... organization capabilities interrelate across the function or segment. The Director , Actuarial of Medicaid Pricing may be...function or segment. The Director , Actuarial of Medicaid Pricing may be responsible for any combination of… more
- City of New York (New York, NY)
- …is recruiting for One (1) City Research Scientist IV to function as the Director of SNAP, Medicaid , and Fair Fares Performance Management, who will: oversee ... policy changes to support implementation of the Mayor's initiatives. The Director of SNAP, Medicaid , and Fair Fares Performance Management will also: - Provide… more
- Humana (Columbus, OH)
- …community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...internal teaching conferences, and other reference sources * Learns Medicaid requirements and understands how to operationalize this knowledge… 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
- State of Massachusetts (Boston, MA)
- …is led by the Director of Program Integrity, who reports to the Deputy Medicaid Director , and consists of 10 internal staff members and dozens of contractors ... The Deputy Program Integrity Director is a policy, people and operational leader...federal entities such as the Centers for Medicare and Medicaid Services, State Auditor's Office, and Office of Inspector… more
- CVS Health (Irving, TX)
- …dedicated to helping you achieve your career goals.** **Position Summary** : The Medicaid Network State Director manages and oversees compliance with our Network ... Affordability Targeted Improvements as identified. * The State Network Director will manage and deploy the Medicaid ...Network Director will manage and deploy the Medicaid National Provider Engagement Program through the Local Market… more
- CVS Health (Raleigh, NC)
- …health care more personal, convenient and affordable. **Position Summary** The Lead Director , Network Management - Medicaid /North Carolina is accountable for ... designing conceptual models, initiative planning, and negotiating Medicaid value based agreements with North Carolina providers, including health systems, clinically… more
- MyFlorida (Tallahassee, FL)
- …sources of evidence, the Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts. Program Planning and Analysis The ... 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
- MyFlorida (Tallahassee, FL)
- …sources of evidence, the Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts. Program Planning and Analysis The ... 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
- MyFlorida (Tallahassee, FL)
- …sources of evidence, the Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts. Program Planning and Analysis The ... 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
- City of New York (New York, NY)
- …care services at little or no cost. Under the general direction of the Senior Director of Medicaid Community Offices with wide latitude for the exercise of ... Medicaid Offices' statistical management reports to the Program Director . These reports identify deficiencies and provide information to assist management… more
- State of Massachusetts (Boston, MA)
- Reporting to the Medicaid Director , the Chief of Staff (COS) is a strategic advisor to the Medicaid Director and member of the MassHealth Executive Team. ... The COS advises the Medicaid Director and MassHealth Executive Team on strategic policy, program, financial, and service provision issues. The role is also… more
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