- Prime Therapeutics (Raleigh, NC)
- …our passion and drives every decision we make. Job Posting Title North Carolina Medicaid Account Manager - Remote Raleigh, NC Job Description The Senior Account ... Manager is responsible for providing complex level support for...for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product… more
- CVS Health (Trenton, NJ)
- …And we do it all with heart, each and every day. Position Summary The Medicaid VBS Network State Manager manages and oversees compliance with our Network ... responsibilities as provided within the State Medicaid contractual requirements as outlined below: Accountable for working...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Cognizant (Boston, MA)
- About the role Schedule: M-F Traveling Required: 40% As a Medicaid Eligibility Delivery Director, you will make an impact by overseeing access, performance, and ... designing and implementing scalable Eligibility Services, overseeing policy development, program segmentation, and operational workflows throughout Cognizant's national operations.… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... with a focus on value-based arrangements and network-wide engagement strategies. The program manager is responsible for managing and implementing key population… more
- CVS Health (San Antonio, TX)
- …3+ years of leadership experience A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / ... oversight of SIU and Fraud, Waste and Abuse activities related to TX Medicaid and CHIP programs. Oversees activities related to the prevention, investigation, and… more
- State of Minnesota (St. Paul, MN)
- Working Title: Managed Care Contracting and Rates (MCCR) Director Job Class: Human Services Manager 4 Agency: Human Services Dept Job ID : 90577 Location : St. Paul ... Date : 12/23/2025 Hiring Agency/Seniority Unit : Human Services Dept / DHS Manager Division/Unit : Health Care Administration / Managed Care Contracting and Rates… more
- Serco (Herndon, VA)
- … program implementation (particularly the Health Insurance Marketplace, Medicare, Medicaid and/or CHIP), program improvement and innovations, and project ... Position Description Serco is seekinga self-starter Senior Manager Compliance to join our talented and fast-paced...and processes, or other federal health programs (such as Medicaid , Children's Health Insurance Program or Medicare)… more
- CVS Health (Columbus, OH)
- …each and every day. Position Summary Aetna is recruiting for a Senior Manager , Value Based Contractor who will partner with business development and network leaders ... with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. You will make an impact by:...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Elevance Health (Greensboro, NC)
- We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid -enrolled infants, children, youth, young ... an accommodation is granted as required by law. The Manager I Care Management ( Manager I GBD...Participates in cross-functional workgroups created to maintain and develop program . Evaluates current processes of Special Program 's… more
- Houston Methodist (Katy, TX)
- At Houston Methodist, the Manager Revenue Cycle position is responsible for the daily management of the staff and operations for one or more of the following areas ... write-offs, staff productivity and work quality and credit balances. The manager position responsibilities include managing the daily work activities of the… more
- CVS Health (Frankfort, KY)
- … Medicaid , Medicare Part D, etc.). In addition, the manager works cross-functionally with Sales Account Management, Client Implementations, Finance, Legal ... we do it all with heart, each and every day. Position Summary As the Manager of Pharmacy Communications, you will serve as the main liaison and subject matter expert… more
- CVS Health (St. Paul, MN)
- …do it all with heart, each and every day. Position Summary As a Manager , Healthcare Data and Analytics (IC), you will be responsible for developing and maintaining ... complex financial reporting solutions that support Aetna's Medicaid Markets. This role will lead reporting for Value-Based...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Cognizant (Dover, DE)
- Product Owner Health Sciences, Consulting Manager About the Role: As a Product Owner for Sales & Enrollment Platforms, you will make an impact by leading the ... member onboarding for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other regulatory… more
- Marshfield Clinic (Beaver Dam, WI)
- …any time have been or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is a condition of employment. ... the most exciting missions in the world! Job Title: Manager Home Health/Hospice Cost Center: 351011118 BDHos-Home Health Scheduled...with exclusion or becomes excluded from any federally funded program . Marshfield Clinic Health System is an Equal… more
- Humana (Bloomington, IL)
- …and behavioral health professionals responsible for care management. The Manager , Care Management, works within specific guidelines and procedures; applies ... for projects and initiatives involving own departmental area. The Manager , Care Management supervises, direct and evaluate a diverse...facing and is part of Humana's Tuberculosis (TB) screening program . If selected for this role, you will be… more
- Cognizant (Columbus, OH)
- …member onboarding for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other regulatory ... enrollment processes for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA). Strong understanding of CMS, ACA, and other regulatory… more
- Molina Healthcare (Pasadena, TX)
- …Opportunity for a Texas licensed RN to join Molina to work with our Medicaid members in the South Houston/Pasadena, TX service delivery area. Our Care Managers ... May provide consultation, resources and recommendations to peers as needed. Care manager RNs may be assigned complex member cases and medication regimens. Care… more
- Bausch + Lomb (Memphis, TN)
- …opportunity to join our dry eye Market Access team. The Field Access Manager is a field-based non-promotional position who will use their extensive knowledge of ... skills in navigating across multiple functions and departments and among program vendors to provide an excellent customer experience. Responsibilities Work directly… more
- Cognizant (Harrisburg, PA)
- Health Provider Consulting Manager About the Role: As a Sr. Consulting Manager you will make an impact by driving client engagement, leading teams, and ... digital transformation initiatives Deep understanding of payer functions and Medicaid plan implementations, including enrollment, billing, claims, care management,… more
- Cardinal Health (Albany, NY)
- …conducts investigations to resolve ethics and compliance issues. Compliance Audit Manager Reporting to the Compliance Director, this position supervises and manages ... annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. Responsibilities Plans… more
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