- Insight Global (Woonsocket, RI)
- Job Description Insight Global is seeking a Project Delivery Program Manager for a large health insurance client of ours. This resource will be responsible for ... leading a migration related to a Medicaid member portal. We are a company committed to...migrations/integrations * Rally + JIRA experience * Experience in Medicaid or Medicare * Risk Management, Budget Management, Clarity… more
- CVS Health (Annapolis, MD)
- … Manager of Claims Management is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and compliance monitoring. This ... role ensures timely and accurate processing of Medicaid claims in accordance with state and federal regulations, contractual requirements, and organizational… more
- NTT DATA North America (Montgomery, AL)
- …The Project Manager will work under the direct leadership of the PMO Program Manager . + Primary point of contact for vendor/cohort + Responsible for the ... forward-thinking organization, apply now. We are currently seeking a Medicaid Project Manager - PMP Certified to...Assist with the development, maintenance, and execution of the Program Management Plan and Integrated Project Plans + Monitor… more
- CVS Health (Hartford, CT)
- …and every day. **Position Summary** Aetna is recruiting for a Manger on the Medicaid VBC Analytics team to support VBC partnerships throughout Aetna's Medicaid ... growth and operationalization of effective value based contracts across Aetna's Medicaid plans. Responsibilities may include: Querying and analysis of complex… more
- CVS Health (Annapolis, MD)
- …and regulatory requirements. + Medicaid Network Management experience, preferably Maryland Medicaid program . + Residing within the state of Maryland highly ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...includes an award target in the company's equity award program . Our people fuel our future. Our teams reflect… more
- CVS Health (Frankfort, KY)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Prime Therapeutics (Trenton, NJ)
- …Come build the future of pharmacy with us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - Remote **Job Description** Innovative business ... with pharmacy department or designated customer contacts. + Directs operations account manager in resolving customer service issues and actions supportive of the… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Jan 2, 2026 Location: Parsippany, United States, 07054 Company: Teva Pharmaceuticals Job Id: 64915 **Who we are** Together, we're on a ... people to make a difference with. **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid ... analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs.… more
- PruittHealth (Charlotte Hall, MD)
- **JOB PURPOSE:** The Business Office Medicaid Specialist plays a crucial role in supporting the financial operations of the organization, specifically focusing on ... Medicaid and compliance. This position is responsible for assisting the Business Office Manager in overseeing the daily operations of the business office,… more
- CVS Health (Lansing, MI)
- …completes State/HSAG PIP templates for submission. + Assists Senior Quality Manager and Director with coordination and implementation of interventions to increase ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our… more
- CVS Health (Baton Rouge, LA)
- …with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to ensure ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our… more
- NTT DATA North America (Montgomery, AL)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Medicaid Senior BA to join our team in montgomery, Alabama (US-AL), United ... cycle of assigned projects. The focus will be the Medicaid Claims Processing System. The Senior BA will support...the future CPMS takeover project working with the Project Manager , client and vendor development team to build out… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States of America) Range: UR ... and provides outreach services to patients requiring public benefits including Medicaid , Child Health Plus, NYS Marketplace Exchange or other public entitlements.… more
- CVS Health (Lansing, MI)
- …**Position Summary** In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level review and rate ... and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and implementation… more
- Elevance Health (Indianapolis, IN)
- **Utilization Management Medical Director - Indiana Medicaid ** **Location:** This role enables associates to work virtually full-time, with the exception of required ... The **Medical Director** is responsible for reviewing cases for IN Medicaid members. Responsible for the administration of physical health medical services,… more
- Elevance Health (Washington, DC)
- …Health Medical Director - Psychiatrist - District of Columbia (aka Washington DC) Medicaid ** **Location:** This role requires associates to be in-office 4 days per ... **Behavioral Health Medical Director** is responsible for reviewing cases for DC Medicaid members including pharmacy, child, and substance use disorders, and all… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE ( Program of All-Inclusive Care for the ... LinkedIn. **Brief summary of purpose:** Under the direction of the Manager 's, the Eligibility and Revenue Operations Representative supports Fallon Health's mission,… more
- Genesis Healthcare (Philadelphia, PA)
- …while making a meaningful impact in the communities we serve. Responsibilities The Medicaid Revenue Cycle Specialist plays a critical role in meeting business goals ... to ensure clean billing and prompt payment. *Direct nursing center Business Office Manager to make any applicable updates in PCC. Independently ensure errors are… more
- Point32Health (Canton, MA)
- …who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Senior Manager , Compliance Program will manage the day-to-day operations of ... and Medicaid Services (CMS) and, as applicable, State Agencies.The Senior Manager , Compliance Program will report to the Government Programs Compliance… more
- State of Colorado (Pueblo, CO)
- Patient Financial Services Manager - Program Management II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5191516) Apply Patient ... Financial Services Manager - Program Management II Salary $95,892.00...including direct supervision of 3 individual units: Medicare/Other Insurance, Medicaid /Self- pay, and Audit, including 3 professional staff, 6… more
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