- 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
- Humana (Bloomington, IL)
- …and behavioral health professionals responsible for care management. The Manager , Care Management, works within specific guidelines and procedures; applies ... tactical operations for projects and initiatives involving own departmental area. The Manager , Care Management supervises, direct and evaluate a diverse group of… 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
- 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 ... clear about role expectations What you need to have to be considered: 2 + years of Digital technology (Business or Technical Consultative) team lead experience, and… more
- Waystar (Atlanta, GA)
- ABOUT THIS POSITION Waystar is seeking a smart and creative Product Manager with hands on experience in the financial and operational challenges facing the ... decisions that lead to highly useable software. As Product Manager , you will be responsible for the complete product...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- CVS Health (Woonsocket, RI)
- …Financial Reports. Ability to travel up to 10% Preferred Qualifications 2 + years managing teams. Knowledge of Healthcare Industry/Medicare/ Medicaid /Commercial ... an exciting opportunity to join our team as Senior Manager , Financial Reporting & Analysis within HCB Controllership. This...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Waystar (Lehi, UT)
- ABOUT THIS POSITION We're looking for a highly technical and hands-on Manager , Application Engineering to lead a team of talented Application Engineers and QA ... systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out...starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time… more
- Humana (Madison, WI)
- …to put those customers at the center of everything it does. The Product Owner 2 is responsible for conveying product vision and roadmap to an Agile delivery team by ... defining user stories and prioritizing product backlog. The Product Owner 2 work assignments are varied and frequently require interpretation and independent… more
- Molina Healthcare (Louisville, KY)
- JOB DESCRIPTION Job Summary Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide oversight on ... daily investigative activities as a back-up to the SIU Manager . This position will be accountable for tracking on investigations conducted by his/her team and will… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first The Care Manager , Telephonic Behavioral Health 2 , in a telephonic environment, assesses and ... for the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 work assignments...associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care… more
- Cayuse Holdings (Austin, TX)
- …Savings Plan with matching after one year Paid Time Off Reports to: Program Manager Working Conditions Professional on site office environment. Ability to ... of a team. Preferred Qualifications: 4 years' experience and knowledge with Texas Medicaid programs. 2 years' experience with the Project Enrollment and… more
- Elevance Health (Grand Prairie, TX)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . Prepare detailed work papers and present findings in… more
- Novo Nordisk Inc. (Bronx, NY)
- …evolving needs of patients with cardiometabolic diseases, come join us! CMCS 2 - Ozempic/Wegovy (Ozempic Primary) The Position Assumes responsibility for achieving ... current co-promotion partners. Internally, the CMCS I reports to the District Business Manager of the specific sales territory. The CMCS I also interacts and… more
- Waystar (Louisville, KY)
- …as well. WHAT YOU'LL DO Proposes technical solutions to the Manager , Application Engineering Designs/develops/tests/implements improvements or new features into the ... the various stages to production Identifies and informs the Manager , Application Engineering of areas of the application that...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Waystar (Lehi, UT)
- …performance. WHAT YOU'LL DO Proposes technical solutions to the Manager , Application Engineering Designs/develops/tests/implements improvements or new features into ... the various stages to production Identifies and informs the Manager , Application Engineering of areas of the application that...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Waystar (Atlanta, GA)
- …security, encryption, and compliance with industry standards (such as SOC 2 , HIPAA). Implement least privilege access, network segmentation, and automated security ... such as EC2, S3, RDS, DocumentDB, Lambda, EKS, Secrets Manager , SSM, API Gateway, and CloudFront and other related...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Molina Healthcare (Dayton, OH)
- …management, care management, utilization management, behavioral health and other program activities in accordance with regulatory, contract standards and ... and training staff to ensure maximum efficiency and productivity, program implementation, and service excellence. Trains and supports team...least 5 years health care experience, and at least 2 years of managed care experienced in one or… more
- Waystar (Louisville, KY)
- …patients and providers. As an Operations Specialist, you will serve as a tier 2 support specialist, working from an active case queue to resolve technical issues, ... This is a support-focused role that also involves project manager -like responsibilities, including coordinating statement setups, managing updates, troubleshooting… more
- Mount Sinai Health System (New York, NY)
- …direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access ... financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred 3 years of health care related billing… more
- Waystar (Atlanta, GA)
- …Enterprise Rule & Edits position reports to our Enterprise Rules & Edits Manager and has the responsibility for establishing new client payer edit configurations. ... systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out...starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time… more
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