• Claims Manager - Maryland Medicaid

    CVS Health (Annapolis, MD)
    …The Manager of Claims Management is responsible for overseeing Medicaid claims operations , inventory management, quality assurance, and compliance ... + Participate in the development of policy and procedure updates for Medicaid claims operations . **Required Qualifications** + Bachelor's degree in Business,… more
    CVS Health (12/14/25)
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  • Medicaid Project Manager - PMP…

    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...experience running multiple concurrent projects + 6+ Years of Medicaid Systems or operations project management experience… more
    NTT DATA North America (12/05/25)
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  • Georgia Medicaid Clinical Account…

    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 ... strong relationships with pharmacy department or designated customer contacts. + Directs operations account manager in resolving customer service issues and… more
    Prime Therapeutics (12/18/25)
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  • Bus Off Medicaid Specialist

    PruittHealth (Charlotte Hall, MD)
    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...6. Assist in internal and external audits related to Medicaid , resident trust accounts and financial operations ,… more
    PruittHealth (11/25/25)
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  • Eligibility & Revenue Operations

    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 ... and LinkedIn. **Brief summary of purpose:** Under the direction of the Manager 's, the Eligibility and Revenue Operations Representative supports Fallon Health's… more
    Fallon Health (11/18/25)
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  • Manager , Prior Authorization Utilization…

    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 ... + Collaborate with internal and external stakeholders-including clinical leadership, operations , IT, and regulatory bodies-to align utilization management with… more
    CVS Health (12/21/25)
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  • Medicaid Senior BA

    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
    NTT DATA North America (12/11/25)
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  • Utilization Management Medical Director - Indiana…

    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 (01/08/26)
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  • Behavioral Health Medical Director - Psychiatrist…

    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
    Elevance Health (01/07/26)
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  • Senior Program Manager - DC Market…

    CareFirst (Washington, DC)
    **Resp & Qualifications** **PURPOSE:** The Sr. Program Manager , DC Market Operations provides leadership for the operation of a single jurisdiction ... Medicaid program including the strategic direction for...collaboration with matrix leaders in marketing, finance, government relationships, operations , health services and compliance, the Manager more
    CareFirst (12/18/25)
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  • Senior Manager , Compliance Program

    Point32Health (Canton, MA)
    …(https://www.point32health.org/) . **Job Summary** The Senior Manager , Compliance Program will manage the day-to-day operations of the compliance ... Services (CMS) and, as applicable, State Agencies.The Senior Manager , Compliance Program will report to the...activities. + Strong subject matter expertise in Medicare and/or Medicaid Operations and Compliance Requirements + Demonstrated… more
    Point32Health (12/23/25)
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  • Manager , Risk Adjustment Operations

    Point32Health (Canton, MA)
    …engagement with senior leaders at contracted provider organizations. + **Risk Adjustment Program Management and Vendor Evaluation** : The Manager will be ... to identify improvement opportunities and recommend changes to improve program results and effectiveness. The Manager will...and reporting that identify and track revenue trends and program results for Medicare, Medicaid , Duals and… more
    Point32Health (12/25/25)
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  • Patient Financial Services Manager

    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
    State of Colorado (01/08/26)
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  • Manager III, Facilities Operations

    The County of Los Angeles (Los Angeles, CA)
    MANAGER III, FACILITIES OPERATIONS AND CRAFTS...are searching for: Has immediate charge of the facilities operations and building crafts program of a ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4855820) Apply  MANAGER III, FACILITIES OPERATIONS AND CRAFTS Salary $136,076.88 - $183,393.84 Annually Location… more
    The County of Los Angeles (11/07/25)
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  • Manager II, Facilities Operations

    The County of Los Angeles (Los Angeles, CA)
    MANAGER II, FACILITIES OPERATIONS AND CRAFTS,...medical center assisting in the management of a facilities operations and building crafts program in a ... ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply  MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL… more
    The County of Los Angeles (01/01/26)
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  • Residential Program Manager 2, (NY…

    New York State Civil Service (Queens Village, NY)
    …As a Residential Program Manager 2, you will oversee residential program operations to ensure the health, care, and safety of individuals residing at ... Manager 2 to manage and oversee residential program operations of a State Operated Community...or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any… more
    New York State Civil Service (01/10/26)
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  • Registered Nurse (RN) Manager , Appeals…

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations...Policies & Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care… more
    LA Care Health Plan (12/09/25)
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  • Operations Manager Behavior Health…

    PeaceHealth (Vancouver, WA)
    **Description** PeaceHealth is seeking an ** Operations Manager Behavior Health for a Full Time, 1.00 FTE, Day position.** The salary range for this job opening ... and various forms of data to improve and emphasize efficient clinical practice. The Operations Manager must prioritize the clinical practice as well as … more
    PeaceHealth (12/20/25)
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  • Senior Manager , Market Access Contracting…

    Ascendis Pharma (Princeton, NJ)
    …develop their skills. Position Summary: We are seeking a highly motivated Senior Manager to support our Contracting Operations function within the Market Access ... individual will be responsible for the day-to-day management of contract operations activities across pharmaceutical pricing, contracting, and rebate agreements with… more
    Ascendis Pharma (12/04/25)
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  • Assistant Program Manager

    Service Source (Oakton, VA)
    …on the Annual Performance Review. + Perform the duties of the Program Manager in his/her absence. Ensure the daily operations are fulfilled and running ... Building Bright Futures! Join our team as an Assistant Program Manager and make a lasting impact...holidays! ✅ Grow your leadership skills while supporting daily program operations ✅ Help participants "graduate" into… more
    Service Source (01/09/26)
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