- 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 with our strategic provider partners to… more
- Cognizant (Boston, MA)
- …program segmentation, and operational workflows throughout Cognizant's national operations . Establish and maintain key performance indicators, dashboards, and ... working experience. Minimum of ten (10) years of experience in state Medicaid and Medicare eligibility, enrollment operations , health plan administration, or… more
- PwC (Des Moines, IA)
- Specialty/Competency: Operations Industry/Sector: Health Services Time Type: Full time Travel Requirements: Up to 80% At PwC, our people in operations consulting ... streamline processes, improve productivity, and drive business performance. As an operations consulting generalist at PwC, you will possess a broad understanding… 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
- 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 ... operations , quality, IT, research and data) to examine program policy or business process changes and assess potential...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 ... to support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. You will make an impact by: Supporting the process for… 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 ... 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 ... heart, each and every day. Position Summary As the Manager of Pharmacy Communications, you will serve as the...pharmacy networks, Retail third party industry knowledge, retail pharmacy operations , and associated impacts to plan sponsors and their… 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
- Humana (Bloomington, IL)
- …and behavioral health professionals responsible for care management. The Manager , Care Management, works within specific guidelines and procedures; applies ... and goals. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. The … 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
- 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 ... in Healthcare industry, including health plans, claims, and provider operations Project management and people management experience Excellent communication skills,… 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
- 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 ... instincts for making decisions that lead to highly useable software. As Product Manager , you will be responsible for the complete product lifecycle of Waystar's… more
- Cleveland Clinic (Fort Lauderdale, FL)
- …years previous experience working with The Joint Commission, Healthcare Facilities Accreditation Program (HFAP), and Centers for Medicare and Medicaid (CMS) ... respected healthcare organizations in the world. As a Regional Manager of Accreditation and Regulatory, you will lead and...location uphold a robust and reliable accreditation and regulatory program . A caregiver in this position works 8:00am to… 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 ... day-to-day activities for the Application Engineering team Handle People Operations responsibilities, including performance reviews and coaching Plan and schedule… more
- CVS Health (Columbus, OH)
- …This position will support network across all lines of business. Understanding business operations to identify gaps and areas where new controls are required The ... audits out of QNXT and PRMS systems to support Medicaid SOC and SOX controls Coordinate with applicable reporting...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Waystar (Louisville, KY)
- ABOUT THIS POSITION We're looking for a motivated, detail-oriented Print Services Operations Specialist to join our fast-paced and growing Payment Operations ... to delivering a best-in-class financial experience for patients and providers. As an Operations Specialist, you will serve as a tier 2 support specialist, working… more
- Cardinal Health (Albany, NY)
- …their medications. Cardinal Health Sonexus Access and Patient Support combines best-in-class program and pharmacy operations with smart digital tools to ... in Payors, PBMs, Specialty Hubs, Patient Services, Patient Assistance Programs, Medicaid , and Pharmacy Operations . Exceptional communication, executive presence,… more
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