- Robert Half Legal (Alpharetta, GA)
- …industry. The hire will be responsible for maintaining compliance with Medicaid and HIPAA regulations and overseeing enterprise risk management processes. This ... a healthcare or government contracting organization * Oversee the compliance with Medicaid and HIPAA regulations, as well as other applicable federal and state… more
- Elevance Health (Middletown, NY)
- …Elevance Health PulsePoint location listed above. The **Provider Network Manager Sr ** will be responsible for developing the Medicaid provider network ... **Provider Network Manager Sr ** **Location:** Latham, NY; Middletown,...Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers.… more
- Elevance Health (Tampa, FL)
- Job Description **Nurse Medical Management Sr .** **Preferred Location** : Florida. **This position will work 100% remote (with the exception of team meetings which ... miles of one of our Elevance Health PulsePoint locations. **Nurse Medical Management Sr .** Responsible to serves as team lead for nursing staff who collaborate with… more
- Elevance Health (NC)
- …are partnering with North Carolina DHHS to operationalize the single, statewide Medicaid Plan designed to support Medicaid -enrolled infants, children, youth, ... the full set of factors that impact health The **Psychologist Reviewer Sr ** is responsible for providing day-to-day guidance, support, and leadership for clinical… more
- Elevance Health (Columbus, OH)
- … Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... **Audit & Reimbursement Senior ** **Location:** This is a virtual position; US...federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health… more
- Molina Healthcare (KY)
- …of urgency, communication and follow through to closure. * Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO ... facilitates process improvement efforts. Will lead re-engineering team and act as project manager in some cases. * Drives efficiency: looks for and documents ways to… more
- WellSense (Boston, MA)
- Senior Contract Manager WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through ... Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical...our members, no matter their circumstances. **Job Summary:** The Senior Contract Manager is responsible… more
- Elevance Health (St. Louis, MO)
- **Provider Contract Analyst Senior ** **Location:** This position will work a hybrid model (remote and in office one to two days per week). Ideal candidates will ... MO, Grand Prairie, TX or Iselin, NJ. The **Provider Contract Analyst Senior ** is responsible for providing...SAS, Excel, or equivalent preferred. + Proficiency in analyzing Medicaid claims data preferred. + Experience analyzing and building… more
- CareOregon (Portland, OR)
- …Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Senior Contract Specialist Exemption Status Exempt Department Contract ... Manager Title Value Based Contract Manager Direct Reports n/a Requisition # 24625 Pay and...one of the listed 9 states. Job Summary The Senior Contract Specialist is a key contributor… more
- CVS Health (Southfield, MI)
- …working schedule of three days onsite per week in Southfield, MI The Sr . Compliance Manager is an experienced/career level compliance position that applies ... and DSNP products in a highly matrixed environment. The Sr . Manager Compliance maintains productive relationships and...and act as the primary liaison to the state Medicaid agency and Contract Management Team (CMT)… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Senior Manager of Reimbursement and Fiscal Management Augusta , Maine , United States | Community & Social Services | Full-time Apply by: Nov. 25, 2024 Apply ... - $105,809.60 per yearPosition Number:02000-4101Location: Augusta Core Responsibilities: The Senior Manager of Rate Setting supports the ongoing… more
- Elderwood (Buffalo, NY)
- …$100,000 / Year Overview Elderwood Independent Practice Association (IPA) is seeking a Senior Manager of Network Development to join our incredible growing team ... Develop and maintain reimbursement tools for organizational use. + Create and maintain contract status summaries and tools to keep senior leadership apprised of… more
- Aspen Dental (Springfield, IL)
- …within our Payor Strategy Team. The successful candidate will report to the Sr . Manager , Payor Strategy. They are responsible for supporting department ... year. As a reflection of our current needs, we have an exciting opportunity to join our team as a Contract Specialist. The Contract Specialist plays a vital role… more
- Aspen Dental (Springfield, IL)
- …our current needs, we have an exciting opportunity to join our Payor Strategy team as Senior Manager , Payor Strategy. The Senior Manager of Payor ... Payor Strategy. **Essential Responsibilities** Responsible for working with Vice President + Senior Vice President of Payor Strategy on managing the contract … more
- CenterLight Health System (NY)
- JOB PURPOSE: The Senior Project Manager , Claims Payment Integrity supports the Senior Vice President and the Director in the day-to-day operations of the ... federal and state guidelines and meets health plan regulatory and provider contract requirements as well as company objectives. This position requires working… more
- Walgreens (Washington, DC)
- **Job Description:** Job Summary The Senior Manager of Federal Government Relations is a key leadership role responsible for shaping and executing the company's ... legislative outcomes that impact the business, its customers, and stakeholders. The Senior Manager will monitor and analyze federal legislation, build strategic… more
- Walgreens (Deerfield, IL)
- …An Equal Opportunity Employer, including disability/veterans. **Job ID:** 1480412BR **Title:** Senior State & Local Government Relations Manager **Company ... developing political strategy for geographic area of responsibility; communicating with contract lobbyists, associations of which Walgreens is a member, elected… more
- Logan Health (Kalispell, MT)
- …strategy and are part of an agile development methodology. This is a senior versatile role that designs and supports intelligent processes and technology to empower ... of health care reimbursement, including Critical Access Hospital Medicare and Medicaid rules and regulations + Experience with compliance with CMS promoting… more
- Mount Sinai Health System (New York, NY)
- …and Cost per Utilization. + Procure and upload all financial data into Experian Contract Manager Tool to determine financial performance. + Model Payer Proposals ... within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System...in Experian Contract Manager Tool. + Reconcile budgeted revenue… more
- Houston Methodist (Houston, TX)
- …Comp, Commercial plans, etc.; knowledge of how to interpret a managed care contract , Medicare and Medicaid and Workers Compensation + Extensive knowledge of ... following:** + **Experience with Government Advantage Payers** + **Centers for Medicare/ Medicaid Services** + **Experience with high dollar hospital accounts** +… more