- Prime Therapeutics (Columbus, OH)
- …make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is responsible for ... process adherence in support of Prime's contracting efforts with Louisiana Medicaid PBM business. This position is responsible for supporting the solicitation,… more
- CVS Health (Tallahassee, FL)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** The Sr . Manager Medicaid Value Based Care (VBC) FL manages and ... with our Network responsibilities as provided within the State Medicaid contractual requirements as outlined below: + Accountable for...contract and product requirements. + The State Network Manager will assist in the recruitment of new value… more
- CVS Health (Columbus, OH)
- …the largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr . Manager provides technical, analytical and business support for the FEP Account ... are deployed, the Medicare Business Analytics - FEP - Sr . Manager incorporates these into all aspects...This position is instrumental in helping to ensure that contract performance guarantees and financial performance are properly monitored… more
- Elevance Health (Atlanta, GA)
- **Provider Network Manager Senior ** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of ... one of our Elevance Health PulsePoint locations. The **Provider Network Manager Senior ** will be responsible for developing the provider network through … more
- CVS Health (Harrisburg, PA)
- …in your next role? Join Aetna/CVS Health, as the Network Management Senior Manager . In this role, you will manage contract performance and support the ... value/volume of spend providers with significant financial implications. + Manages contract performance and drives the development and implementation of value-based… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Client Audit Specialist, Sr . - Remote **Job Description** The Client Audit Specialist Sr is ... client, and/or functional audit expectations. The Client Audit Specialist Sr provides consultation and strategic advice regarding audit management practices… more
- Elevance Health (Woodbridge, NJ)
- …onsite per week)** **Position Overview:** Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this ... role is contracting and negotiating contract terms. Typically works with the most complex providers....experience is a must + Experience with government business ( Medicaid /Medicare) strongly preferred + Negotiating experience is a must… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Client Audit Specialist, Sr . - Remote **Job Description** As a member of the Client Audit Management ... (CAM) team, the Client Audit Specialist, Sr is accountable for managing regulatory and/or client-initiated audits. This role maintains a thorough understanding of… 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
- Molina Healthcare (Columbus, OH)
- …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
- Molina Healthcare (Lincoln, NE)
- …+ Demonstrates Healthcare business process and/or functional knowledge + Knowledgeable of State Medicaid contract Service Level Agreements and IT support for and ... **Business Relationship Management** + Serve as a member of Health Plan Senior Leadership Team + Focus on building Trust relationship with stakeholders, such… 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 (Atlanta, GA)
- **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
- CVS Health (Southfield, MI)
- …**Position Summary** This position is located in the state of Michigan 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
- Fallon Health (Worcester, MA)
- …**Brief Summary of Purpose:** With general direction from the Director of Quality, the Senior Program Manager ensures that the health plan is compliant with all ... Medicaid Services (CMS), the Massachusetts Division of Medicaid (MassHealth) or Senior Care Options (Navicare)....(MassHealth) or Senior Care Options (Navicare). The Senior Program Manager takes the lead on… 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
- 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
- Providence (Irvine, CA)
- …and retain the best people, we must empower them._** **Providence is calling a Senior Manager Contracting who will:** + Be responsible for leading, or ... member, in significant negotiations with Payors for acceptable reimbursement terms and contract languages for all entities with continuum of care + IE Hospitals,… 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
- 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