- Humana (Honolulu, HI)
- …thinking capable of providing frameworks to maximize available resources to achieve growth.The Medicaid Senior Insurance Product Manager plays a critical role in ... Become a part of our caring community and help us put health firstHumana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy… more
- AlohaCare (Honolulu, HI)
- …Medicare/ Medicaid AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed ... Med-QUEST Division, Department of Health, Centers for Medicare and Medicaid Services, and others.Responsible to maintain AlohaCare's confidential information in… more
- HealthEdge Software Inc (Honolulu, HI)
- …to claims adjudication, benefits configuration, interfaces to third-party claims editors, and Provider data maintenance processes. You will define and prioritize ... As a Senior Product Manager , within the claims value stream for HealthRules...functions you will create business requirements, user stories, and provide overall prioritization of work. You will also be… more
- Public Consulting Group (Honolulu, HI)
- …and client presentations.Plan, monitor, and manage ongoing tasks with the project manager . Provide guidance and support to project teams in subject matter ... and grant reporting.Analyze and interpret federal and state law and regulations. Provide guidance related to cost allocation for public assistance programs including… more
- Pair Team (San Francisco, CA)
- … data -driven technology platform, Arc, for care coordination. Through Medicaid MCOs, we provide healthcare for hard-to-reach, high-need individuals, ... them to high-quality care.Pair Team cares for the highest-need Medicaid recipients through a community-led model. We build local...care. As a support system for the community, we provide wraparound clinical services, up-skill CBO staff to become… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Medicaid Program Manager 1--A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4670594) Apply Medicaid Program Manager 1--A Salary ... within the Bureau of Health Services Financing (BHSF) that reports directly to the Medicaid Program Manager 1 B. This section is responsible for oversight of… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Medicaid Program Manager 2 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4672063) Apply Medicaid Program Manager 2 Salary ... Function of Work: To administer medium size and moderately complex statewide Medicaid program(s). Level of Work: Manager . Supervision Received: Broad from… more
- CVS Health (Northbrook, IL)
- …iCAPs and external CAPs across all markets to facilitate internal reporting to Medicaid leadership + Maintain documentation and data within the designated ... position that supports the compliance program activities and deliverables of a Medicaid managed care organization. In partnership with and under the direction of… more
- Staffing Solutions Organization (Albany, NY)
- …improvement efforts that span the Medicaid enterprise.The Medicaid Program Manager will work within the Division of Data Services & Analytics (DDSA) ... Medicaid Program Manager One Commerce Plaza,...program, whose mission is to transform the way that Medicaid data is organized, understood, and leveraged.… more
- CVS Health (Austin, TX)
- …make health care more personal, convenient and affordable. **Position Summary** The Medicaid senior manager , network management: * Negotiates, executes, conducts ... contracting, provider issues/resolutions, related systems and information contained. * Provide guidance and share expertise to others on the team. *… more
- CVS Health (Dallas, TX)
- …to helping you achieve your career goals._** **In this Texas Medicaid individual contributor role the contract negotiator:** + Negotiates competitive contracts ... and activities related to execution, loading, and ongoing maintenance of provider contracts. + Negotiates and supports the implementation of value-based contract… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …hoc analysis. **Essential Duties & Responsibilities** + Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each ... and review to ensure completeness of information received. Upload data into Medicaid systems and authorize transactions....for key findings and changes to state programs. + Provide backup for Medicaid team members in… more
- Sutherland Global Services (Torrance, CA)
- …accountable, dynamic & people person to join us as an Associate Manager to oversee customer deliverables, process maintenance & improvement, and people management ... Line: Produce solid and effective strategies based on accurate and meaningful data reports and analysis and/or keen observations. + Define Sutherland's reputation:… more
- Elevance Health (Miami, FL)
- …summary statistical procedures. + Develops and analyzes business performance reports (eg for claims data , provider data , utilization data ) and provides ... **Business Information Analyst Senior- Medicaid ** **Location:** This position will work a hybrid...is responsible for analyzing, reporting, and developing recommendations on data related to complex and varied business metrics. Typically… more
- CVS Health (St. Paul, MN)
- …HR team! This individual will be expected to partner with the Lead HRBP to provide strategic and day-to-day HR support for the Aetna Medicaid organization. The ... practices as part of the Business Advisory Services leadership team. + Provide insight on enterprise talent strategy, including assessment of executive talent gaps… more
- Healthfirst (NY)
- …Finance to understand the monthly financial results and prepare any supporting materials to provide guidance on key topics for State Programs teams + Help to support ... understanding of, and experience with, financial analysis of managed care products ( Medicaid and/or Long-Term Care products) and the overall healthcare industry +… more
- CVS Health (New Albany, OH)
- …of strategies to monitor quality and performance metrics, resolving escalated provider issues, and collaborating with other departments to enhance the overall ... that systems are configured appropriately to allow proper claims payment and provider reimbursement. * Collaborates with multiple departments to identify root cause… more
- City of New York (New York, NY)
- …live telephone agents who speak to callers directly and are able to provide case specific information. Constituents can call the Infoline telephone service line for ... Team Supervisor, with some latitude for independent judgement, the Medicaid Helpline Agent is responsible for providing information to...from the client regarding their case. - Review pertinent data from New York State EMEDNY system in order… more
- Elevance Health (Miami, FL)
- …for Medicaid business. + Works closely with analytical team to analyze Medicaid data . + Analyzes complex end user needs to determine optimal means ... **Business Analyst III- Medicaid ** **Location:** This position will work a hybrid...users of the software to address questions/issues. + May provide direction and guidance to team members and serves… more
- Fallon Health (Worcester, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... from scheduling access, collecting images, coding chart and updating data software. The CRS must have the ability to...to end + Collect documentation feedback and submit to Manager for provider education efforts + Update… more
