- AlohaCare (Honolulu, HI)
- …to our RSS feeds to receive instant updates as new positions become available. Director of Product Management - Medicare/ Medicaid AlohaCare is a local, non-profit ... health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive...product's lifecycle and unites product development and sales. The Director of Product Management provides leadership and direction for… more
- Blue Cross Blue Shield Association (Chicago, IL)
- …projects within assigned regulatory and legislative areas (both federal and state ), including the identification of key business issues, policy and legislative ... officials, policymakers, and other organizations. Provides policy input and support to State Services on NAIC and other state -related initiatives to assure… more
- Blue Cross Blue Shield Association (Washington, DC)
- …projects within assigned regulatory and legislative areas (both federal and state ), including the identification of key business issues, policy and legislative ... officials, policymakers, and other organizations. Provides policy input and support to State Services on NAIC and other state -related initiatives to assure… more
- MedStar Health (Washington, DC)
- …improvement plans where appropriate.Ensure strict adherence to all federal and Maryland state Medicaid regulations, including data privacy and security measures. ... the organization through dynamic regulatory and healthcare environments. The VP - Executive Director is accountable for the day-to-day operations and profit and… more
- ASSOCIATION FOR COMMUNITY AFFILIATED PLANS (Washington, DC)
- …improvement plans where appropriate.Ensure strict adherence to all federal and Maryland state Medicaid regulations, including data privacy and security measures. ... the organization through dynamic regulatory and healthcare environments. The VP Executive Director is accountable for the day-to-day operations and profit and… more
- Change.org, PBC (Washington, DC)
- …connects patients, personal care providers, managed care organizations, and states.The Director , Strategic Partnerships is a critical and dynamic leadership role ... partner relationships with clearinghouses, 3rd party EDI vendors, payers, providers, state aggregators, and Partner Connect vendors. Reporting directly to the VP,… more
- Chapters Health System (Washington, DC)
- …claims processing Demonstrated expertise and knowledge with third party payors to include Medicaid , Medicare and state and federal regulations for both acute and ... Director , Billing and Collections It's inspiring to work...and/or services provided to all clients. Comply with all State , federal and local government regulations, maintaining a strong… more
- The National Coalition of Healthcare Recruiters (Santa Clara, CA)
- …a tremendous quality of life with a wonderful climate, low cost of living, NO State Income Tax, and is a great place to call home!!General Summary:The Director ... of Case Management leads and manages the day-to-day operations of utilization, clinical resource and case management departments and focuses on the continuum of care… more
- AlohaCare (HI)
- …by the Chief Operations Officer. Frequent interaction and coordination with Plan Operations leaders to include the Senior Director of Plan Operations , ... The Company: AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to… more
- CalOptima (Los Angeles, CA)
- …the incumbent will participate in and contribute to overall CalOptima Health operations and strategy development, bringing a current knowledge and future vision to ... including data, systems and applications, architecture, and infrastructure and operations support.Uses influence and negotiation to create collaboration to enable… more
- The Cigna Group (Bloomfield, CT)
- **Job Purpose/Description** The Legal Compliance Senior Director - Express Scripts Medicaid and Commercial is responsible for the development, implementation, ... the organization to identify and mitigate compliance risks. The Legal Compliance Senior Director - Express Scripts Medicaid and Commercial will serve as the… more
- Humana (Columbus, OH)
- … Medicaid capitation rate to identify rate adequacy issues. + Experience negotiating Medicaid capitation rate with State Medicaid agencies. + Experience ... a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range… more
- CVS Health (Hartford, CT)
- …new and exciting ways every day. Aetna is recruiting for an Executive Director , Medicaid Provider Experience Standardization who is responsible for ensuring the ... points to drive alignment and transparency with the Network Operations Team and the Medicaid Health Plans....the process to transition each Health Plan from current state to the new standard. This leader is responsible… more
- Humana (Columbus, OH)
- …Medical Director responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve ... by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal… more
- Elevance Health (Indianapolis, IN)
- **Medical Director -Indiana Medicaid ** **Location: This is a hybrid position. Candidates must live within 50 miles of an Elevance Health location. Prefer ... of experience providing health care is required. Additional experience may be required by State contracts or regulations if the Medical Director is filing a role… more
- State of Georgia (Fulton County, GA)
- …Responsibilities - Position Overview: OMC/HSI Budget and Financial Analyst reports to the Director of the Office of Medicaid Coordination and Health Systems ... of Behavioral Health and Developmental Disabilities (DBHDD) is the state agency that focuses solely on policies, programs, and...Duties and Responsibilities: Under the broad supervision of the Director of the Office of Medicaid Coordination… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …and new people to make a difference with. **The opportunity** The Manager of Medicaid Compliance and Analytics will manage operations of Medicaid ... other activities that ensure process efficiencies. The Manager of Medicaid Compliance and Analytics reports to Director ...experience within a pharmaceutical company, state , and/or state agency or as a Medicaid consultant… more
- Elevance Health (Overland Park, KS)
- **Kansas Medicaid Compliance Consultant Senior** **Location: Must be located in/a resident of Kansas** This position will take part in Elevance Health's hybrid ... Kansas The **Compliance Consultant Senior** owns facilitation of correspondence with the state of Kansas. This includes working closely with the Compliance … more
- CVS Health (Princeton, NJ)
- …Behavioral Health Senior Manager of Network Relations will report to the Executive Director of Network Management and will work in close partnership with the ABHNJ ... Behavioral Health Medical Director , Behavioral Health Administrator, CEO, COO, CMO, CFO, and...ability to effectively interact with providers, advocacy groups and State partners + Excellent organization and time management skills… more
- City of New York (New York, NY)
- …oversight for Home Attendant and Housekeeping services for active cases. The Executive Director of Field Operations plans and manages the activities of the ... of independent judgment, initiative and decision making, the Executive Director of Field Operations will oversee, direct,...Medicaid . Manage the review and analysis of staff operations to ensure uniformity in the application of mandated… more
