• Medicaid Implementation Sr

    Humana (Denver, CO)
    …caring community and help us put health first** Humana Healthy Horizons is seeking a Medicaid Implementation Senior Business Project Manager to manage a ... change management and project management are best suited for this role. The Medicaid Implementation Senior Business Project Manager will serve as a… more
    Humana (10/29/24)
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  • Health Plan Account Dir Sr - Remote

    Prime Therapeutics (Denver, CO)
    business (Employer Markets, Health Insurance Marketplace, Commercial, Medicare, Medicaid , Specialty) or with unique Prime contract requirements; drive the ... we make. **Job Posting Title** Health Plan Account Dir Sr - Remote **Job Description** The Sr ...advanced degree + Experience working within assigned line of business or market segment (Commercial, Medicare, Medicaid ,… more
    Prime Therapeutics (10/25/24)
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  • Regulatory Analyst Sr - Remote

    Prime Therapeutics (Denver, CO)
    …passion and drives every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible ... and participates in committee review meetings within the Commercial, Medicare, Medicaid , and Health Insurance Marketplace for the assigned department. This position… more
    Prime Therapeutics (10/30/24)
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  • Senior Strategy Advancement Professional…

    Humana (Denver, CO)
    Medicaid products and capabilities to support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for ... Care Organization **OR** 2+ years of experience in strategy consulting supporting Medicaid managed care organizations. + Experience in business development or… more
    Humana (10/29/24)
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  • Medicaid Children's Behavioral Health…

    Public Consulting Group (Denver, CO)
    …and Grants Management + Assessments and Feasibility Studies PCG is looking for a Senior Consultant in Medicaid policy and funding as it relates to children's ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health,...children's behavioral health services. PCG is looking for a Senior Consultant in Medicaid policy and funding… more
    Public Consulting Group (10/23/24)
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  • Sr . Director, Pharmacy Network Management…

    Prime Therapeutics (Denver, CO)
    …It fuels our passion and drives every decision we make. **Job Posting Title** Sr . Director, Pharmacy Network Management - Remote **Job Description** The Senior ... market leading pharmacy reimbursement methodologies that support all of Prime's business assuring coordination with performance standards and corporate goals. + Lead… more
    Prime Therapeutics (10/24/24)
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  • Senior Technology Implementation

    Humana (Denver, CO)
    …an in-depth evaluation of variable factors. The Senior Technology Implementation Professional gathers and documents business system and functional ... a part of our caring community and help us put health first** The Senior Technology Implementation Professional delivers new technological solutions to meet … more
    Humana (10/29/24)
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  • Senior Business Systems Analyst

    Humana (Denver, CO)
    **Become a part of our caring community and help us put health first** The Senior Business Systems Analysis Professional who is part of the System Optimization ... ensuring optimal performance and integration across the procurement landscape. The Senior Business Systems Analysis Professional performs analyses of systems,… more
    Humana (10/29/24)
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  • Senior Compliance Professional

    Humana (Denver, CO)
    …Coordinate business partner engagement with external regulators + Coordinate implementation and compliance with corrective action plans, as needed + Provide ... a part of our caring community and help us put health first** This Senior Compliance Professional role supports Humana's suite of Medicare and Commercial Dental and… more
    Humana (10/29/24)
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  • Senior Network Engineer

    Humana (Denver, CO)
    …analyzes, plans and modifies network components supporting customer communication implementation activities. The Senior Network Engineer work assignments ... situations or data requires an in-depth evaluation of variable factors. The Senior Network Engineer will be responsible for providing engineering and operational… more
    Humana (10/30/24)
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  • Senior Payment Integrity Analyst

    HealthEdge Software Inc (Denver, CO)
    **Overview** **Position Overview:** We are seeking a Senior Payment Integrity Specialist to play a key role in building and implementing proprietary healthcare edits ... in claims processing. The successful candidate will be responsible for taking a senior level role in analyzing claims data, as well as translating contract terms,… more
    HealthEdge Software Inc (10/09/24)
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  • Data & Reporting Business Analyst - Remote

    Prime Therapeutics (Denver, CO)
    …to develop detailed design specifications according to standards. **Job Description** The Business Analyst will support the Colorado Medicaid Pharmacy Benefits ... and requests for ad hoc reports to support sales, implementation , new product development, specials. + Queries data warehouse...to adjust focus **Reporting Structure** + Could report to Business Analyst Lead, Manager, Director, Sr Director,… more
    Prime Therapeutics (10/18/24)
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  • AVP, IT Service Management

    Humana (Denver, CO)
    …use of ServiceNow, JSM, or other platforms as necessary. + Collaborate with senior leadership to integrate ITSM into business process operations, ensure IT ... exceptional stability and performance for our IT infrastructure. Leads design, implementation , and optimization of ITSM processes for the cloud environment, DevOps,… more
    Humana (10/29/24)
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  • SVP, Home Solutions Strategy and Business

    Humana (Denver, CO)
    …that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of home health services, and ... in their personal and professional well-being, all from day one. The Home Solutions business segment is comprised of two major brands - CenterWell Home Health (CWHH)… more
    Humana (10/29/24)
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  • Director of Engineering - Remote US

    Public Partnerships LLC (Denver, CO)
    …and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and ... to develop and enhance the products from concept to implementation to product go-live. + Research, Evaluate and Incorporate...strategies that deliver significant value to our customers and business . + Hold a high bar for execution and… more
    Public Partnerships LLC (10/19/24)
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  • Lead Google Cloud Solutions Engineer, Network

    Humana (Denver, CO)
    …experience. The individual in this role will lead Humana network infrastructure implementation for Google Cloud. The Lead Cloud Solutions Engineer (Network) performs ... to ensure an integrated architecture across interdependent technologies. Works with senior executives to develop and drive segment or enterprise-wide functional… more
    Humana (10/29/24)
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  • Summer 2025 - Market Intelligence Analyst…

    Highmark Health (Denver, CO)
    …carriers), topics (ex. technology, virtual health, industry trends), and lines of business (ex. ACA, commercial, Medicare Advantage, Medicaid ). The work can ... will support strategic initiatives and priorities for product development and implementation and/or market and competitive intelligence. Gather and analyze internal… more
    Highmark Health (09/14/24)
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  • Financial Analytics Lead

    Humana (Denver, CO)
    …strong relationships with key stakeholders discussing financial performance and incorporate business insights into the financial models. + Implementation and ... seeking a Financial Analytics Lead. This individual will work across the business , and will be highly involved in reporting, planning, underwriting, strategic… more
    Humana (10/29/24)
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  • Value-Based Reimbursement Strategic Partners…

    Highmark Health (Denver, CO)
    …integration into the overall Enterprise strategy through collaboration with Senior -level internal/external stakeholders. Ensures a high degree of development, ... development and completion of sales cycle (from model conception to implementation ) of VBR programs for key strategic accounts and/or initiatives.Support strategic… more
    Highmark Health (10/10/24)
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  • Actuary, Risk and Compliance

    Humana (Denver, CO)
    …us put health first** This Actuary role is a role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage programs, including ... you will have a unique opportunity to provide guidance and collaborate with business partners and leadership on these growing and expanding programs. In addition to… more
    Humana (10/29/24)
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