- CVS Health (Scottsdale, AZ)
- … managed care organization. In partnership with and under the direction of the Chief Medicaid Compliance Officer and Medicaid Compliance leadership team, ... department projects and initiatives to improve and enhance Aetna's Medicaid Compliance program, and serve as the...operations and new program requirements in accordance with Aetna's state Medicaid contracts. The incumbent will have… more
- Sumitomo Pharma (Phoenix, AZ)
- …a dynamic, highly motivated, and experienced individual for the position of **Sr. Manager , Medicaid Contract Administration.** The Sr. Manager , Medicaid ... the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid claims and dispute resolution with state agencies. This position… more
- Prime Therapeutics (Phoenix, AZ)
- …fuels our passion and drives every decision we make. **Job Posting Title** Contract Manager Vendor Performance - LA Medicaid - Remote **Job Description Summary** ... documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract incentives. **Job Description**… more
- Prime Therapeutics (Phoenix, AZ)
- …our passion and drives every decision we make. **Job Posting Title** Contract Manager - NC Medicaid **Job Description Summary** Responsible for the ... documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract incentives. **Job Description**… more
- Public Consulting Group (Phoenix, AZ)
- …. **Job-Specific Responsibilities** + Provide strong leadership on all Medicare/ Medicaid cost settlement and supplemental payment projects, effectively supervising ... and reports completed by team members. + Review applicable Federal and State policies and regulations associated with various audit types. + Develop peer-to-peer… more
- CVS Health (Scottsdale, AZ)
- …has an exciting opportunity as an Analyst for our rotational program in the Compliance Center of Excellence (COE). This role will rotate through one or more areas ... of the Compliance COE to support audit or reporting activities. The...supporting the team's monitoring and auditing plan of our Medicaid , Medicare, PBM Mail, Specialty Pharmacy, Omnicare, Coram, Healthspire… more
- J&J Family of Companies (Phoenix, AZ)
- …problem solving and project management skills. + Understanding of national and state legislative, Medicare, Medicaid , and private payer initiatives affecting ... Field Reimbursement Manager , CAR-T - Northeast Region - 2406206269W **Description**...and external office staff regarding the Medicare treatment guidelines, Medicaid Managed Care, commercial plans, policy changes, formulary status… more
- Molina Healthcare (Phoenix, AZ)
- …provides direction and implementation of NCQA accreditation surveys and federal/ state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior ... (eg, removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state ...results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may… more
- Adelante (Phoenix, AZ)
- 340B Program Manager Job Details Job Location Adelante Healthcare Center Support Office - Phoenix, AZ Position Type Full Time Education Level HS Diploma from ... school Job Category Health Care Description POSITION SUMMARY The 340B Program Manager is responsible for Adelante's 340B drug pricing program. This position will… more
- Prime Therapeutics (Phoenix, AZ)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Manager - Remote **Job Description** We are hiring for two Pharmacy Network ... Managers to join our team! The Pharmacy Network Manager is responsible for development and management of Prime's retail, mail, specialty and quality-based pharmacy… more
- HealthEdge Software Inc (Phoenix, AZ)
- **Overview** **Position Overview** **:** As aSenior Manager ,Product ManagementforHealthEdgeSource, you willbededicatedto developing innovative solutions for the ... and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for… more
- Humana (Phoenix, AZ)
- …community and help us put health first** We are seeking a visionary Product Manager to lead our Product Security and DevSecOps initiatives. In this critical role, ... our strategy + Partner with cross-functional teams to ensure compliance with industry standards and regulations (eg, SOC 2,...contractors who live and work from home in the state of California will be provided payment for their… more
- Highmark Health (Phoenix, AZ)
- …underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management ... and pricing changes made by health plans, CMS and/or the states' Medicaid programs. **ESSENTIAL RESPONSIBILITIES** + Lead in working with customers, Software… more
- HonorHealth (Scottsdale, AZ)
- …Navigation will ensure all aspects of the Oncology Care Model (OCM) is in compliance with the Centers of Medicare and Medicaid Services requirements. The ... all aspects of the Oncology Care Model are in compliance with the requirements of Centers of Medicare and... with the requirements of Centers of Medicare and Medicaid Services. Responsible for maintaining and enhancing navigation services… more
- Adelante (Phoenix, AZ)
- …relations/contact work + Experience and knowledge of health care programs available through state and federal programs such as Medicaid /AHCCCS, DES, etc. + ... services. Work is performed under the direct supervision of the Eligibility Manager at each site. EXPECTATIONS Every Adelante employee will strive to maximize… more
- CVS Health (Chandler, AZ)
- …Health! Our Caremark Member Operations division of CVS Health's Pharmacy Benefit Manager business is hiring hundreds of Customer Care Representatives in your area! ... hiring Customer Care support teams for the Pharmacy Benefit Manager (PBM) division of CVS Health. In this role,...evolving. Example call types include Commercial, Medicare Part D, Medicaid , and a variety of specific clients. You will… more
- Banner Health (Phoenix, AZ)
- … compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the ... **Primary City/ State :** Phoenix, Arizona **Department Name:** Coding Ambulatory **Work...make needed corrections and ensure accurate coding, reimbursement, and compliance . 7. Provides mentoring for less experienced staff members… more
- Banner Health (Mesa, AZ)
- **Primary City/ State :** Mesa, Arizona **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care Great careers are built at Banner ... at Desert in Mesa, Arizona. Within our over 200 bed, state -of-the-art facility, specially trained nurses, physicians and other clinical professionals utilize… more
- CenterWell (Phoenix, AZ)
- …primary care 'on-call' program of CenterWell as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your ... license or willing to obtain a medical licenses in state of practice; eligible and willing to obtain licenses...and unrestricted DEA license * Medicare Provider Number * Medicaid Provider Number * Minimum of two to five… more
- CenterWell (Mesa, AZ)
- …primary care 'on-call' program of CenterWell as needed. * Assures personal compliance with licensing, certification, and accrediting bodies. * Spend 100% of your ... license or willing to obtain a medical licenses in state of practice; eligible and willing to obtain licenses...and unrestricted DEA license * Medicare Provider Number * Medicaid Provider Number * Minimum of two to five… more