- Conduent (Richmond, VA)
- …managing complex, matrixed teams to ensure project success?** We are seeking a ** Medicaid Management Systems Implementation Leader** to spearhead projects ... that involve the successful implementation of Medicaid Management Systems....Managing and overseeing a team of Project Managers, ensuring contract implementation is completed efficiently and in… more
- Prime Therapeutics (Columbus, OH)
- …+ Experience with analyzing state and federal regulations + Experience using Contract Management software including maintaining and managing databases **Minimum ... fuels our passion and drives every decision we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior … more
- Humana (Columbus, OH)
- …support to assigned health plan and/or specialty companies relative to Medicare/ Medicaid /TRICARE/Employer Group product implementation , operations, contract ... of diverse scope and complexity ranging from moderate to substantial. The Medicaid Market Development Advisor serves as the primary resource on regulations for… more
- Staffing Solutions Organization (Albany, NY)
- …and work collaboratively with Medicaid Managed Care Plans. 1. Assist with contract management functions. 1. Collaborate and work with staff, contractors, and ... reflection of our clients and the people they serve. ** Medicaid Program Advisor - Albany, NY** **DPDM - 1422**...Health Insurance Programs (OHIP), Division of Program Development and Management in a broad range of planning, implementation… more
- WellSense (Boston, MA)
- …The Senior Contract Manager is responsible for the development, implementation and management of a cost-effective provider network, maintaining complex ... Senior Contract Manager WellSense Health Plan is a nonprofit...implementation ; . Knowledge of federal and state Medicare, Medicaid , and relevant guidelines, regulations and standards; . Effective… more
- WellSense (Manchester, NH)
- …their circumstances. **Job Summary:** The Contract Manager facilitates development; implementation and management of new and current cost-effective provider ... Contract Manager WellSense Health Plan is a nonprofit...implementation ; + Knowledge of federal and state Medicare, Medicaid , and relevant guidelines, regulations and standards; + Effective… more
- Elevance Health (Richmond, VA)
- …ancillary, or medical group. Provides advice and analytic support to Medical Directors, contract negotiators and management on cost of care issues to help ... **Provider Contract Analyst Senior** **Location:** This position will work...system changes to pursue cost savings. + Reviews results post- implementation to ensure projected cost savings are realized and… more
- Healthfirst (MT)
- …rules within the claims processing system. + Identify claims configuration and contract implementation defects and improve departmental performance by supporting ... rules within the claims processing system. + Identify claims configuration and contract implementation defects and improve departmental performance by supporting… more
- CVS Health (Olympia, WA)
- …and group Behavioral Health providers within a defined market. You will manage contract performance and support the development and implementation of strategic, ... network management unit. + Assists with the design, development, management , and or implementation of strategic network configurations, including integration… more
- Marshfield Clinic (Marshfield, WI)
- …care providers. This individual is responsible to assist in the development, implementation and management of contracting activities for hospital, professional, ... Specialist assists with the boilerplate and special term contract negotiations and implementation of the ...participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must… more
- Abbott (Livermore, CA)
- …Commercial payor contract review experience + Managed Medicare and managed Medicaid contract experience + Experience working for healthcare providers + ... Well developed, advanced knowledge and skills for assisting in the commercial contract review process, including the implementation of contractual arrangements.… more
- Aspen Dental (Springfield, IL)
- …our current needs, we have an exciting opportunity to join our team as a Contract Specialist. The Contract Specialist plays a vital role within our Payor ... report to the Senior Manager of Payor Strategy. The Contract Specialist Team oversees all operational aspects of our...well as our insurance plan partners. + Manage the implementation and communication of contracts in assigned markets. +… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …& Medicaid Services (CMS), Office of Acquisition and Grants Management (OAGM), Medicare Support Contracts Group (MSCG), Division of Medicare Program Contracts ... (DMPC). As a Contract Specialist, GS-1102-14, you will be responsible for procurement...to prepare a solicitation package; AND (3) Ensuring proper implementation of Federal procurement laws and policies to complex… more
- CVS Health (Columbus, OH)
- …Medicare and/or Medicaid Delegation + Delegation / capitation and associated contract and performance oversight + PMP Certification + Key concepts (high level) ... (clinical, operations, Medicare segment). **Required Qualifications** + Successful project management experience in health operations or similar disciplines with… more
- MyFlorida (Tallahassee, FL)
- …Policy. Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including: all Medicaid ... contract interpretations, policy transmittals, and provider alerts); processing Medicaid Managed Care Plan Report Guide revisions; and updating and/or requesting… more
- CVS Health (Springfield, IL)
- …successful track record negotiating contracts which includes experience within Network Medicaid management . Proven working knowledge of provider financial issues ... level review and analysis, dispute resolution and/or settlement negotiations. Manages contract performance and supports the development and implementation of… more
- CVS Health (Kenner, LA)
- …in Louisiana. These responsibilities include leading all aspects of the plan including implementation of all contract requirements, ownership of profit and loss ... for program implementations; coordinating with internal resources to implement contract requirements; communicating ongoing implementation progress with… more
- CVS Health (Tallahassee, FL)
- …with Serious Emotional Disturbance (SED). **Core duties:** + Accountable for development, implementation , and ongoing management of complex medical management ... Finally, the BH Clinical Liaison supports the design and implementation of Behavioral Health specific programs and initiatives including..., Quality, etc) to ensure delivery of high-quality care management solution to the FL Medicaid SMI… more
- Spokane County (Spokane, WA)
- …mental health assessments, develops and implements treatment plans, provides case management referral and care coordination with other mental health professionals, ... for eligible individuals whose behavioral health services are funded with non- Medicaid funds. + Tracks and monitors applicable inpatient readmissions within sixty… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …opportunities for improvement in payment terms, methodologies, and network participation. + Contract Implementation and Monitoring: Ensure timely and accurate ... aptitude in MS Office products (including Excel, PowerPoint, Outlook and Word) and contract management software. + Ability to travel to various locations (payer… more