- CVS Health (Northbrook, IL)
- …position that supports the compliance program activities and deliverables of a Medicaid managed care organization. In partnership with and under the direction of ... the Chief Medicaid Compliance Officer and Medicaid Compliance leadership...communicate and influence ethical and compliant outcomes, inform projects, provide status updates, and address issues + Actively participate… more
- CVS Health (Columbus, OH)
- …and performance oversight + PMP Certification + Key concepts (high level) of provider networks as they pertain to Medicaid products (contracting, adequacy, ... within network as well as other business areas (clinical, operations, Medicaid segment). **Skills In** + Project management fundamental skills: planning,… 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
- The Cigna Group (Bloomfield, CT)
- **Job Purpose/Description** The Legal Compliance Senior Director- Express Scripts Medicaid and Commercial is responsible for the development, implementation, ... administration, and oversight of the Pharmaceutical Benefit Manager (PBM) Medicaid and Commercial Compliance Programs. This role reports directly to the Managing… more
- CVS Health (Phoenix, AZ)
- …Lead HRBP to provide strategic and day-to-day HR support for the Aetna Medicaid organization. The Senior HR Business Partner will be expected to regularly ... well as strategic initiatives.Responsibilities: + Strategic business advisor to executive/ senior business leaders to align talent management practices, workforce… more
- CVS Health (Oklahoma City, OK)
- …health care more personal, convenient and affordable. **Position Summary** The Senior Contract Manager , Network Management negotiates, executes, conducts high ... contracting, provider issues/resolutions, related systems and information contained. * Provide guidance and share expertise to others on the team. *… more
- CVS Health (Princeton, NJ)
- …make health care more personal, convenient and affordable. **Position Summary** The Behavioral Health Senior Manager of Network Relations is a key role on the ... of ABHNJ' s Behavioral Health Network. The Behavioral Health Senior Manager of Network Relations will report... provider services requirements under this Agreement + Provide provider education and develop and deliver… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Director of Technology Modernization, Medicaid Programs Durational Project Manager Recruitment # 240801-0415VR-001 Location Hartford, CT Date Opened 8/7/2024 ... + + Introduction Unique Opportunity: Director of Technology Modernization, Medicaid Programs - Durational Project Manager (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=0415VR&R1=&R3=)… more
- Elevance Health (Palo Alto, CA)
- Care Consultant Sr . (California Provider Success) - JR126324 **Location** : Must reside **in the state of California** , and within 50 miles (1 hour commute) of ... at least 1 day per week. The **Care Consultant Sr .** for ** Provider Success** is responsible for...responsible for consulting with providers (Commercial, Medicare Advantage and Medicaid Lines of Business) to assess and deploy appropriate… more
- Elevance Health (Lexington, KY)
- Care Consultant Sr . ( Provider Success) - JR126256 **Location** : Prefer State of Kentucky residence. Those in bordering states will be considered. (Requires ... 25% - 30% of the time.)** The **Care Consultant Sr .** for ** Provider Success** is responsible for...is responsible for consulting with providers (Medicare Advantage and Medicaid ) to assess and deploy appropriate interventions to drive… more
- Elevance Health (Richmond, VA)
- Provider Network Management Sr (Contract Negotiations) (JR128784) **Location:** Candidates must reside within 50 miles or 1-hour commute each way of one of our ... being 1 day in an office per week. The ** Provider Network Management Sr ** **(** Hospital Contracts)...or any combination of education and experience, which would provide an equivalent background. **Preferred Qualifications:** + Experience in… more
- Molina Healthcare (NM)
- …and monitoring for key performance measurement activities. **Knowledge/Skills/Abilities** The Senior Specialist, Provider Engagement contributes to one or ... healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures maintenance of Provider Quality Improvement programs… more
- New York eHealth Collaborative (Albany, NY)
- …State's public health and Medicaid efforts. Position Summary: NYeC is seeking a Sr . Financial Planning & Analysis Manager who will collaborate with the Head ... Sr . Financial Planning & Analysis Manager ...that are essential to our business. This role will provide analytical, financial reporting, and perform other related responsibilities… more
- Plante Moran (Columbus, OH)
- Healthcare Reimbursement - Consulting Sr . Manager + Location: United States, Ohio, Columbus + Location: United States, Ohio, Cleveland Make your mark. Our ... senior care healthcare consulting team focuses on our clients'...Lead and manage strategic engagements focused on preparation of Medicaid and Medicare cost reports + Prepare, review, and… more
- Elevance Health (Woodbridge, NJ)
- The Social Work Case Manager Sr will be dedicated to the NJ Healthy Homes program and will be responsible for ensuring coordination of Housing Services with all ... other services provided to NJ Medicaid members. This associate will work with the LTSS...related policies and procedures. + Cultivating stakeholder relationship. + Provide oversight of all house-related services and Wellpoint housing… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Senior Risk Manager Full-Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... a Forbes "Best Employer" seven times. Position Summary: The senior risk manager is responsible for the...Licensure Requirement: Current Tennessee RN license Apply/Share Job Title SR RISK MANAGER ID 4064924 Facility Covenant… more
- American Heart Association (Dallas, TX)
- …career. The American Heart Association has an excellent opportunity for a ** Sr . Program Development Manager , Data Solutions, Performance Measures** supporting ... create and implement a specific HIT strategic plan supported by volunteers and Senior Management, aligning with Quality and Health IT's overall strategic plan. With… more
- Elevance Health (KS)
- **LTSS Network Education Representative Sr ** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles ... Olathe, KS** Elevance Health PulsePoint locations. The **LTSS Network Education Rep Sr ** is responsible for enhancing and overseeing a comprehensive initial and… more
- University of Miami (Miami, FL)
- …& Operations to work at the UHealth Medical Campus. Core Summary The Senior Manager , Facilities & Operations administers leadership for various projects, ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Sr . Manager , Facilities & Operations The department… more
- General Dynamics Information Technology (Fairfax, VA)
- …be a meaningful part of improving how agencies operate. Our work depends on a Sr ./ Lead Salesforce Developer joining our team to support Centers for Medicare & ... Medicaid Services (CMS) activities. This position is 100% remote...At GDIT, we foster a people-centric environment. As a Sr ./ Lead Salesforce Developer supporting CMS, you will be… more