• The Computer Merchant, LTD. (West Mclean, VA)
    JOB TITLE: Project Manager JOB LOCATION: Remote WAGE RANGE*: $47.61 - 59.52 JOB NUMBER: REMT000101 REQUIRED EXPERIENCE: Bachelor's degree required; Master's ... toward certification. Preferred Qualifications Experience with healthcare delivery systems, Medicaid /Medicare programs, or government contracts strongly preferred. Developing strong… more
    job goal (01/07/26)
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  • Manager , Prior Authorization Utilization…

    CVS Health (Baton Rouge, LA)
    …with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to ensure ... ensuring adherence to regulatory and contractual requirements. This is a fully remote position. Eligible candidates may live anywhere in the contiguous United… more
    CVS Health (12/21/25)
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  • Case Manager , Registered Nurse…

    CVS Health (Lansing, MI)
    …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... them with appropriate resources and support services. The Care Manager provides education and guidance to members and their...learn the role of care management within Medicare and Medicaid managed care. + Familiarity with community resources and… more
    CVS Health (01/04/26)
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  • Care Manager Specialist ( Remote

    CVS Health (Springfield, IL)
    …an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, ... conditions. The CMS collaborates closely with the Registered Nurse Care Manager , Care Coordinator, Social Worker, and other interdisciplinary care team participants… more
    CVS Health (01/01/26)
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  • Care Manager ( Remote )

    CareFirst (Baltimore, MD)
    …and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** CHPMD Medicaid **Equal Employment ... **Resp & Qualifications** **PURPOSE:** We are looking for an experienced Care Manager to support our Maryland Medicare enrollees. Under minimal supervision, the Care… more
    CareFirst (12/24/25)
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  • Clinical Case Manager Behavioral Health…

    CVS Health (Springfield, IL)
    …can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With ... delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements,… more
    CVS Health (12/05/25)
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  • Temporary to Hire Prior Authorization RN - Hybrid…

    Fallon Health (Worcester, MA)
    …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... psychosocial information from the medical records on site, through remote electronic access, telephonically or by fax in a...Keeps records and submits reports as assigned by the Manager * Refers high-risk cases to the appropriate FH… more
    Fallon Health (12/14/25)
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  • State Administrative Manager 15 - HSA…

    State of Michigan (Lansing, MI)
    State Administrative Manager 15 - HSA Analytics, LTC Finance & Reimbursement Policy Section Print ... (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5191175) Apply  State Administrative Manager 15 - HSA Analytics, LTC Finance & Reimbursement Policy… more
    State of Michigan (01/08/26)
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  • Manager Provider Network Management

    AmeriHealth Caritas (Washington, DC)
    **Responsibilities:** Responsible for managing the day-to-day activities of the DC Medicaid Plan Network Management department and staff. Responsible for assisting ... contracting management activities as it relates to the DC Medicaid Plan. Ensures that the department and staff remain...experience preferred. + 1 to 3 years managing dual eligibility health insurance, ACA Exchange Business & DSNPs. +… more
    AmeriHealth Caritas (01/01/26)
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  • Nurse Case Manager

    Actalent (Jacksonville, FL)
    …changing priorities and hybrid schedules. + InterQual experience. + Certified Case Manager . + Familiarity with Medicaid /Medicare regulations. + Experience with ... Actalent is Hiring a Team of Remote Nurses // Case Management / Must be...Nurse in FL!! Job Description The OB RN Case Manager will coordinate care for maternal and child health… more
    Actalent (01/06/26)
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  • Research Admin Specialist II-CTMS, US…

    Huron Consulting Group (Chicago, IL)
    …interpret and apply clinical guidelines including Centers for Medicare and Medicaid , Federal Drug Administration, National Comprehensive Cancer Network. + Highly ... to no errors. + Intermediate Excel competency + This is a full time US- REMOTE role. This salaried position may require working additional hours at times, depending… more
    Huron Consulting Group (12/08/25)
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  • Manager , Health Systems Analytics

    Bristol Myers Squibb (Princeton, NJ)
    …It includes providing analytical support for strategies related to Medicare and Medicaid reforms, Pharmacy Benefit Manager (PBM) reforms, Inflation Reduction Act ... also be limited for the capability centers. Employees in remote -by-design or lab-based roles may be eligible for summer...on the nature of their work, and should discuss eligibility with their manager . Employees covered under… more
    Bristol Myers Squibb (01/10/26)
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  • Senior Associate - Payer Contracting (US…

    Amgen (Washington, DC)
    …top regional MCO and Medicaid customers. This role reports to a Senior Manager of Payer Contracting. The Senior Associate will be an instrumental member of the ... your career. **Senior Associate - Payer Contracting (US - Remote )** **What you will do** Let's do this. Let's...salary, Amgen offers a Total Rewards Plan, based on eligibility , comprising of health and welfare plans for staff… more
    Amgen (01/07/26)
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  • Clinical Care Manager - Pediatric

    WellSense (NH)
    …our members, no matter their circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for members throughout the ... data, motivational interviewing techniques and evidence-based practices, the Clinical Care Manager engages with the member and the multidisciplinary team to develop… more
    WellSense (12/26/25)
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  • Social Work Care Manager

    WellSense (NH)
    …our members, no matter their circumstances. **Job Summary** The Social Work Care Manager (SWCM) works collaboratively with the patient centered care team. The SWCM ... a recent incarceration. Our Investment in You: . Full-time remote work . Competitive salaries . Excellent benefits **Key...knowledge of the most common conditions presented in the Medicaid population and is able to assess, manage and… more
    WellSense (12/26/25)
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  • Director of Home Health Authorizations,…

    CenterWell (Nashville, TN)
    …community and help us put health first** A **Director of Authorizations & Eligibility ** is a senior revenue cycle leader responsible for the strategic oversight, ... operational execution, and continuous improvement of all authorization, insurance eligibility re-verification and payer maintenance for a large, complex Home Health… more
    CenterWell (01/08/26)
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  • Product Owner Consultant - Fusion ( Remote

    CareFirst (Baltimore, MD)
    …an in-depth knowledge of agile process and principles and/or product manager experience. **Preferred Qualifications:** + Medicare/ Medicaid and Facets experience ... and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Government Programs Value Stre **Equal Employment… more
    CareFirst (11/19/25)
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  • Product Owner, Health Sciences - Consulting…

    Cognizant (Phoenix, AZ)
    **Product Owner Health Sciences, Consulting Manager ** **About the Role:** As a Product Owner for Sales & Enrollment Platforms, you will make an impact by leading the ... features. * Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and… more
    Cognizant (11/15/25)
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  • Care Manager

    LIFEPlan CCO NY (Chappaqua, NY)
    …Year Degree Travel Percentage Up to 75% Description Job Summary: The Care Manager provides services within the Care Management programs, including Health Home Care ... position may support Willowbrook Class Members. The core responsibility of the Care Manager is to oversee and coordinate access to services for people with… more
    LIFEPlan CCO NY (01/09/26)
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  • Physician Manager 20 - Medical Director

    State of Michigan (MI)
    Physician Manager 20 - Medical Director Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4848644) Apply  Physician Manager 20 - Medical ... enjoy better lives. Many State of Michigan jobs offer alternate work schedules and remote -work options that can help give the flexibility you need. The State of… more
    State of Michigan (12/31/25)
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