- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, ... performance. By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... focus on value-based arrangements and network-wide engagement strategies. The program manager is responsible for managing and implementing key population health and… more
- Commonwealth Care Alliance (Boston, MA)
- …CA-Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the performance of ... the implementation of CCA's model of care and strategic objectives. The Manager leads performance evaluation and improvement efforts, including reporting and data… more
- COOLSOFT (Raleigh, NC)
- …ie, Scrum, Kanban -Participate in and own SCRUM ceremonies along with the Project Manager and Business Analyst. -Experience with software implementation projects ... * Agency Interview Type: Webcam Interview Only Description: We are seeking a Sr . Specialist for a critical project to replace an on-premises custom-built… more
- Commonwealth Care Alliance (Boston, MA)
- …and performance improvement. The Provider Relations Director reports to the Sr Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: - ... Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory… more
- CVS Health (Lansing, MI)
- …of initiatives/programs and completes State/HSAG PIP templates for submission. + Assists Senior Quality Manager and Director with coordination and implementation ... coordination of corporate compliance and external surveys as needed. + Support the project life cycle including requirements gathering, creation of project plans… more
- Capital One (Mclean, VA)
- Sr . Manager , Consumer Intelligence - Corporate Strategy... Medicaid on consumer financial health. As a Senior Manager on the team, you will be ... upon number of hours to be regularly worked. McLean, VA: $193,000 - $220,300 for Sr . Manager , Strategy Candidates hired to work in other locations will be… more
- Capgemini (Cincinnati, OH)
- **About the job:** Job role responsibilities of **Program Manager / Sr Project Manager ** - Markets and Growth portfolio Medicare Advantage/ DSNP/ ... Medicaid or Exchange program/ product build knowledge (Enrollment, Eligibility,...project documentation Escalate issues to Business Owner/ Program Manager / Leadership Promote cross-functional communication between impacted business &… more
- Molina Healthcare (NM)
- …of New Mexico** is seeking a dynamic **Community Engagement & Growth Sr Specialist** in/near the **Albuquerque** area **.** **Bilingual, Spanish speaking is a ... with community-based organizations and providers to promote Molina's services. The Sr Specialist will collaborate with internal teams (Quality, Provider Relations,… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** As the Sr Manager , Data Science, you will be a technical and operational leader reporting to the VP of Data Science. Your primary ... a regulated environment. **WHAT YOU'LL DO** Team Leadership & Project Execution + Lead, mentor, and develop a team...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Covenant Health Inc. (Crossville, TN)
- Overview Senior Risk Manager and Regulatory Specialist, Quality Managment Full Time, 80 Hours Per Pay Period, Day Shifts Cumberland Medical Center Overview: ... a family-oriented environment focused on exceptional patient care. Position Summary: The Sr . Risk Manager and Regulatory Specialist position is responsible for… more
- Point32Health (MA)
- …**Job Summary** Under the direction of the Director, Clinical Pharmacy Operations, the Senior Manager , Clinical Pharmacy Operations is responsible for managing a ... of programs, and trend review by therapeutic class. Work with Pharmacy Benefit Manager (PBM) to monitor pharmacy spend and performance to identify opportunities for… more
- General Dynamics Information Technology (Fairfax, VA)
- …part of improving how agencies operate. Our work depends on a Lead and/or Sr . Salesforce Developer joining our team to support Centers for Medicare & Medicaid ... we foster a people-centric environment. As a Lead and/or Sr . Salesforce Developer supporting CMS, you will be trusted...a Lead (Development Lead for their Scrum Team) or Senior Developer, depending on the needs of the program.**… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** While our Sr . Specialist Application Engineers are involved in multiple things throughout the Technology organization, primarily they are ... Success department in resolving issues relating to production processes. The Sr . Specialist Application Engineer is responsible for troubleshooting and resolving… more
- Datavant (Honolulu, HI)
- …and life experiences to realize our bold vision for healthcare. The Risk Adjustment Sr Data Analyst is an experienced analyst possessing a deep understanding of the ... to understand business objectives and deliver results. As a Sr . Data Analyst, you will: + Take ownership of...+ Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Elevance Health (Norfolk, VA)
- **JR171732 Coding Auditor Sr ** CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists ... of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from… more
- Waystar (Atlanta, GA)
- …project requirements + Participate in weekly project status meetings with the Project Manager + Serve as a mentor for client adoption consultants + Assume ... **ABOUT THIS POSITION** The Sr . Solution Adoption Consultant role will act as...with client, vendor, team members and team leaders regarding project issues, risks, and needs + Translate client and… more
- CVS Health (Frankfort, KY)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working knowledge of… more
- NTT DATA North America (Montgomery, AL)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Medicaid Senior BA to join our team in montgomery, Alabama ... cycle of assigned projects. The focus will be the Medicaid Claims Processing System. The Senior BA...current MMIS and plan for the future CPMS takeover project working with the Project Manager… more
