- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …May serve as backup to management (ie Medicaid Program Supervisor, Medicaid Program Manager 1B). + Other tasks as assigned. QUALIFICATIONS REQUIRED: ... escalated matters. + Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid ...of Medicaid and Eligibility policy to interpret Medicaid claims. + Participates in the development and implementation… more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a **Case Manager , Medicaid Long Term Support Program ** to join #TeamMVP. ... clinical and Case Management experience. Experience working in a Medicaid Long Term Support Program (LTSS) or...Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of… more
- CVS Health (Annapolis, MD)
- … Manager of Claims Management is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and compliance monitoring. This ... role ensures timely and accurate processing of Medicaid claims in accordance with state and federal regulations, contractual requirements, and organizational… more
- CVS Health (Boise, ID)
- …and every day. **May reside anywhere in the US** **Position Summary** The Health Service Manager -Policy Writer for Medicaid is a key member of the Medical ... Policy & Program Solutions Team. The Medicaid Medical Coding Policy Writer is an individual contributor and will research and develop moderate to complex coding… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Medicaid Provider Audits and Investigations Manager ** **Job Class: Human Services Manager 2** **Agency: Human Services Dept** + **Job ID** : ... this position provides executive leadership and strategic oversight of health care program integrity within Minnesota's Medicaid system. The incumbent manages… more
- Prime Therapeutics (Santa Fe, NM)
- …our passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior ... Account Manager is responsible for providing complex level support for...for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product… more
- CVS Health (Chicago, IL)
- …compliance within our network responsibilities as provided within the state Medicaid contractual requirements. This position holds a variety of functions for ... or Network Strategy * Minimum 5+ years' experience in Medicaid Managed Care business segment environment with exposure to...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Annapolis, MD)
- …and regulatory requirements. + Medicaid Network Management experience, preferably Maryland Medicaid program . + Residing within the state of Maryland highly ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...includes an award target in the company's equity award program . Our people fuel our future. Our teams reflect… more
- CVS Health (Columbus, OH)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- NTT America, Inc. (Little Rock, AR)
- …will work as part of a team providing Business Operations Support (BOS) for a state Medicaid Program . Working under the direction of the team manager , they ... inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Medicaid / EVV Business Analyst to join our team in Little Rock,… more
- Accura Healthcare (Omaha, NE)
- Accura HealthCare has an opportunity to invite a Medicaid Billing Specialist - Lead to join our growing accounting and finance team! We are a multi-state senior ... the healthcare industry, specifically Skilled Nursing Facility (SNF) billing experience. Medicaid billing experience is necessary to be considered. JOB SUMMARY: The… more
- Fallon Health (Worcester, MA)
- …experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an ... alternative to nursing home care, is a program that helps people 55 and older continue living...the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of… more
- Elevance Health (Durham, NC)
- **Utilization Management Medical Director- NC Medicaid ** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... will be responsible for utilization review case management for North Carolina Medicaid . May be responsible for developing and implementing programs to improve… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Sr. Program Manager , DC Market Operations provides leadership for the operation of a single jurisdiction Medicaid ... profitability, growth, and stability of the business. The Sr Program Manager will have responsibility for business...deliver the overall strategic plan for a single jurisdiction Medicaid program . Through collaboration with matrix leaders… more
- New York State Civil Service (Rochester, NY)
- NY HELP Yes Agency Mental Health, Office of Title Residential Program Manager 2 (NY HELPS), Rochester Psychiatric Center, P27340 Occupational Category Health ... Description Rochester Psychiatric Center is currently recruiting a Residential Program Manager 2 to manage and oversee...or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any… more
- Service Source (Springfield, VA)
- …change, and strengthen communities . Join Our Team! ServiceSource is proudly hiring a Program Manager to oversee the daily services of our Oakton, VA Community ... and 401(a) options. + Upward Mobility: Established promotion opportunities and clear career pathways ({ Program Manager >> Sr. Program Manager / Division … more
- General Dynamics Information Technology (Fairfax, VA)
- …**Job Family:** Science and Research **Skills:** CMS Reporting,Data Management,Health Program Management, Medicaid ,Medicare **Experience:** 10 + years of related ... MEANINGFUL WORK AND PERSONAL IMPACT: + Oversee health services research assistance program for Medicare and Medicaid , including data analysis, technical… more
- Molina Healthcare (Carson City, NV)
- …QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met...experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects… more
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based ... efforts. Through reporting, data analysis, and partnership management, the LTSS Program Manager ensures that providers meet contractual, regulatory, and… more
- Commonwealth Care Alliance (Boston, MA)
- …& Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships ... CCA's mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship … more
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