- CVS Health (Annapolis, MD)
- …The Manager of Claims Management is responsible for overseeing Medicaid claims operations , inventory management, quality assurance, and compliance ... + Participate in the development of policy and procedure updates for Medicaid claims operations . **Required Qualifications** + Bachelor's degree in Business,… 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** : ... provides executive leadership and strategic oversight of health care program integrity within Minnesota's Medicaid system. The...of all provider types. + Plan and implement policy, program , operations , and budget changes. + Understands… 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 ... as for internal staff that aligns PE/Network functions with Operations and Claims as needed + Research, review, and...or Network Strategy * Minimum 5+ years' experience in Medicaid Managed Care business segment environment with exposure to… more
- NTT America, Inc. (Little Rock, AR)
- …as part of a team providing Business Operations Support (BOS) for a state Medicaid Program . Working under the direction of the team manager , they will ... experience supporting large, complex Medicaid system implementation projects and/or Medicaid business operations * Minimum 2 years of experience supporting… 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 program including the strategic direction for...collaboration with matrix leaders in marketing, finance, government relationships, operations , health services and compliance, the Manager … more
- Commonwealth Care Alliance (Boston, MA)
- …medical, behavioral health, and/or social needs. + Strong understanding of **Medicare, Medicaid (MassHealth), and dual-eligible program operations ** , ... 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based… more
- Fair Haven Community Health Care (New Haven, CT)
- …equitable, high-quality, and culturally responsive patient-centered care. Job purpose The Pharmacy Operations & 340B Program Manager provides strategic ... use areas and ensure maximum participation and compliance with program guidelines. + Monitor and audit inventory, Medicaid...with contract pharmacies, wholesalers, and EMR teams to support program operations . + Apply data-driven methods to… more
- Point32Health (Canton, MA)
- …engagement with senior leaders at contracted provider organizations. + **Risk Adjustment Program Management and Vendor Evaluation** : The Manager will be ... to identify improvement opportunities and recommend changes to improve program results and effectiveness. The Manager will...and reporting that identify and track revenue trends and program results for Medicare, Medicaid , Duals and… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER III, FACILITIES OPERATIONS AND CRAFTS...are searching for: Has immediate charge of the facilities operations and building crafts program of a ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4855820) Apply MANAGER III, FACILITIES OPERATIONS AND CRAFTS Salary $136,076.88 - $183,393.84 Annually Location… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER II, FACILITIES OPERATIONS AND CRAFTS,...medical center assisting in the management of a facilities operations and building crafts program in a ... ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations...Policies & Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care… more
- New York State Civil Service (Rochester, NY)
- …a Residential Program Manager 2 to manage and oversee residential program operations of a State Operated Community Residence (SOCR). The SOCR provides ... Manager 2, you will oversee residential program operations to ensure the health, care,...or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any… more
- AccentCare, Inc. (Indianapolis, IN)
- Overview Business Operations Manager Location: Indianapolis, Indiana Position: Business Operations Manager Job ID: 70406 Remote/Virtual Position: NO ... of care we're building together. Be the Best Business Operations Manager You Can Be If you...lease. + * Maintain records related to the hospice program state license, Medicare and Medicaid Certification,… more
- Marshfield Clinic (Weston, WI)
- …support the most exciting missions in the world!** **Job Title:** Lab Operations Manager - East **Cost Center:** 301691161 WesHos-Laboratory **Scheduled Weekly ... Normal (United States of America) **Job Description:** The Lab Operations Manager is responsible for managing laboratory...or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is… more
- Marshfield Clinic (Weston, WI)
- …support the most exciting missions in the world!** **Job Title:** Operations Manager **Cost Center:** 301691005 Weston-Administration **Scheduled Weekly Hours:** ... (United States of America) **Job Description:** **JOB SUMMARY** The Operations Manager is responsible for the day-to-day...or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is… more
- City of New York (New York, NY)
- …is recruiting for one (1) Principal Administrative Associate III to function as Section Manager , Fair Hearings Operations who will: - Coordinate and control the ... representation of the Agency at NYS Administrative Hearings in the following program areas: Cash Assistance (CA), Supplemental Nutrition Assistance Program … more
- Commonwealth Care Alliance (Boston, MA)
- …making in alignment with clinical licensure. * Strong understanding of Medicare, Medicaid (MassHealth), and dual-eligible program operations , including ... & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships… more
- Service Source (Oakton, VA)
- …. Lead the Way in Building Bright Futures! Join our team as a Division Manager and make a lasting impact on adults with disabilities. This is your chance to ... + full benefits ✅ Locations: Oakton, VA (PIERS Day Program ) & Arlington, VA (Access Employment Program )...compliance with all State and Federal regulatory guidelines, including Medicaid , Licensure, and CARF as well as other funding… more
- State of Minnesota (Vadnais Heights, MN)
- **Working Title: Revenue Integrity Manager ** **Job Class: State Program Administrator, Manager Senior** **Agency: Direct Care and Treatment** + **Job ID** : ... : 11/24/2025 + **Hiring Agency/Seniority Unit** : Direct Care and Treatment / DCT Manager + **Division/Unit** : DCT Support Services / DCT Finance Supv + **Work… more
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