- BlueCross BlueShield of North Carolina (NC)
- …timely, accurately and in compliance with the Centers for Medicare and Medicaid Services (CMS) requirements. Ensures that future program enhancements are funded and ... with business needs. Identifies, evaluates and resolves issues that conflict with project deliverables. Collaborates closely with project team members, business… more
- Nestle (Bridgewater, NJ)
- …Compliance_ * Ensures compliance with government pricing programs, including Medicare Part D Program, VA Federal Supply Schedule Program, Medicaid Drug Rebate ... for patients and consumers. **Job Description:** The Senior Government Pricing and Contracting Manager for Nestle Health Science USA will play a critical role in… more
- Elevance Health (Durham, NC)
- We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid -enrolled infants, children, youth, young ... in safe, stable, and nurturing homes. The Innovations and Outcomes Monitoring Manager is responsible for leading initiatives to improve and innovate programs under… more
- Molina Healthcare (Columbus, OH)
- Molina Healthcare is hiring for a **Program Manager - Payment Integrity/Prepayment Solutions Implementation.** This role is remote and can be worked from states we ... processing. + Experience working within Payment Integrity and/or Prepayment solutions. + Project Management, and/or Technical Project Management. + Above average… more
- Molina Healthcare (Columbus, OH)
- …for all Medicare lines of business the annual Medicare and Medicare- Medicaid Plan Applications and Plan Benefit Package design. Provides centralized year-round ... Provides oversight and update of the Medicare public website, collaborating with internal project management teams and IT support on an ongoing basis. Assists in the… more
- Prime Therapeutics (Columbus, OH)
- …the implementation of process changes + Working knowledge of Medicare Part D , Medicaid , and/or Health Insurance Marketplace guidance + Strong interpersonal ... It fuels our passion and drives every decision we make. **Job Posting Title** Manager , Client Audit Services - Remote **Job Description** The Manager Client… more
- Guthrie (Cortland, NY)
- …and oversight of clinical requirements developed by the Center for Medicare and Medicaid (CMS), the Department of Health (DOH), and The Joint Commission (TJC). The ... into ongoing management and operational activities and that they are effective d . Works in tandem with hospital regulatory leadership to standardize regulatory… more
- Molina Healthcare (Columbus, OH)
- …Knowledge/Skills/Abilities + Independently manage and deliver Enrollment Enterprise wide project initiatives from inception through delivery + Subject matter expert ... needs, support to other business units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends and provides… more
- Boehringer Ingelheim (Ridgefield, CT)
- …accrual forecasts and by providing support for Managed Care / Medicare Part D group efforts as required in order to support the Contracting Department's efforts ... related to 340B and Manage the 340B dispute process for either State Medicaid Program, Covered Entities and/or PBMs. + Participate in the LTF Development and… more
- Molina Healthcare (Los Angeles, CA)
- …goals improving Molina's enrollment growth objectives, with primary responsibility for Medicaid . Works collaboratively with key departments across the enterprise to ... rate. Works collaboratively with other key departments to increase Medicaid assignment percentage for Molina. + Provides leadership for...model. May also serve as the Acting Supervisor or Manager for the team upon management request. + Responsible… more
- Molina Healthcare (Everett, WA)
- …social services, and community resources. (Bonus, but not required in Managed Care, Medicaid , Health Plan or Health Insurance etc..) + Previous experience in a ... such as homeless shelters, etc.) + Participates in ongoing or project -based activities that may require extensive member outreach (telephonically and/or… more
- Spokane County (Spokane, WA)
- …Integrated Behavioral Healthcare Quality Supervisor and the Integrated Behavioral Health Manager and other department leadership, and in alignment with the overall ... System for Award Management (SAM) systems, in any capacity for the Medicare, Medicaid , and all Federal healthcare programs. Selection Factors + Knowledge of relevant… more
- UNC Health Care (Chapel Hill, NC)
- …communities we serve. **Summary:** This position functions as a mid-level manager with daily operational responsibilities for all aspects of Financial Counseling ... and daily operational processes to include financial assistance and Medicaid eligibility screening, insurance premium, copayment, and grant fund assistance,… more
- Superior Ambulance Service (Elmhurst, IL)
- …team with data analysis, daily and monthly reporting, and responses to manager information requests. Strong ability to conduct critical process analysis, manage ... HCPC/ICD\-9 codes + Familiar with ambulance physician certification requirements for Medicare, Medicaid and Managed Care + Strong knowledge of Medicare, Medicaid … more
- City of New York (New York, NY)
- …provided are intensive case management, direct linkages to Cash Assistance, Medicaid , Supplemental Nutrition Assistance Program (SNAP), Long Term Care. Homemaking, ... maintain stable, healthy lives. Under the direction of the HASA Regional Manager , with latitude for independent judgment, initiative and decision-making the Center… more
- CenterWell (Arlington, TX)
- …Our care team consists of Doctors, Advanced Practice professionals, Pharm D , Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based ... on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude… more
- State of Colorado (Denver, CO)
- …administered state supervised system. The Permanency Unit consists of one manager , five program administrators, and one Program Assistant. Each program administrator ... from other state agencies, in the areas of mental health, health, self-sufficiency, Medicaid , housing, etc to improve access to services and resources for foster… more
- Molina Healthcare (Provo, UT)
- …with and between other departments within the organization. + Evaluates project /program activities and results to identify opportunities for improvement. + Surfaces ... to Manager and Director any gaps in processes that may...Experience** 1 year of experience in Medicare and in Medicaid . **Preferred License, Certification, Association** + Certified Professional in… more
- Molina Healthcare (Detroit, MI)
- …or with and between key provider network partners. + Evaluates project /program activities and results to identify opportunities for improvement. + Surfaces ... to Manager and Director any gaps in processes that may...Experience** 1 year of experience in Medicare and in Medicaid . **Preferred License, Certification, Association** + Certified Professional in… more