- Elevance Health (Grand Prairie, TX)
- **Director Medicaid Plan Marketing** **Location:** 2505 N HWY 360, Grand Prairie TX. Relocation assistance offered. This role requires associates to be in-office 3 ... of virtual work, promoting a dynamic and adaptable workplace. The **Director Medicaid Plan Marketing** is responsible for the planning and direction of specific… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare- Medicaid plans)_** + **_Experience managing external audits and communicating with ... with leadership in maintaining Centene Corporation's Compliance with Duals ( D -SNP) Program requirements. Provide regulatory interpretation, perform compliance reporting,… more
- Molina Healthcare (Chandler, AZ)
- …DESCRIPTION** **Job Summary** Focuses on process improvement, organizational change management, project management and other processes relative to the business. ... Project management includes estimating, scheduling, costing, planning, and issue/risk...Jira and smartsheets is preferred + Knowledge in Medicare, Medicaid and Marketplace is highly preferred. + Able to… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Product Manager - Hybrid - Albany, NY** In this role, you will be responsible for ... including internal and external customers, data engineers, analysts, developers, and Medicaid Program stakeholders to ensure the creation of high quality, accessible… more
- Nestle (Bridgewater, NJ)
- …health and nutrition for patients and consumers. **POSITION SUMMARY:** The Senior Manager is responsible for executing and refining national and regional distributor ... Managers and the Director of the Distributor Channel, the Senior Manager develops and implements channel-specific strategies that respond to evolving healthcare… more
- WelbeHealth (Boston, MA)
- …payment model, including ability to track and analyze revenue streams (eg Medicare, Medicaid , Part D ) along with PACE rates and regulatory constructs **Job ... general or public accounting experience + Minimum of two (2) years of accounting manager and project -lead experience + Proficiency in applying the principals of… more
- Amgen (New York, NY)
- …us and transform the lives of patients while transforming your career. **Field Reimbursement Manager - New York** **What you will do** Let's do this. Let's change ... the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified...products are covered under the benefit design (Commercial, Medicare, Medicaid ) + Serve as a payer expert for defined… more
- Molina Healthcare (Cincinnati, OH)
- …QUALIFICATIONS:** + CBAP, or Certified Coding Specialist (CCS) certification. + Project Management Experience + Familiarity with Medicaid -specific Scorable ... **Job Description** **Job Summary** The Payment Integrity Program Manager - Health Plan is a subject matter...claims coding (CPT, ICD, HCPCS, Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL,… more
- Ascendis Pharma (Princeton, NJ)
- … project management, and communication skills. As the Senior Manager , Contracting Operations, you will be responsible for working with internal/external ... skills. Ascendis Pharma is looking to hire a Senior Manager , Contract Operations to join our team. Responsibilities will...and public payers, national and regional health plans, state Medicaid , Medicare Part B and D , VA/DOD,… more
- Molina Healthcare (Layton, UT)
- …with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional ... Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract… more
- Ascendis Pharma (Princeton, NJ)
- …+ Familiarity with government pricing implications ( Medicaid , 340B, Medicare Part D ) is a plus. + Excellent project management, analytical, and ... their skills. Position Summary: We are seeking a highly motivated Senior Manager (Contractor) to support our Contracting Operations function within the Market Access… more
- Molina Healthcare (Las Vegas, NV)
- …reporting or collection + CAHPS improvement experience + State QI experience + Medicaid experience + Supervisory experience + Project management and team ... **Job Description** **Job Summary** The Manager , Quality Program Management and Performance oversees and...package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V \#PJCorp \#LI-AC1 Pay Range: $76,757 - $149,676 /… more
- Molina Healthcare (Provo, UT)
- …and processing. This role will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and ... adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either… more
- Molina Healthcare (Las Cruces, NM)
- …(EOE) M/F/ D /V. Star, Star Plus, Community Connector, Nonclinical Case Manager , Care Manager , Community Engagement, Public Health, Healthcare, Health Care, ... 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
- Molina Healthcare (NE)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... Duties** + Acts as a lead specialist to provide project , program, and/or initiative related direction and guidance for...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… 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 (Savannah, GA)
- …and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member per Month (PMPM) costs while maintaining high quality care + ... of technical experience + 2 or more years of project leadership experience + Licensure requirements of the state...and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to five… more
- CenterWell (Grand Prairie, 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