- Highmark Health (Indianapolis, IN)
- …the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted business ... expectations for all personnel and related entities supporting core functions of Medicaid and CHIP contracts . The position actively manages the day-to-day… more
- CommonSpirit Health (Phoenix, AZ)
- **Responsibilities** **Job Summary / Purpose** The Region Contract Manager for Payer Strategy & Relationships (PSR) assists PSR leaders in the development, ... with updating project plan documents and communications plans. + Monitors contract terms, termination dates, and rate update deadlines to assure proper and… more
- Abbott (Austin, TX)
- …Our team in **Austin, TX (or Alpharetta, GA)** is looking for a ** Contract Strategy & Business Engagement Manager ** **.** This person will spearhead ... the development, execution, and optimization of contract pricing strategies for all Cardiovascular contracting businesses. This role entails shaping and deploying… more
- COOLSOFT (Raleigh, NC)
- …strategic alternatives for business solutions. * Preferred to have experience with Medicaid , managed care, and Pharmacy Benefit Manager (PBM) operations. areas. ... HIPPA Agile Project Management Power Point Presentations Specialist (Jobs in...Power Poi Open Date 24-Jun-2025 Close Date Job type Contract Duration 5 Months Compensation DOE Status requirement Job… more
- Stony Brook University (Bohemia, NY)
- Care Manager , Sayville Project **Required Qualifications (as...and skills to assume the role of the Care Manager in the Medicaid Health Home Initiative. ... public entitlements and advocacy. **Brief Description of Duties:** The Care Manager provides field-based care management services to adult persons with psychiatric… more
- NTT DATA North America (Albany, NY)
- …of job** **:** The Medicaid Enterprise System (MES) Quality Assurance (QA) Project Manager will work with client management and have overall responsibility ... now. We are currently seeking a MES Quality Assurance Project Manager to join our team in...function overseeing MES projects over the life of the contract or the system, whichever comes first. The MES… more
- Rush University Medical Center (Chicago, IL)
- …pricing in the contract management system. + Assist Directors Contracting in contract implementation of FFS and VBC contracts for Members. + Work closely ... through Rush University Medical Center Human Resources. The Payer Contracting Manager is responsible for developing and maintaining relationships with third party… more
- State of Colorado (Denver, CO)
- Enterprise Solutions Integration (ESI) Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4960379) Apply Enterprise Solutions Integration ... (ESI) Manager Salary $89,520.00 - $116,400.00 Annually Location Denver Metro,...Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other… more
- CVS Health (Lansing, MI)
- …Program as described in CMS Medicare Managed Care Manuals/regulations, applicable Medicaid rules and government contracts , including risk assessment, auditing ... heart, each and every day. **Position Summary** The Sr. Manager is an experienced/career level compliance position that applies...* Maintain in-depth working knowledge and expertise in Medicare, Medicaid and State regulations and contracts in… more
- CVS Health (Indianapolis, IN)
- …reviews for Medicaid health plans, handling coding questions for claims, contracts , benefits, and references files (CPT, ICD 10, Modifiers, ICD 10 Procedure ... problem-solving abilities **Preferred Qualifications** Clinical Coding Experience - Content Manager Claim Processing Medicaid Working with SQL Application… more
- Henry Ford Health System (Troy, MI)
- …that will evaluate and analyze contract proposals including reviewing/revising contract language and operational requirements. 2. Review contracts with ... leading the Managed Care Contracting team in evaluating, analyzing, and negotiating contract terms and reimbursement rates with health plans. PRINCIPLE DUTIES AND… more
- System One (Baltimore, MD)
- …Benefits Manager Consultant Client: Health Insurance Organization Location: Remote Contract Type: Contract -to-Hire Rate: $120/HR Job Summary ALTA IT Services ... is seeking an experienced Pharmacy Benefits Manager Consultant for a contract -to-hire engagement with...vendor management, and driving overall business readiness. Key Responsibilities Project Leadership & Accountability + Lead and manage the… more
- Aston Carter (Valencia, CA)
- Job Title: Market Access Manager Job Description We are seeking a proven and strategic Market Access Manager to spearhead efforts in securing coverage, ... expertise in navigating the intricacies of private insurance carriers, Medicare, and Medicaid , along with a robust ability to drive evidence-based strategies that… more
- Sanofi Group (Cambridge, MA)
- …+ ** Contract Execution Rate** : Percentage of specialty pharmacy contracts successfully executed within the specified timeframe. + **Service Level Agreement ... **Job Title:** Rare Blood Trade Account Manager **Location:** Remote/Field **About the Job** The Rare...Develop, maintain, and execute specialty pharmacy purchase and services contracts for Rare Blood Disorders. + Ensure Rare Blood… more
- MyFlorida (Tallahassee, FL)
- …certifications: PMI Certified Project Management Professional, Florida Certified Contract Negotiator, Florida Certified Contract Manager LICENSURE, ... and the FX Governance structure. Interfaces with business units, Enterprise Project Management Office, and Strategic Enterprise Advisory Services vendor for the… more
- Centene Corporation (New York, NY)
- …departmental budget + Initiate and execute standard physician and ancillary provider contracts + Coordinate all pre- contract activities with providers such as, ... site visits, credentialing, orientation to contractual requirements, etc. + Maintain contracts and correspondence files in organized and accessible manner for all… more
- Centene Corporation (Trenton, NJ)
- …activities for the recruitment, contracting and retention of providers. Negotiate contracts and develop strategies and methodologies for specific network development ... in compliance with Company policies/standards and government regulations. + Prepare provider contracts and monitor process to ensure timely execution of contracts… more
- UTMB Health (Galveston, TX)
- Manager , Hospital/Professional Insurance Follow-Up - Revenue Cycle HB Billing & Denials **Galveston, Texas, United States** **New** Business, Managerial & Finance ... Knowledge of Epic Patient Accounting System **Job Summary:** The Manager of Hospital/Professional Insurance Follow-Up coordinates and directs all… more
- NorthWest Senior & Disability Services (Salem, OR)
- …Implement, monitor and adjust transition plan + Transition case to ongoing Case Manager + Support and promote Diversion and Transition services + Promote Agency ... concept + Facilitate confidence in Diversion and Transition Case Manager , and therefore the Agency and programs + Protect...Facilities which are closing and no longer operate under Medicaid to find alternate care + Carry enhanced care… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- **Next Generation Desktop Program Manager ** **Category:** Project Management **Main location:** United States, Virginia, Fairfax **Position ID:** J0425-0109 ... . **Position Description:** CGI Federal is seeking an experienced Program Manager to lead the Department of Health and Human Services (HHS),… more
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