- Unknown (Washington, DC)
- …with a proven track record in strategic and thought leadership, budgeting, and financial management within a health plan. The ideal candidate will have a deep ... Vice President, Medicaid Regional President About the Company Influential organization...Regional President About the Company Influential organization in the health & wellness industry Industry Insurance Type Public Company… more
- Unknown (Washington, DC)
- …medicare and medicaid behavioral health military and veterans health program implementation advisory services quality improvement maternal health ... Research Non-Profit Other Specialties health research policy &analysis health program development management & evaluation health care planning finance &… more
- Unknown (Washington, DC)
- …Commission, health departments, and the Centers for Medicare and Medicaid Services. This role involves overseeing compliance for various healthcare entities, ... a preference for a degree in nursing or allied health , and a Certified Professional in Healthcare Quality...of related healthcare experience, including 7 years of direct management experience, is required, preferably within an academic medical… more
- Unknown (Washington, DC)
- …The role also demands a leader with a strong background in care management operations within Medicaid , Medicare Advantage, or ACO environments, and the ... the Company Innovative healthcare technology (HealthTech) company Industry Hospital & Health Care Type Privately Held, VC-backed Founded 2021 Employees 51-200… more
- Home Care Evolution (Vienna, VA)
- …you a Licensed Practical Nurse (LPN) with a passion for patient care, coordination, and quality assurance in home health ? Join our growing team at Virginia Home ... 24 hours Benefits: 401(k) Competitive salary Dental insurance Flexible schedule Health insurance Opportunity for advancement Training & development Now Hiring:… more
- Executive Care (Leesburg, VA)
- …healthcare or related field. Experience working with healthcare/home healthcare standards and quality assurance or risk management . Working knowledge of Virginia ... HCO (Home Care Organization) and CMS (Centers for Medicare & Medicaid Services) documentation standards a plus Excellent organizational, communication, and… more
- Humana (Washington, DC)
- …Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other ... a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines… more
- Humana (Washington, DC)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service ... part of our caring community and help us put health first** The Associate Vice President (AVP) of Medicare...first** The Associate Vice President (AVP) of Medicare and Medicaid Encounter Submissions is responsible for the integrity, accuracy,… more
- Humana (Washington, DC)
- …Professional initiates, negotiates, and executes physician, hospital, and/or other Behavioral Health contracts and agreements within the Virginia Medicaid space. ... and reimbursement rates to providers in building and maintaining Medicaid Behavioral Health provider networks. Analyzes the...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth ... skills for technical and non-technical audiences + Demonstrated project management skills with the ability to drive work independently...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Prime Therapeutics (Washington, DC)
- … plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a health plan, healthcare consulting firm, PBM, or other government ... we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government Programs - Medicare &… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Procurement Lead; Medicaid generates and implements efficient sourcing and category ... course of action. Responsibilities + Understands and explains procurement and supplier management and oversight processes to Medicaid markets and business areas… more
- Humana (Washington, DC)
- …analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee meetings (ex; operations, quality , etc.). + Partner with ... part of our caring community and help us put health first** The Associate Director, Procurement generates and implements...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Humana (Washington, DC)
- …Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other ... a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and… more
- CVS Health (Washington, DC)
- …from the National Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance, Medicaid Investigations, MCO Medicaid FWA Unit in the ... At CVS Health , we're building a world of health...comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the… more
- Cardinal Health (Washington, DC)
- …medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare, Medicaid ). + Proven leadership and team management abilities. ... **Job Summary:** The Manager, Revenue Cycle Management , is responsible for overseeing the insurance collection...operations of the insurance follow-up team, ensuring productivity and quality standards are met. + Monitor aging reports and… more
- HCA Healthcare (Falls Church, VA)
- …will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with ... verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management , customer service, payroll and… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Quality Assurance Professional 2 develops and implements programs to establish and ... and improve same. Trains and/or coaches staff and management in areas such as quality improvement,...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** Call Quality Professionals provide information that will assist in the feedback and the ... your skills to make an impact** **Required Qualifications** **Active Health insurance license or the ability to obtain within...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
