- Abt Global Inc. (Durham, NC)
- **The Opportunity** As a Project Director , you will lead large project teams through complex health analytic engagements, serving both State and Federal ... strategy, and visualization. You will help to operationalize and execute Medicaid policy and IT transformation projects. You will oversee interdisciplinary teams… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical ... in KY** **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The... market populations. May provide cross-coverage for other state Medicaid markets. May participate on project teams… more
- Cognizant (Raleigh, NC)
- …only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in ... among patients, hospitals, and government agencies to ensure eligibility for Medicaid , social security, county indigent, or other types of healthcare funding.… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical ... Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
- Prime Therapeutics (Raleigh, NC)
- …at least 5 years in product development + Must be eligible to work in the United States without need for work visa or residency sponsorship Must be eligible to ... drives every decision we make. **Job Posting Title** Product Director - State Public Sector Business Development - Remote...work in the United States without the need for work… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical ... Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other… more
- Prime Therapeutics (Raleigh, NC)
- …leadership / people management experience. + Must be eligible to work in the United States without need for work visa or residency sponsorship. **Additional ... our passion and drives every decision we make. **Job Posting Title** Senior Director Clinical Account Management - Remote **Job Description** The Sr Director … more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** Humana is seeking a strategic and experienced Director of Business Performance Management, ... effectiveness, compliance, and the achievement of key business objectives. The Director will be responsible for establishing clear performance metrics, driving… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and ... planning support for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an in-depth understanding of how… more
- IQVIA (Raleigh, NC)
- …deliver medical breakthroughs in the real world. PURPOSE The National Account Director is responsible for managing all aspects of national and regional accounts, ... under the direction of the project 's Client Lead. This includes developing contracts to optimize...launch of new drugs in Managed Care accounts, PBMs, Medicaid PBMs, and State Government Accounts by introducing product… more
- Prime Therapeutics (Raleigh, NC)
- …benefits, implementations or related area) + Must be eligible to work in the United States without need for work visa or residency sponsorship **Additional ... in business requirements, system specifications, process flows, process change and/or project management in supporting Compliance with Medicaid requirements. +… more
- Prime Therapeutics (Raleigh, NC)
- …the Affordable Care Act (ACA) + Must be eligible to work in the United States without need for work visa or residency sponsorship **Additional Qualifications** ... are aligned with expectations of applicable regulatory guidance + Lead project management efforts for highly sensitive Compliance initiatives + Represents the… more
- Prime Therapeutics (Raleigh, NC)
- …Actuarial designation (ASA or FSA) + Must be eligible to work in the United States without need for work visa or residency sponsorship **Additional ... + Excellent quantitative, problem solving, and analytical skills + Strong project management and organizational skills + Excellent verbal and written communication… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** Humana is a publicly traded, Fortune 50 healthcare company with a legacy of innovation, ... one of the largest health benefits providers in the US . At the core of this evolution is Humana's...evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid , and other health plans to millions. By integrating… more
- Datavant (Raleigh, NC)
- …platform is powered by the largest, most diverse health data network in the US , enabling data to be secure, accessible and usable to inform better health decisions. ... manager will collaborate with other managers and the department director to set strategy and mobilize the team to...3+ years of experience working with Medicare, ACA, and/or Medicaid risk adjustment models + 5+ years of data… more
- Evolent (Raleigh, NC)
- …services and/or configuration, preferably in a leadership role + General understanding of US health care, Managed Care Organizations, and/or Medicaid + Lives the ... issue resolution, process improvement, and more. This position reports to the Director . Provider Data Managment. + Leadership responsibility for a team of 3-7… more