- Public Consulting Group (Providence, RI)
- …. Employee will be responsible for Medicaid , SNAP, WIC and other state government programs . They will be analyzing business requests, making ... + Experience with CMS, Medicaid , SNAP, WICK, and other state government programs **Supervisory Responsibility** + None **Working Conditions** + Remote… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is...to execute the strategy + Establish key relationships with Government Program owners at the plans, and… more
- Prime Therapeutics (Providence, RI)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... is responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and … more
- Elevance Health (Providence, RI)
- … contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs ._ The **Audit and Reimbursement ... Senior** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of… more
- CenterWell (Providence, RI)
- …to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore Coding Operations works on ... caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance...inquiries and issues. + May participate in coder education programs on coding compliance. + Follows state … more
- Humana (Providence, RI)
- …the HOS program in all aspects of Humana's Medicare Advantage government business segment. + Lead and manage strategic initiatives, including the development of ... caring community and help us put health first** The Senior Program Delivery Professional HOS Strategic Initiatives strategically identifies enterprise partners to… more
- Fallon Health (Foxborough, MA)
- …and inspiring hope_ , we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... plans for member experience, service, and clinical quality. Fallon Health's NaviCare is a program for people age 65 and older, who live in our service area, and… more
- Public Consulting Group (Providence, RI)
- …public better. We provide the full spectrum of technology consulting services to help state and local agencies meet operational and program needs that enhance ... * Responsible for organizational migration, gap analysis, and coordination of program improvement, communications, and training activities related to MEMS Modules,… more
- Public Consulting Group (Providence, RI)
- …better serve populations in need by making meaningful and lasting changes in government organizations. Services: + Program Consulting + Finance Consulting and ... and other tools. + Develop expertise in federal and state funding requirements, including Title IV-E, Medicaid ,...strategies. + Ability to interpret and apply federal and state policy to financial planning and program … more
- Fallon Health (Foxborough, MA)
- …strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE ( Program of All-Inclusive Care ... determine the number of hours' members require for MassHealth programs such as the personal care attendant program...rating category to ensure members are in the correct State defined rating category o Maintains up to date… more
- Sumitomo Pharma (Providence, RI)
- …Disease products to ensure access for patients through various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove ... escalations as needed to ensure timely access for patients + Engage with government stakeholders, including state and federal health agencies, to ensure… more
- Fallon Health (Attleboro, MA)
- …health and inspiring hope, we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... Insurance and more!! **+ *$20/hr to start and exceeds state pay average! You can also make extra depending...and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short.… more
- Fallon Health (Dartmouth, MA)
- …health and inspiring hope, we strive to be the leading provider of government -sponsored health insurance programs -including Medicare, Medicaid , and PACE- in ... and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short....within an "active ageing" mindset in which policies and programs that promote mental health and social connections are… more
- Prime Therapeutics (Providence, RI)
- …Word, and system operations (eg workflow processes and case management) + Government programs (Medicare) knowledge **Preferred Qualifications** + Contact Center ... of business to review the benefits of the MTM program . This position speaks with members to gather and...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Humana (Providence, RI)
- …help us put health first** The Software Engineer 2 within Humana Government Business codes software applications based on business requirements. The Software ... skills and teamwork abilities. + Successfully receive interim approval for government security clearance (NBIS- National Background Investigation Service) + Our… more
- Evolent (Providence, RI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... + **This position is 100% Remote and can be completed from any state . Multiple opportunities for a flexible schedule and both part-time and full-time options… more
- Evolent (Providence, RI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... medical necessity guidelines, as well as other requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
- Elara Caring (Fall River, MA)
- …**Director of Intake** to lead the **Home Care Intake Operations for the State of Massachusetts.** This strategic leadership role is responsible for managing the ... multiple teams, develop operational strategies, ensure compliance with payer and program requirements, and partner with executive leadership to drive efficiency and… more
- Evolent (Providence, RI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
- Evolent (Providence, RI)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more