- Commonwealth Care Alliance (Springfield, MA)
- …and drive both program-wide and provider-specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation Partnerships and ... CA-Provider Engagement & Performance **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based… more
- Commonwealth Care Alliance (Boston, MA)
- …engagement The Manager of Provider Communications will report to the Senior Director of Delegation Partnerships and Performance and will support the ongoing ... 011230 CA-Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and nurturing… more
- Commonwealth Care Alliance (Boston, MA)
- …CA-Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the performance of ... the implementation of CCA's model of care and strategic objectives. The Manager leads performance evaluation and improvement efforts, including reporting and data… more
- Staffing Solutions Organization (Albany, NY)
- …a reflection of our clients and the people they serve. **Social Care Contract Manager ( Senior Healthcare Data Specialist) in Albany, NY** **Division of Program ... works to integrate health and human services within the Medicaid program. The bureau is composed of two units:...the unique opportunity to support the S ocial Care Network (SCN) program implementation under New York's 1115 Waiver… more
- Commonwealth Care Alliance (Boston, MA)
- … network performance against internal and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. - ... for cultivating high-impact relationships with key healthcare providers, optimizing network performance, and ensuring compliance with regulatory standards. The… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, ... performance. By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role… more
- CVS Health (Annapolis, MD)
- …complex contracting options, financial/contracting arrangements and regulatory requirements. + Medicaid Network Management experience, preferably Maryland ... cost initiatives. **Responsibilities** **include:** + Analyzes market needs and opportunities for network expansion, identifies gaps in the existing network , and… more
- CVS Health (Columbus, OH)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working knowledge of… more
- CVS Health (Chicago, IL)
- … growth, and efficiency targets. Manages and oversees compliance within our network responsibilities as provided within the state Medicaid contractual ... Relations or Network Strategy * Minimum 5+ years' experience in Medicaid Managed Care business segment environment with exposure to benefits and/or contract… more
- Humana (Little Rock, AR)
- …claims operations, and other business teams involved in the administration of Medicaid business at Humana. The Senior Business Intelligence Engineer will ... Payment Solutions (INPS) department which falls under the Provider Process and Network Organization (PPNO). The Senior Business Intelligence Engineer will be… more
- CVS Health (Helena, MT)
- …or Mountain time zones - Experience supporting compliance/regulatory activities including network adequacy reporting, network gap mitigation activities and ... coast region states a plus - Experience in commercial, Medicare and Medicaid lines of business ideal **Education** Bachelor's Degree or equivalent combination of… more
- The Salvation Army (Syracuse, NY)
- Overview Seeking a Senior Enhanced Care Manager to join our Divisional Headquarters Team Our Full Time opportunities offer: + Generous time off every year ... Program + Tax Deferred Annuity (403B) + Christmas Bonus SCOPE AND PURPOSE OF POSITION: Senior Enhanced Care Manager will serve as coordinator of the Care … more
- Leidos (Baltimore, MD)
- …missions. The Digital Modernization Sector at Leidos currently has an opening for a Senior ISSO/Security Manager to work in our Baltimore, Maryland office. This ... operate, maintain, modernize and transform its legacy system. **Primary Responsibilities:** The Senior ISSO/Security Manager for a large CRM modernization effort… more
- Cardinal Health (Bismarck, ND)
- …can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through ... long and short-range changes in the reimbursement environment including Medicare, Medicaid , Managed Care, and Commercial medical and pharmacy plans while planning… more
- Providence (Santa Monica, CA)
- **Description** Senior Contract Sourcing Program Manager at Providence Saint John's Health Center in Santa Monica, CA. This position is Full time and will work ... rating for quality, safe care from the Centers of Medicare and Medicaid Services (CMS). Purchased Services and Physician Contracting provides contract negotiation… more
- CVS Health (Carson City, NV)
- …controls through collaborating with cross-functional teams. This position will support network across all lines of business. + Understanding business operations to ... Database audits + Support audits out of QNXT and PRMS systems to support Medicaid SOC and SOX controls + Coordinate with applicable reporting areas as needed to… more
- CVS Health (Harrisburg, PA)
- …for supporting complex Capitation analyses that support our strategic goals for Medicaid , Medicare, IFP and commercial, and working collaboratively with the ... Network to determine the financial impact resulting from changes...Understanding of both Commercial and Medicare plans to help network partners to make sound decisions to drive solutions.… more
- CenterWell (Phoenix, AZ)
- …relationship with specialist, hospitalist, SNF and other providers to form a narrow network of quality service focused on senior population health + Responsible ... and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to five...insurance and many other opportunities. **About us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care… more
- New York State Civil Service (Albany, NY)
- …of the Title Deputy Director of EISG: Position for Expr. IT Manager (6406) Occupational Category Legal Salary Grade NS Bargaining Unit M/C - Managerial/Confidential ... State NY Zip Code 12224 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - Albany-areaDeputy Director, Electronic Investigative Support… more
- Providence (Santa Monica, CA)
- …Be a part of our distinguished team dedicated to excellence in patient care. Senior Radiation Therapist at Providence Saint John's Health Center in Santa Monica, CA. ... 5-star rating for quality, safe care from the Centers of Medicare and Medicaid Services (CMS). Responsible for assisting the department supervisor, manager ,… more
