- Novo Nordisk Inc. (Elmira, NY)
- …current co-promotion partners. Internally, the CMCS I reports to the District Business Manager of the specific sales territory. The CMCS I also interacts and ... level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage… more
- 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 ... 011230 CA-Provider Engagement & Performance **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with… more
- Lundbeck (Deerfield, IL)
- Senior Benefits and HR Systems Analyst Requisition ID: 6994 Location: Deerfield, IL, US Do you want to join a team where the mission is meaningful, the challenges ... programs and policies. Identifies and implements tools and resources for program administration with a focus on developing, standardizing, and improving processes,… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Value-based program oversight and performance ... the demonstrated ability to handle multiple projects. - Strong understanding of Medicare , Medicaid, duals program , and health plan operations, including… more
- Wipfli LLP (Milwaukee, WI)
- …offers a career-defining opportunity. Job Summary Under the direction of the Partner/ Senior Manager leading the respective service area, region or industry, ... the Manager , Provider Compliance & Reimbursement is responsible for preparing...preparing cost reports and providing reimbursement consulting within the Senior Living space. This role includes reviewing skilled nursing… 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 ... complex, cross-functional projects and meeting deadlines. + Strong understanding of Medicare , Medicaid, duals program , and health plan operations, including… 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
- Commonwealth Care Alliance (Boston, MA)
- …Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory ... improvements, and enhance provider satisfaction and performance. - Partner with senior leaders to communicate resolution and outcomes and drive cross-functional… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- Insight Global (Woonsocket, RI)
- …* Must be able to manage roadmaps and schedule performance, and report to Sr Program Manager and upper-level stakeholders * Must be able to identify, mitigate, ... Job Description Insight Global is seeking a Senior Project Manager to support a...and report risks to Sr Program Manager and upper-level...and report risks to Sr Program Manager and upper-level… more
- CVS Health (St. Louis Park, MN)
- …we do it all with heart, each and every day. **Position Summary** As the ** Senior Manager of Stars** , you will lead the market-wide strategy, performance ... improvement, and execution of the Medicare Stars quality program for Allina Health...of strategic initiatives. + Comfortable presenting to and influencing senior leadership. **Preferred Qualifications** + Health plan experience. +… more
- Amazon (CO)
- Description Application deadline: Jan 8, 2026 As a Program Manager II on the One Medical At -Risk team, you will be the primary builder of new and existing ... balancing time, quality, and resources to optimize project and program outcomes * Lead the end-to-end implementation of new...driving end to end delivery, and communicating results to senior leadership experience - 3+ years of driving process… more
- Centene Corporation (Jefferson City, MO)
- …a fresh perspective on workplace flexibility. **Position Purpose:** With the Corporate Medicare Finance Team, this position will support, manage and drive enterprise ... the QAI(quality and affordability initiative) and process improvement projects for Medicare product. + Produce QAI performance report, communicate the performance… more
- The Cigna Group (Bloomfield, CT)
- This position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This ... Part D Health Plans: PDP, MAPD, and Special Needs Program (SNPs) + Review Medicare Part D...D bid development consulting experience preferred + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager … more
- Humana (Miami Lakes, FL)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and… more
- Fallon Health (Springfield, MA)
- …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 ... who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare ...achieves personal referral and outreach goals for the NaviCare program .Manages a territory and group of referral source accounts,… more
- Fallon Health (Worcester, MA)
- …experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an ... alternative to nursing home care, is a program that helps people 55 and older continue living...be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary… more
- CVS Health (Harrisburg, PA)
- …all with heart, each and every day. **Position Summary** **Position Summary** The Senior Manager Health Care Quality Management will be responsible for managing ... the Quality Program for the Florida Fully Integrated Duals Eligible (FIDE)...plan. This involves oversight and execution of contractually required Medicare and Medicaid regulatory deliverables, HEDIS activities, quality improvement… more
- Medtronic (Minneapolis, MN)
- …25% of travel to enhance collaboration and ensure successful completion of projects. The ** Senior HEPR Program Manager ** will serve in a highly visible ... the Aortic business's Health Economics, Policy and Reimbursement team. We are seeking a Senior HEPR Program Manager to support global reimbursement strategy… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Sr. Program Manager , DC Market Operations provides leadership for the operation of a single jurisdiction Medicaid ... ensure the profitability, growth, and stability of the business. The Sr Program Manager will have responsibility for business direction, financial performance,… more
