- Sumitomo Pharma (Columbus, OH)
- **Title: Sr . Manager , Medicaid Contract Administration** **Location: Remote/occasional onsite (if local to MA). Flexible work/life balance.** Sumitomo ... seeking a dynamic, highly motivated, and experienced individual for the position of ** Sr . Manager , Medicaid Contract Administration.** The Sr . … more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons is a seeking a Senior Project Manager ( Medicaid Network Implementation) who is accountable for ... end-to-end provider-related functions in new Medicaid market implementations. The Senior Project Manager makes decisions supporting technical and operational… more
- Conduent (Baton Rouge, LA)
- …improve processes?** **Do you enjoy leading a team?** **About the Role** As a Senior Manager -Delivery, you will manage the performance and success of an approx ... culture where individuality is noticed and valued every day. ** Senior ** ** Manager , Delivery** _(Position is ON-SITE in_...90 person Medicaid Long Term Care and Call Center team of… more
- CVS Health (Hartford, CT)
- …the country to transform the health of individuals and their neighborhoods. The Senior Manager , Plan Implementation, works to ensure that all components of ... and agile environment. Aetna Better Health is the Aetna Medicaid division of CVS Health. We are committed to...smoothly while working closely with project managers to turn contract requirements into reality. The manager plays… more
- CVS Health (Houston, TX)
- …Summary In this Texas Medicaid individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level review and ... guidelines in support of national and regional network strategies.* Manages contract performance and supports the development and implementation of value-based … more
- CVS Health (Houston, TX)
- …and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and ... Summary In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct...implementation of strategic, value-based contract relationships, maintain and enhance provider networks to meet… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …or discounts in the event of noncompliant formulary findings. Reporting to the Manager , Contract Compliance, the incumbent will be responsible for identifying ... to key internal and external stakeholders. In addition, the Sr . Contract Compliance Analyst will participate in...account formularies across commercial, Medicare Part D, and managed Medicaid channels. * Reviews Teva products on each formulary… more
- CareOregon (Portland, OR)
- Job Title Sr Accountant Department 3006 - Finance Exemption Status Exempt Requisition # 24296 Direct Reports n/a Manager Title Accounting Operations Manager ... Portland, Oregon or SW Washington. Job Summary This position performs senior level accounting functions for the organization. Primary responsibilities include… more
- Humana (Indianapolis, IN)
- …us put health first** Humana Healthy Horizons in Indiana is seeking a Senior Provider Education & Outreach Professional to develop and grow positive, long-term ... within the contracted working relationship with the health plan. The Senior Provider Education & Outreach Professional work assignments involve moderately complex… more
- HCA Healthcare (Asheville, NC)
- …purpose and integrity. We care like family! Jump-start your career as a Medicaid Eligibility Area Manager today with Mission Hospital. **Benefits** Parallon at ... (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid...vary by location._** Come join our team as a Medicaid Eligibility Area Manager . We care for… more
- Elevance Health (Columbus, OH)
- … Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... **Audit & Reimbursement Senior - Medicare Cost Report Audit** **_Location: This is...federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health… more
- Elevance Health (Columbus, OH)
- …Medicaid Services to transform federal health programs._ The Audit and Reimbursement Senior will support our Medicare Administrative Contract (MAC) with the ... **Audit & Reimbursement Senior ** **Location:** This is a virtual position; the...federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health… more
- CVS Health (St. Paul, MN)
- …in our dynamic and growing C ustom Formulary Consultants ( CFC ) team ? The Senior Manager (consultant) role on the C FC team is a highly visible, client-facing ... with multiple customer market segments ( ie, Commercial, Managed Medicaid , Med D, Exchange formularies). The C FC team,...win business while insuring we meet our client rebate contract guarantees, services our custom formulary clients . CFC… more
- Penn Medicine (Philadelphia, PA)
- …CVO completes and maintains credentials and privileges of 10,000 providers. As the CVO Senior Manager , you will collaborate with and provide data to health ... system operational leaders that include the Senior Manager of CVO Enrollment who has...(TJC), Department of Health (DoH), Centers for Medicare & Medicaid Services (CMS), and the National Committee on Quality… more
- CVS Health (Phoenix, AZ)
- …more personal, convenient and affordable. Position Summary Aetna is recruiting for a Senior Manager , National Value Based Care (VBC) Development who will support ... innovative and strategic provider Medicaid relationships as part of the National VBC Business...enterprise wide initiatives. + Support contracting efforts including negotiating contract deal terms and support the development and implementation… more
- Hartford HealthCare (Wethersfield, CT)
- …the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr . Payer Analyst develops a modeling process for ... to minimize payer policy impacts on hospital revenue to Manager of Payer Contract Analytics. 2. Develops...to benchmark reimbursement rates to Contracted Commercial, Medicare and Medicaid reimbursement levels. 3. Builds contract terms… more
- CVS Health (Hartford, CT)
- …next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level ... market-based, behavioral health groups and facility providers. You will manage contract performance and support the development and implementation of strategic,… more
- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Pharmacist Account Manager - Remote in Raleigh, NC **Job Description ... solutions to clients. Serves as clinical liaison for assigned Pharmacy contract (s) and manages overall client relationship. Participates in the development of… more
- Conduent (Olympia, WA)
- …be part of a culture where individuality is noticed and valued every day. ** Senior Manager , Rx Claims Service Delivery-Olympia, WA** **Are you comfortable in a ... for ensuring delivery of all contractual requirements for a State Medicaid fiscal agent project **Responsibilities** + Managing IT departments and Pharmacy… more
- Providence (Portland, OR)
- **Description** ** Senior Actuarial Analyst \*Remote Reporting to the Actuarial Manager VBC, Sr . Actuarial Analyst, leads and/or assists in developing, ... improving the performance of value-based care (VBC) and risk arrangements at the contract level, at the portfolio level, and at the regional/service area level.… more