- COOLSOFT (Raleigh, NC)
- Stakeholders Medicaid Operations Experience Analyst (Jobs in Raleigh, NC) Requirement id 155875 Job title Analyst Job location in Raleigh, NC Skills ... required Application Systems Analyst, Data Exchange, Trouble Shooting PC, Stakeholders Medicaid Operations Experie Open Date 07-Nov-2025 Close Date Job type… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- About the Department The Finance & Operations department brings insights and intelligence to inform decision making & drives digitalization and business solutions to ... attain NNI goals. Finance & Operations works closely across the organization to guide enterprise-wide...not limited to Managed Care, and Medicare Part D, Medicaid as well as current and future Healthcare Reform… more
- Merck & Co. (North Wales, PA)
- Job DescriptionThis role is part of National Contract Operations and Supply Chain (NCOSC), which delivers end-to-end services that enable affordable patient access, ... system - including pharmacy benefit managers (PBMs), health plans, state Medicaid agencies, pharmacies/wholesalers, and infusion companies - for our Company's… more
- Staffing Solutions Organization (Albany, NY)
- …which is a reflection of our clients and the people they serve. ** Medicaid Program Advisor 1 in Albany, NY** **Division of Program Development & Management ... knowledge and implementation. The BASP is seeking a passionate Medicaid Program Advisor to support the team in its...the Health Home Program team to support Health Home operations and program initiatives as follows: + Serves as… more
- Commonwealth Care Alliance (Boston, MA)
- …not required for the job. **Required Experience (must have):** + 5+ years + Experience with Medicaid and Medicare products and programs + Experience or ... behavioral health, and/or social needs. + Strong understanding of **Medicare, Medicaid (MassHealth), and dual-eligible program operations ** , including… more
- Staffing Solutions Organization (Albany, NY)
- …eligibility and claims systems. + Take the appropriate actions regarding Medicaid enrollment and premium reimbursement. + Understand the Medicare Savings Program ... as it applies to NY Medicaid . + Demonstrate systems processes for new employees and...processed. + Calculate monthly unit statistics and provide to operations management for inclusion on routine production reports. +… more
- Commonwealth Care Alliance (Boston, MA)
- …related field preferred. Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Value-based program ... demonstrated ability to handle multiple projects. - Strong understanding of Medicare, Medicaid , duals program, and health plan operations , including regulatory… more
- Commonwealth Care Alliance (Boston, MA)
- … operations , and compliance standards. - Partner with internal stakeholders to ensure educational initiatives support system-wide consistency and continuous ... experience in provider relations, network management, or healthcare operations within a managed care organization, health plan, or integrated delivery… more
- Abt Global Inc. (Durham, NC)
- …to inform strategic decision-making. + Leverage deep functional expertise in digital operations to effectively engage key customers and stakeholders across ... Solutions Principal focused on the Centers for Medicare and Medicaid Services (CMS), you will be responsible for developing...share across the CMS organization. Specifically, you work with stakeholders across the enterprise to lead the design and… more
- Commonwealth Care Alliance (Boston, MA)
- …cross-functional projects and meeting deadlines. + Strong understanding of Medicare, Medicaid , duals program, and health plan operations , including regulatory ... foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This role ensures providers are well-informed, engaged,… more
- Commonwealth Care Alliance (Boston, MA)
- …demonstrated ability to handle multiple projects. - Strong understanding of Medicare, Medicaid , duals program, and health plan operations , including regulatory ... the Manager, LTSS Program, this position supports the efficient operations and performance of CCA's contracted CBOs by providing...management, social work, or a related field preferred. Required Experience (must have): - 1+ years of experience… more
- Commonwealth Care Alliance (Boston, MA)
- …quality measures (HEDIS, CAHPS, HOS) and value-based contract performance metrics + Experience with Medicare Advantage, Medicaid ; and dually eligible populations ... on CCA's Population Health goals; including Medicare Star measures, Medicaid -Medicare Plan withhold measures, quality performance metrics incorporated into other… more
- Commonwealth Care Alliance (Boston, MA)
- …and/or startup experience is a plus - Medicare Advantage and/or Managed Medicaid strategy, operations , and policy experience Required Knowledge, Skills & ... 081290 InstED- Operations Position Summary: Our healthcare system is under...Departments because they have no alternatives. The poor patient experience , the sub-optimal care, and the estimated $8.3B spent… more
- Commonwealth Care Alliance (Boston, MA)
- … experience required. Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Experience or ... in alignment with clinical licensure. - Strong understanding of Medicare, Medicaid (MassHealth), and dual-eligible program operations , including regulatory and… more
- Somatus (Mclean, VA)
- …Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a ... for patients with CKD and ESRD. Operating at the intersection of strategy, operations , and relationship management, the ideal candidate will have what it takes to… more
- Tidelands Health (Myrtle Beach, SC)
- …coding/billing issues. Informs, educates, and coordinates with other Revenue Cycle, Clinical Operations , and other stakeholders regarding the coding and charge ... and regulations, Follows compliant charge capture in accordance with Medicare, Medicaid or Third-Party payer guidelines. + Assists with development of policies,… more
- Centers for Independence (Milwaukee, WI)
- …degree OR equivalent work experience in a related field. **Minimum Required Experience :** Minimum of 2 years human services operations or related ... **Position Type** Full Time **Education Level** 4 Year Degree or Equivalent Experience **Travel Percentage** Minimal; Less than 10% **Job Shift** Day **Job… more
- National Health Care Associates (Ridgefield, CT)
- …both verbal and written, with the ability to interact effectively with diverse stakeholders + Proven leadership abilities with experience managing teams and ... on. And as National grows with the acquisition of Laurel Ridge, you will experience real career growth in an environment where your expertise and dedication is… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …and Legislators. Lead the preparation of financial statements and reports specific to Medicaid operations . + Manage a finance team dedicated to Medicaid ... * Minimum of 5-7 years of progressive financial leadership experience , with significant exposure to Medicaid programs....improvement in financial systems, controls, and processes tailored to Medicaid operations . Stay updated on Medicaid… more
- DATAMAXIS (Springfield, IL)
- …* Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations . * With the ... standards and policies. Required Qualifications: * More than four (4) years of experience working directly with/for State Medicaid agencies or equivalent. * More… more
