- CVS Health (VA)
- …And we do it all with heart, each and every day. **Position Summary** The ** Medicare Compliance Consultant ** is a compliance role that supports ... partnership with - and under the direction of - the health plan, Medicare Compliance Officer, and other team members, this position will help develop and… more
- Prime Therapeutics (Richmond, VA)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Consultant Sr - Remote **Job Description** The Pharmacy Network Consultant Sr ... pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulations + Represent Network Management department in audits and… more
- Elevance Health (Norfolk, VA)
- **Provider Contract/Cost of Care Consultant ** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, ... as required by law. The **Provider Contract/Cost of Care Consultant ** provides analytical support to the Cost of Care...Uses analytic tools to track both health risks and compliance , as well as supporting the contract negotiation process.… more
- Humana (Arlington, VA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- General Dynamics Information Technology (Fairfax, VA)
- …personal impact as a **Salesforce Enterprise Manager** supporting the Centers for Medicare and Medicaid Services (CMS) Federal Services System Support and Oversight ... acceptance testing, ensuring proper bandwidth utilization, timely ticket resolution and compliance + Ensure the clarity, accuracy, and efficiency of the program's… more
- Humana (Richmond, VA)
- …Adhere to established guidelines and procedures to ensure consistency and compliance . **Potential Duties** + Advocate for our agile development approach and ... with the organization's strategy and long-term goals. + Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that… more
- CVS Health (VA)
- …and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business. + Conduct market ... pricing consultation and strategy in an evolving regulatory environment to ensure compliance . + Exercising sound business judgment to achieve proper balance between… more
- CenterWell (Norfolk, VA)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... improving consumer experiences **Preferred Qualifications** + Knowledge of Medicaid and Medicare programs + Excellent oral and written communication skills + Good… more
- Humana (Richmond, VA)
- …through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to ... the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards. Champion transparency, accountability,… more
- ChenMed (Portsmouth, VA)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and… more
- ChenMed (Richmond, VA)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...with the applicable center and market leadership to ensure compliance with guidelines along with participating in risk and… more
- Humana (Richmond, VA)
- …communications and processes + Relevant SAFe certificationssuch as SAFeProgram Consultant , SAFe Lean Portfolio Management, andSAFe Agilist **Additional Information** ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more