- Highmark Health (Providence, RI)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Providence, RI)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Point32Health (Canton, MA)
- …to our members, partners, colleagues and communities. **Job Summary** The Lead Compliance Program Manager will be responsible for development, implementation and ... well as external stakeholders including government regulators and auditors. The Lead Compliance Program Manager will be responsible for collaborating with… more
- Prime Therapeutics (Providence, RI)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Providence, RI)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Humana (Providence, RI)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Prime Therapeutics (Providence, RI)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- Aveanna Healthcare (Worcester, MA)
- RN Clinical Manager ApplyRefer a FriendBack Job Details Requisition #: 204886 Location: Worcester, MA 01606 Category: Clinical Care and Support Salary: $100,000.00 ... per year Position Details Clinical Manager - Aveanna Healthcare - Worcester, MA Are you...standards, and Aveanna policies to ensure top-tier care and compliance . + Provide On-Call Leadership:Be a consistent, reliable resource… more
- Prime Therapeutics (Providence, RI)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- **ePMO Project Manager ** **Category:** Project Management **Main location:** United States, Massachusetts, Canton **Position ID:** J0625-0840 **Employment Type:** ... -Learn more (xweb.asp?clid=21001&page=cookiespolicy#integrationofyoutube) . **Position Description:** The ePMO Program/Project Manager collaborates with Executive and Business sponsors to successfully… more
- Aveanna Healthcare (Worcester, MA)
- …functions associated with all operations of an Aveanna branch. Additionally, Operations Manager is responsible for initiating and maintaining compliance with all ... Home Health Branch Manager ApplyRefer a FriendBack Job Details Requisition #:...State regulations governing Home Health Care Agencies and ensuring compliance with Aveanna's policies and procedures. Other Duties: +… more
- Fallon Health (Worcester, MA)
- …Regulatory Manager is an essential function to Fallon Health's compliance with CMS regulations, NCQA standards, EOHHS applicable regulatory requirements, and ... of CMS, spotlight, IPRO, NCQA and other applicable regulatory and internal- compliance audits. **Responsibilities** **Care Management (CM) Regulatory Manager … more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... to teach assessment processes, care pathways, and other workflows required by the Care Manager positions * Works with Leaders to ensure the new hire is proficient in… more
- Point32Health (Canton, MA)
- …the Director, Customer Experience (CX), the CX Measurement & Improvement Program Manager is directly responsible for leading two heavily regulated annual survey ... programs and strategic improvement initiatives. The Customer Experience Program Manager is key role on the enterprise Customer Experience team and is responsible for… more
- Fallon Health (Milford, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care… more
- Humana (Providence, RI)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Prime Therapeutics (Providence, RI)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- Molina Healthcare (Worcester, MA)
- …of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and oversight of integrated ... more direct report supervisors, facilitates integrated, proactive HCS management, ensuring compliance with state and federal regulatory and accrediting standards and… more
- BD (Becton, Dickinson and Company) (Warwick, RI)
- …self. Become a **maker of possible** with us. **Job Overview:** The **Senior Manager - Payer Relations, Market Access (PRMA)** is a very important customer-facing ... (PRS) platform, within BD's Surgery business unit. The Senior Manager is required to establish new or revise existing...key technologies with regional commercial health plans, and State Medicaid Agencies + Work cross functionally with key account… more
- Gentiva (Warwick, RI)
- …in people's lives every day. **Overview** We're looking for a **Patient Care Manager ** to join our team.You will report directly to the Executive Director, ... Administrator, or Senior Patient Care Manager . You will be responsible for maintaining a high...and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory… more