- Elevance Health (Chicago, IL)
- ** Business Strategy Plan Director - Risk Adjustment, Medicaid ** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... Health PulsePoint locations. The ** Business Strategy Plan Director - Risk Adjustment, Medicaid ** is responsible...based on continuous needs assessment. + Responsible for the development implementation and monitoring of line of business… more
- CVS Health (Hartford, CT)
- …convenient and affordable. Job Purpose and Summary: The LTSS/SAI National Senior Medical Director , reporting to a Regional CMO of Medicaid , will collaborate with ... and provide strategic guidance supporting initiatives across the national Medicaid LTSS line of business including but...the plan leadership for NCQA and audits.* Lead the Medicaid markets national SAI ideation, development , and… more
- CVS Health (Hartford, CT)
- …with Legal and Compliance to ensure alignment on and understanding of business interpretation of Compliance requirements. + Ensure Medicaid Provider Operations ... make health care more personal, convenient and affordable. Position Summary: The Lead Director will be part of the Aetna Network organization and have oversight and… more
- Serco (Washington, DC)
- …policies, business process; operations and contract deliverables, for estimating Medicaid and CHIP eligibility error rate and improper payments. + Oversee ... legally protected characteristics. Click here to apply now (https://careers-sercous.icims.com/jobs/64187/ medicaid -chip-eligibility-assistant-program- director /job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834477830) **New to Serco?** Join our… more
- CVS Health (Irving, TX)
- …and cost initiatives. Responsibilities include, but not limited to: . Manages Medicaid contract performance and drives the development and implementation of ... care more personal, convenient and affordable. Position Summary The Lead Director , Network Management (Texas) is accountable for designing conceptual models,… more
- Elevance Health (Indianapolis, IN)
- ** Medicaid Quality Management Health Plan Director Sr.** **Location:** This position will work a hybrid model (remote and office) out of the Indianapolis, ... relocate or currently reside within 50 miles of the Indianapolis office. The ** Medicaid ** **Quality Management Health Plan Director Sr.** will be responsible for… more
- CVS Health (Austin, TX)
- …make health care more personal, convenient and affordable. Position Summary The Lead Director will manage the development of contracts and agreements with ... market-based, group/system providers. Manages contract performance and supports the development and implementation of value-based contract relationships in support… more
- Elevance Health (West Des Moines, IA)
- …of the Des Moines, Iowa office. The Medicaid QM Health Planning Director will be responsible for driving the development , coordination, communication, and ... ** Medicaid Quality Management Health Planning Director **...advanced degree in a health care related field or business strongly preferred. + Previous experience working with NCQA,… more
- CVS Health (Topeka, KS)
- …care more personal, convenient and affordable. Position Summary Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout this ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in sixteen states: Arizona, California,...supports the Aetna Better Health of Kansas. This Medical Director will be a "Work from Home" position primarily… more
- Elevance Health (Columbia, SC)
- **Operations Director - Medicaid ** **Location:** Columbia, South Carolina. This position will work a hybrid model (remote and office). The ideal candidate will ... of one of our South Carolina Elevance Health PulsePoint locations. The **Operations Director - Medicaid ** will be responsible for ensuring the appropriate… more
- Humana (Frankfort, KY)
- …problems of diverse scope and complexity ranging from moderate to substantial. The Medicaid Pharmacy Director , internally known as a Clinical Pharmacy Lead, ... help us put health first** The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal… more
- Conduent (Hamilton, NJ)
- …of a culture where individuality is noticed and valued every day. ** Director , Medicaid Eligibility** **_(Relocation Assistance & $ign-On Bonus available)_** **Do ... be responsible for Operation and Delivery functions including the design, development , implementation and maintenance of processes and procedures. This will enable… more
- CVS Health (Tampa, FL)
- …provider data and/or provider contracting activities/support 1+ years of new business implementation focus in Medicaid Preferred Qualifications *Project ... health care more personal, convenient and affordable. Position Summary You will oversee Medicaid provider data operations related to claim pends, new business … more
- Mathematica (Columbus, OH)
- …Medicaid program design and implementation at a public or private entity such as Medicaid director , disability services director , deputy director for ... seasoned professional who are recognized experts with experience leading Medicaid and programs at the state level to join...and interpretation of quantitative and qualitative data * Direct business development efforts and lead proposals for… more
- CVS Health (Northbrook, IL)
- …Engagement , the Manager will work closely with cross-functional leadership across the Medicaid business to establish and champion local market culture committed ... outstanding opportunity for an enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna Better Health… more
- Universal Health Services (Leesburg, VA)
- …documentation meet the requirements of the regulatory agencies mentioned above. + The Medicaid Specialist must report regularly to the Director of Risk ... in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets… more
- Serco (Washington, DC)
- …of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as ... eligibility reviews, medical reviews, and data processing reviews, of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting… more
- Humana (Richmond, VA)
- …conflict with Humana IT's development timelines. + Serves as the 'Senior Business Architect' for Medicaid , with a strong understanding of how the industry's ... Solutions devises an effective strategy for executing and delivering on IT business initiatives. The Lead, Technology Solutions works on problems of diverse scope… more
- Serco (Washington, DC)
- …of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as ... eligibility reviews, medical reviews, and data processing reviews, of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting… more
- Highmark Health (Charleston, WV)
- …generated by external and internal action effecting customer satisfaction. + Assist the Director of Member Experience in the development and implementation of ... resources. The MHT Member Advocate must collaborate with the Care Management Director and care coordinators, provide member support related to enrollment, access and… more