- Tris Pharma (Monmouth Junction, NJ)
- …to: executive management (Chief Executive Officer (CEO), Chief Financial Officer (CFO), Director of Pharmacy Services, State Medicaid officials of key accounts ... have an opening in our Monmouth Junction, NJ facility for an experienced SR Director , Market Access and Trade.The Senior Director , Market Access and Trade is… more
- CVS Health (Hartford, CT)
- …Network Contracting and Medicaid Provider Relations, and other departments to maintain compliance of provider related tasks. The Lead Director may manage a ... part of the Aetna Network organization and have oversight and monitoring of Medicaid network compliance requirements, focused first on Medicaid credentialing… more
- Elevance Health (Indianapolis, IN)
- …send you a check, or ask you for payment as part of consideration for employment. ** Medicaid Quality Management Health Plan Director Sr.** + Job Family: QLT ... Date:May 03, 2024 + Reference: JR113040 **Location:** + IN, INDIANAPOLIS **Description** ** Medicaid Quality Management Health Plan Director Sr.**… more
- State of Indiana (Indianapolis, IN)
- Director of Medicaid Finance Date Posted: Apr 16, 2024 Requisition ID: 442371 Location: Indianapolis, IN, US, 46204 Work for Indiana B egin a fulfilling career ... fully engaged with this mission. Role Overview : The Director of Medicaid Finance is responsible for...Amendments and Indiana Administrative Code rule changes to ensure compliance with Indiana and Federal laws to achieve reimbursement… 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 ... Aetna National Medicaid , Regional and health plan leadership to identify, develop, implement, and evaluate the effectiveness of key LTSS strategic initiatives… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... (10) Years of Clinical Practice with Older Adults (Medical Director ) is dedicated full time to the Indiana Pathways...authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which… more
- Humana (Columbus, OH)
- …community and help us put health first** The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new delivery models. ... components, and work is performed without direction. The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make… more
- Providence (Portland, OR)
- …in the development, implementation and monitoring of the strategic business plan for Medicaid strategy. Evaluates performance improvement opportunities and ... **Description** The Executive Director is responsible for the overall strategy and...population health initiatives related to accountable care activities for Medicaid Strategy and Sustainability including implementation of strategies, daily… more
- CVS Health (Irving, TX)
- …care more personal, convenient and affordable. Position Summary The Lead Director , Network Management (Texas) is accountable for designing conceptual models, ... initiative planning, and negotiating Medicaid value based agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs and… more
- Humana (Richmond, VA)
- …for the strategic management and oversight of financial operations for Humana's Virginia Medicaid Plan , and oversees the budget, financial reporting, and all ... in this role coordinates day-to-day financial operations directly with the health plan Chief Executive Officer (CEO). **Use your skills to make an impact**… more
- CVS Health (Austin, TX)
- …. Health Plan /Payer or Provider Systems experience Preferred Qualifications . Medicaid regulatory experience . Medicaid contracting & setup experience. . ... health care more personal, convenient and affordable. Position Summary The Lead Director will manage the development of contracts and agreements with providers and… 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, ... of Pharmacy and implements changes as necessary to maintain compliance supporting both the business and public relations strategies....per yearThis job is eligible for a bonus incentive plan . This incentive opportunity is based upon company and/or… more
- Conduent (Hamilton, NJ)
- …where individuality is noticed and valued every day. **Job Description:** ** Director , Medicaid Eligibility** **_(Relocation Assistance & $ign-On Bonus ... situations for all levels of employees and management. + Collaborating with compliance owners to ensure processes align with regulatory requirements for applicable… more
- McLaren Health Care (Indianapolis, IN)
- …of the Compliance Team and manages day-to-day activities under the Plan 's Medicaid Programs' compliance plan . The Manager, Medicaid Compliance ... We are looking for a Manager, Medicaid Compliance to join us in...experience. + Three (3) years' progressive experience in health plan compliance programs including two (2) years'… more
- CareOregon (Portland, OR)
- …Nevada, Texas, Montana, or Wisconsin. Job Title Actuarial Services Manager - Medicaid and Medicare Exemption Status Exempt Department Finance Manager Title ... Director , Actuarial Services Direct Reports Actuarial Staff Requisition #...position is responsible for managing actuarial analysis related to Medicaid and Medicare Advantage lines of business with a… more
- Humana (Richmond, VA)
- …implementations are involved + Be on point for the technology portion of all state Medicaid compliance audits. These will often tie back to the P&Ps noted here ... diverse scope and complexity ranging from moderate to substantial. The Medicaid Lead, Technology Solutions builds strategic partnerships and manages relationships… more
- CVS Health (New York, NY)
- …Relations representatives (approximately 4) and reports to the local Lead Director . Oversees the maintenance of working relationships with the existing network ... and delivery systems in conjunction with network. Engages to ensure compliance and regulatory requirements are met. Develops and implements training programs… more
- CareOregon (Portland, OR)
- …and state regulations and contractual obligations related to the Oregon Health Plan Medicaid program. The position oversees the development, execution, and ... Job Title Director , Compliance and Quality Oversight Exemption... Compliance + Develop, execute and oversee a compliance plan which includes risk assessment and… more
- Bausch Health (Bridgewater, NJ)
- …for leading compliance in regulated government/federal programs and price calculations ( Medicaid AMPs, BPs, Medicare Part B ASPs, PHS 340B pricing & Non-FAMPs). ... + Oversight of all government program related activities (ie, TX state Medicaid formulary additions, PHS 340B non- compliance disclosure letters, etc.).… more
- Bozeman Health (Bozeman, MT)
- …the managerial and administrative tasks involved in establishing, monitoring and updating the Compliance Plan as well as the Compliance Department's ... Bozeman Health Board of Directors has designated the System Director of Compliance & Privacy to serve...Functions: + Establishes, monitors, and updates the Bozeman Health Compliance Plan . + Maintains compliance … more
