- 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 ... relocate or currently reside within 50 miles of the Indianapolis office. The ** Medicaid ** ** Quality Management Health Plan Director Sr.** will be… more
- CVS Health (Hartford, CT)
- …RFP/RFI/RFA LTSS SME input and participation for writing and orals.* Collaborate with Care Management , quality , and population health t teams and others to ... of Medicaid , will collaborate with Aetna National Medicaid , Regional and health plan leadership to...line of business including but not limited to UM, Quality , care management , and network growth as… more
- Elevance Health (Indianapolis, IN)
- ** Medicaid Whole Health Domain Director** **Location:** This position will work a hybrid model (remote and office). Must live within 50 miles of one of our ... Elevance Health PulsePoint locations. The ** Medicaid Whole ...Growth Partner areas (including but not limited to Enterprise Quality , Health Equity Network, Marketing, and Clinical… more
- NORC (Bethesda, MD)
- Principal Research Scientist - Health Care Quality Measurement: Medicare, Medicaid , & Commercial Insurance Programs Job no: 502274 Work type: Regular ... policy projects, with an emphasis on those related to health care quality measurement. NORC recognizes that...education) including at least 5 years of policy project management + Expert knowledge of Traditional Medicare, Medicare Parts… more
- Universal Health Services (Leesburg, VA)
- …style and a service philosophy based on integrity, competence and compassion. Our Risk Management and Quality Assurance Department is looking for a fulltime ... for ensuring institutional compliance with the Virginia Department of Behavioral health and Developmental Services, Virginia Medicaid Services, Tricare and… more
- CVS Health (Northbrook, IL)
- …for implementing and optimizing provider engagement initiatives for all Aetna Medicaid Health Plans, executing comprehensive strategies aimed at fostering ... Medicaid Risk Adjustment initiatives to broader Aetna Medicaid Health Plan goals. This position will...etc.) Primary Responsibilities % Time Market Support & Performance Management 30% + Engage with clinical team and specific… more
- Mathematica (Chicago, IL)
- …in improving Medicaid and other government programs through effective project management , and/or providing technical assistance to health care entities. * ... Management Analysts with a strong interest in project management in our Medicaid project area. This...are seeking prospective employees with a passion for project management and an interest in improving public health… more
- CVS Health (Hartford, CT)
- …a suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Senior Manager of Medicaid Risk ... of attention to detail.Preferred Qualifications - 2+ years of experience in the health care industry, Medicaid operations, risk adjustment, or medical coding and… more
- CVS Health (Austin, TX)
- …to identify and manage initiatives that improve total medical cost and quality . . Health Plan/Payer or Provider Systems experience Preferred Qualifications ... Bring your heart to CVS Health . Every one of us at CVS ...with all contracting strategies and meeting and exceeding accessibility, quality , compliance, and financial goals and cost initiatives. Negotiates… more
- Humana (Columbus, OH)
- …Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other ... a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines… more
- CVS Health (Irving, TX)
- …negotiating Medicaid value based agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs and others, in accordance ... ability to identify and manage initiatives that improve total medical cost and quality . . Health Plan/Payer or Provider Systems experience . Experience with… more
- McLaren Health Care (Indianapolis, IN)
- …considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. McLaren Health Plan is our ... We are looking for a Manager, Medicaid Compliance to join us in leading our...of Minorities/Females/Disabled/Veterans** **\#LI-AK1** **Qualifications:** **Required:** + Bachelor's degree in health , management or related field or Associate's… more
- Elevance Health (Tampa, FL)
- Nurse Medical Management Sr - Medicaid (JR107109) **Location:** Must reside within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This is primarily a ... with clinical reviewers and/or medical directors to ensure medically appropriate, high quality , cost-effective care throughout the medical management process. +… more
- Louisiana Department of State Civil Service (New Orleans, LA)
- …Concepts Function of Work: To perform advanced research, analyses, and/or policy management activities for Medicaid programs. Level of Work: Advanced. ... Program Specialist 2 by the presence of advanced research, analysis and policy management responsibility. Differs from Medicaid Program Supervisor by the absence… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …to modernize and innovate solutions to improve the quality of life and health outcomes for the state's Medicaid members. The Program Integrity Reporting & ... Benefits + Questions Job Description The Iowa Department of Health and Human Services (HHS), Iowa Medicaid ...coding certification in an active status with the American Health Information Management Association (AHIMA) or American… more
- Humana (Louisville, KY)
- **Become a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product ... of a leading healthcare company committed to improving the health of the communities it serves. We are a...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- CVS Health (Albany, NY)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...being the Bronx. Work closely with one, or more, Medicaid licensed home care agencies, hospitals, community organizations or… more
- CVS Health (Downers Grove, IL)
- …understanding of Aetna Medicaid products and services + Support the content management lifecycle by working with SMEs to identify new content for the Medicaid ... Bring your heart to CVS Health . Every one of us at CVS ...successful candidate will play a critical role in the quality of our RFP responses and the efficiency of… more
- Public Consulting Group (Columbus, OH)
- …for scope, schedule, , quality , , communications, risk, and , stakeholder management activities, all while adding deep Medicaid and Medicaid Enterprise ... public sector solutions implementation and operations improvement firm that partners with health , education, and human services agencies to improve lives. Founded in… 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 ... full optimal data processing review function for timely and quality deliver of the PERM program.The candidate in this...matter expertise in claims data processing review for the Medicaid and Children's Health Insurance Program. **_Hybrid… more