- Sumitomo Pharma (Columbia, SC)
- …highly motivated, and experienced individual for the position of Sr. Manager, Medicaid Contract Administration. This position is responsible for managing the ... Medicaid decisions as it relates to Model N implementation and payment process. + Experience in processing ...Compliance, and Legal) to clarify policy compliance requirements and contract language clauses. + Keep current on regulatory and… more
- Highmark Health (Pittsburgh, PA)
- …The incumbent develops the strategic direction and insurers it's execution for revenue management , federal and state regulatory and contract compliance, care ... the health plan. Collaborate on the development and oversee implementation and reporting of the annual short- and long-term...Degree in Government **EXPERIENCE** **Required** + 10 years of Medicaid Experience + 10 years in Management … more
- Pulaski County Special School District (Little Rock, AR)
- …OT and PT services, provide direct therapy services and provide leadership/ management of all Medicaid reimbursement programs. PERFORMANCE RESPONSIBILITIES: + ... contracted therapy procurement and administrative oversight of associated processes, including contract development and implementation . + Help to develop and… more
- Centene Corporation (Olympia, WA)
- …and contract language + Identify, evaluate, and analyze the impact of Medicaid and Medicare regulatory issues and advise management concerning impact + ... regulatory requirements. + Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between Health Plan and… more
- Ascendis Pharma (Princeton, NJ)
- …and efficient contract implementation . Key Responsibilities: + Contract Lifecycle Management : Support drafting, execution, and administration of payer, ... contract alignment and implementation . + System Management : Experience with contract management ...BPO service providers. + Familiarity with government pricing implications ( Medicaid , 340B, Medicare Part D) is a plus. +… more
- Abbott (Austin, TX)
- …Our team in **Austin, TX (or Alpharetta, GA)** is looking for a ** Contract Strategy & Business Engagement Manager** **.** This person will spearhead the development, ... execution, and optimization of contract pricing strategies for all Cardiovascular contracting businesses. This role entails shaping and deploying innovative pricing… more
- J&J Family of Companies (Titusville, NJ)
- …HCC/GCCO) and external reviews (eg, PWC), ensuring the timely coordination and implementation of management action plans. Ensure work and deliverables align ... Description:** Johnson and Johnson is recruiting for the Finance Manager Government Contract Compliance role. This position is based in Titusville, NJ. At Johnson… more
- Mount Sinai Health System (New York, NY)
- …are a plus. **Experience Requirements** + Minimum 3-5 years of experience in contract management , coding, and analysis in a healthcare setting. + Experience ... interpret complex contract terms and financial data. + Proficient in contract management systems, modeling software, and financial reporting tools. +… more
- CommonSpirit Health (Phoenix, AZ)
- … of the payer relationships. The Manager assists PSR leaders in the development, implementation and management of PSR system standards for contracting and payer ... **Responsibilities** **Job Summary:** The Division Contract Manager for Payer Strategy & Relationships (PSR)...and Relationships (PSR) assists PSR leaders in the development, implementation and management of PSR system standards… more
- CVS Health (Nashville, TN)
- …and group Behavioral Health providers within a defined market. You will manage contract performance and support the development and implementation of strategic, ... network management unit. + Assists with the design, development, management , and or implementation of strategic network configurations, including integration… more
- CVS Health (Sacramento, CA)
- …auditing, building, and loading contracts, agreements, amendments and/or fee schedules in contract management systems per Aetna's established policies + Conducts ... data, contract integrity and performance + Manages contract performance and supports the development and implementation...that may include, but are not limited to, database management and contract coordination + Organizing and… more
- Highmark Health (Camp Hill, PA)
- …proposal development, contract negotiation, and ongoing contract management . Actively monitor changes in state-level Medicaid programs and adapt ... strong relationships with key state Medicaid officials and stakeholders. + ** Contract Management & Compliance:** Oversee the administration and compliance of… more
- Prime Therapeutics (Richmond, VA)
- …Medicare, and Medicaid ). This individual is the primary relationship and contract owner for their assigned account/s and oversees a cross-functional account ... and drives every decision we make. **Job Posting Title** AVP Account Management - REMOTE (FL Preferred) **Job Description** The Assistant Vice President Client… more
- NTT DATA North America (Albany, NY)
- …vulnerability management and cyber security policies related to the Medicaid Transformation program. + Directs and oversees the development and implementation ... and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We… more
- Cornell Cooperative Extension (Watertown, NY)
- …to work with a Medicaid funded program/population. + Familiarity with Medicaid /1115 waiver implementation . + Familiarity with reviewing and following recipes ... for Cornell Cooperative Extension Association of Jefferson County for the 1115 Medicaid Waiver program, and as such will provide screening, navigate referrals, and… more
- CVS Health (Tallahassee, FL)
- …including National Committee for Quality Assurance (NCQA) and state regulators for Medicaid and CHIP. Links the quality management activities to business ... using innovation, integration, and information. Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities,… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- …and communication across DHHS offices. * Oversee vendors through procurement and contract management for CCBHC efforts; plan, direct, and coordinate work ... plan administration; health planning; policy or program design and implementation ; healthcare-related program operations or project management . Professional… more
- CareOregon (Portland, OR)
- …and implementation of a Community Health Improvement Plan. Resource Management + Contributes to and monitors Value-Based Payment (VBP) contracts and other ... Wisconsin. Job Title Vice President, Columbia Pacific CCO Exemption Status Exempt Management Level Vice President Direct Reports CCO Leaders and Staff Manager Title… more
- CVS Health (Frankfort, KY)
- …+ Serves as the liaison between Aetna and state regulators to assure State Medicaid Agency Contract execution is completed annually as required and that all ... heart, each and every day. **Position Summary** As the Lead Director, DSNP Program Management you will support the General Manager in all aspects of the … more
- CVS Health (Springfield, IL)
- …The Behavioral Health Director reports to the Senior Director Behavioral Health - Medicaid Care Management . This is a fully remote role. Eligible candidates ... and procedures as necessary + Support all products including ICM (Integrated Care Management ), MLTSS ( Medicaid Long Term Support Services), and FIDE (Fully… more