- Commonwealth Care Alliance (Boston, MA)
- …Program Specialist will have a wide range of responsibilities including project management support, data review, documentation, and assisting external partners. ... interest and demonstrated capabilities. The position will report to the LTSS Program Manager . Reporting to the Manager , LTSS Program, this position supports the… more
- Molina Healthcare (Vancouver, WA)
- …DESCRIPTION** **Job Summary** Focuses on process improvement, organizational change management, project management and other processes relative to the business. ... Project management includes estimating, scheduling, costing, planning, and issue/risk...package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V. Pay Range: $77,969 - $155,508 / ANNUAL *Actual… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare- Medicaid plans)_** + **_Experience managing external audits and communicating with ... with leadership in maintaining Centene Corporation's Compliance with Duals ( D -SNP) Program requirements. Provide regulatory interpretation, perform compliance reporting,… more
- Molina Healthcare (OH)
- …to manage resources, mitigate risks, and ensure stakeholder satisfaction. Although a project management role, this role will be assigned some operations initiatives ... monitors task activities, and ensures state contract timelines are met. Monitors the project from inception through delivery. May engage and oversee the work of… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Product Manager - Hybrid - Albany, NY** In this role, you will be responsible for ... including internal and external customers, data engineers, analysts, developers, and Medicaid Program stakeholders to ensure the creation of high quality, accessible… more
- Molina Healthcare (Carson City, NV)
- …Analysis Professional (CBAP), or Certified Coding Specialist (CCS) certification. + Project Management Experience. + Familiarity with Medicaid -specific Scorable ... tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- CVS Health (Nashville, TN)
- …Health is currently looking for a dynamic individual to join our team in a Manager role. In this client facing project management role, you will be responsible ... as well as researching claim specific questions. As a Manager of Client Audit, you will be responsible for...competing priorities. . Have a deep knowledge base of Medicaid and Exchange regulations, as well as having some… more
- Molina Healthcare (Sterling Heights, MI)
- …is an Equal Opportunity Employer (EOE) M/F/ D /V. Key Words: Program Manager , Skilled Nursing, SNIP, SNIF, LTC, Medicare, Medicaid , Duals, CMS, Survey, ... Healthcare is hiring for a Post Acute Network Program Manager in Michigan **.** This role is remote with...a meaningful impact through partnership, strategy, and collaboration - we' d love to hear from you! **Apply today!** This… more
- University of Southern California (Alhambra, CA)
- The Manager uses clinical, coding and CDI expertise to perform daily operational management. This position evaluates the adequacy and effectiveness of internal and ... coding and CDI practices, including federal and state compliance standards. The Manager uses Health Information Management and Revenue Cycle knowledge to perform… more
- CVS Health (Carson City, NV)
- …Medicaid Integrated Product Experience + Experience with Part D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory ... will do** + Acts as a top-level specialist on project management and develops a comprehensive plan that encompasses...D reporting requirements + 3+ years serving as project lead + Adept at problem solving and decision… more
- Prime Therapeutics (Indianapolis, IN)
- …* PBM and/or health plan experience * Government Programs, Medicare Part D /B and/or Medicaid experience RxCLAIM experience **Minimum Physical Job Requirements** ... decision we make. **Job Posting Title** Health Plan Account Manager Sr - Remote **Job Description** The Sr Health...- Remote **Job Description** The Sr Health Plan Account Manager serves as a line of business specialist for… more
- CVS Health (Harrisburg, PA)
- …processes. **Preferred Qualifications** + 2+ years of experience within Medicare Part D Stars Program Management, Medicare / Medicaid HEDIS measurement or ... its goals and key deliverables. + Provide business and operational project and program management support for improvement initiatives and cross-functional work… more
- Molina Healthcare (Sterling Heights, MI)
- …leadership to healthcare services function - providing support for project /program/process design, execution, evaluation and support, and ensuring compliance with ... online portals and databases. Preferred Qualifications * Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional… more
- Molina Healthcare (Akron, OH)
- …leadership to healthcare services function - providing support for project /program/process design, execution, evaluation and support, and ensuring compliance with ... online portals and databases. **Preferred Qualifications** + Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified… more
- Ascendis Pharma (Princeton, NJ)
- …+ Familiarity with government pricing implications ( Medicaid , 340B, Medicare Part D ) is a plus. + Excellent project management, analytical, and ... their skills. Position Summary: We are seeking a highly motivated Senior Manager (Contractor) to support our Contracting Operations function within the Market Access… more
- Molina Healthcare (NM)
- …(EOE) M/F/ D /V. Key Words: health care, insurance, health insurance, Medicaid , Medicare, health coach, community health advisor, family advocate, health educator, ... membership growth and retention for Molina Healthcare of New Mexico Medicaid . + Build and maintain relationships with community-based organizations and healthcare… more
- Molina Healthcare (Aurora, IL)
- …gaps, MACs, and member facing initiatives and communications. We focus on Medicaid and MMP, and support MHI Medicare and Marketplace programs. Highly qualified ... Well versed in Data Analysis, Excel, creating and understanding reports, project management skills. **Job Summary** Responsible for achieving established goals… more
- Commonwealth Care Alliance (Boston, MA)
- …Program Specialist will have a wide range of responsibilities including project management support, data review, documentation, and assisting external partners. ... interest and demonstrated capabilities. The position will report to the LTSS Program Manager . Reporting to the Manager , LTSS Program, this position supports the… more
- Molina Healthcare (Queens, NY)
- …goals improving Molina's enrollment growth objectives, with primary responsibility for Medicaid . Works collaboratively with key departments across the enterprise to ... rate. Works collaboratively with other key departments to increase Medicaid assignment percentage for Molina. + Provides leadership for...model. May also serve as the Acting Supervisor or Manager for the team upon management request. + Responsible… more
- Molina Healthcare (Cedar Rapids, IA)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... Duties** + Acts as a lead specialist to provide project , program, and/or initiative related direction and guidance for...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
