- Aveanna Healthcare LLC (Vancouver, WA)
- …Vancouver , WA . This position provides the opportunity to help develop and provide professional guidance to our field staff, as well as monitor our clinical ... proper operation of necessary equipment and supplies related to patient care Provide direct client care as needed Promote and manage expectations and satisfaction… more
- Pairtu (San Francisco, CA)
- …for a senior, hands-on operator who can work across credentialing, payer contracting, provider onboarding, and day-to-day ops while keeping a sharp eye on patient ... need structure and predictability or 'need to be a manager ' this isn't for you. The upside? You'll level...Do** **1. Own Credentialing & Compliance Workflows** - Manage provider credentialing, payer enrollment, and ongoing compliance. - Keep… more
- Campbell County Health (Gillette, WY)
- …documents significant interactions, and maintains clinical charts and other reporting data . Must be licensed or provisionally licensed and requires a Master's ... Health, Campbell County Medical Group, and Campbell County School District to provide primary medical care, behavioral health, and substance use counseling services… more
- CVS Health (St. Paul, MN)
- …all with heart, each and every day. **Position Summary** + Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining ... Medicaid Provider data within Aetna QNXT. + Team...Medicaid Provider data within Aetna QNXT. + Team...or Network operations. + 1+ years of experience in Medicaid provider operations. + At least 1… more
- CVS Health (Annapolis, MD)
- … Manager of Claims Management is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and compliance monitoring. This ... federal regulations, contractual requirements, and organizational performance standards. The manager partners cross-functionally with Provider Relations, Configuration,… more
- NTT DATA North America (Montgomery, AL)
- …an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Medicaid Project Manager - PMP Certified to join our team in ... **Req ID:** 349933 NTT DATA strives to hire exceptional, innovative and passionate...organization, apply now. We are currently seeking a Project Manager to join our team in Montgomery Alabama. This… more
- Humana (Tallahassee, FL)
- …Consumer Service Operations is responsible for the daily activities for Florida Medicaid Contact Center Operations. The Manager , Consumer Service Operations ... up to 200+ associates and leaders supporting the Florida Medicaid plan. The manager will oversee strategic...guarantee prompt resolution of inquiries, follow ups, and calls. Provide education and details about benefits provided by the… more
- CVS Health (Hartford, CT)
- …Medicaid plans. Responsibilities may include: Querying and analysis of complex provider claim, financial and other data to support VBC ... and every day. **Position Summary** Aetna is recruiting for a Manger on the Medicaid VBC Analytics team to support VBC partnerships throughout Aetna's Medicaid … more
- Molina Healthcare (ID)
- …as subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, ... **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to...utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor health plan performance… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …selected. **How you'll spend your day** + Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter ... and review to ensure completeness of information received. Upload data into Medicaid systems and authorize transactions....for key findings and changes to state programs. + Provide backup for Medicaid team members in… more
- MyFlorida (West Palm Beach, FL)
- …needed regarding new/ongoing policies. Provides feedback on Waiver Support Coordinator and Medicaid Waiver provider scorecards as requested. Ensures current and ... MEDICAID WAIVER SUPERVISOR - 67013921 Date: Dec 15,...processes by ensuring submissions made to the Regional Operations Manager and Deputy ROM for approval follow the Agency… more
- CVS Health (Baton Rouge, LA)
- …day. **Position Summary** Coordinate effective resolution of member and/or provider /practitioner appeals, complaints and grievances. Responsible for the day-to-day ... management of staff to ensure effective resolution of member or provider /practitioner appeals, complaints and grievances for all products, which may contain multiple… more
- NTT DATA North America (Montgomery, AL)
- …processes and performance metrics + Analyzes source systems and identifies potential data gaps + Provide project management support, including: + Scope ... **Req ID:** 349932 NTT DATA strives to hire exceptional, innovative and passionate...forward-thinking organization, apply now. We are currently seeking a Medicaid Senior BA to join our team in montgomery,… more
- Fallon Health (Worcester, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... in core system accurately and timely. This is to be completed through review of data integrity reports, and working closely with Provider Partners, Provider … more
- Point32Health (Canton, MA)
- …engagement and consultation activities supporting the complete and accurate capture of risk adjustment data . To be successful, the Manager will need to rely on ... and programs (internal and vendor-driven) that optimize performance across our provider networks serving Point32Health's Medicare, Medicaid , Duals and Commercial… more
- Commonwealth Care Alliance (Boston, MA)
- …account manager , relationship manager , and performance partner - using data , provider feedback, and system collaboration to enhance provider ... Engagement & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for...and Data Insight * Analyze and interpret provider data related to utilization, cost, quality,… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and ... executing communication strategies that foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... and Systems (CAHPS), and social determinants of health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams… more
- Humana (Baton Rouge, LA)
- …providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...-friendly insights. + Lead the design and refinement of provider -facing data views (dashboards, insights, performance summaries)… more
- AmeriHealth Caritas (Washington, DC)
- …Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. This position is also responsible ... for all provider network recruiting and contracting management activities as it...with claim payment methodologies. + Maintains familiarity with State Medicaid fee schedules and analyzes comparable Plan pricing guidelines.… more
