- Jobleads-US (Washington, DC)
- …a part of our caring community and help us put health first The Senior Configuration Professional - Workday Compensation configures the Workday HRIS based on ... with Compensation teams as well as other teams throughout Humana, the Senior Configuration Professional - Workday Compensation will understand the current… more
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA-Network Contracting **Position Summary:** Under the direction of the Senior Contract Manager, Provider Contracting, the Senior Provider Contract ... contractual arrangements meet financial budgetary targets and legal and/or regulatory compliance requirements. + Maintain a solid understanding of Medicare and … more
- Wipfli LLP (Milwaukee, WI)
- …feel it. For those looking to make a difference and find a professional home, Wipfli offers a career-defining opportunity. Wipfli is seeking a highly experienced ... the latest governmental developments impacting the healthcare industry and ensure compliance with relevant regulations. + Build a trusted advisor relationship with… more
- Commonwealth Care Alliance (Boston, MA)
- …network performance against internal and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. - ... provider operations and satisfaction. - Strong understanding of Medicare and Medicaid health plan operations, including regulatory and compliance requirements.… more
- Commonwealth Care Alliance (Boston, MA)
- …preferred. Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Value-based program oversight and performance ... with common analytics tools such as excel - Ability to have a professional presence across internal and external stakeholders and across various levels and functions… more
- Commonwealth Care Alliance (Boston, MA)
- …Services and Supports (LTSS) provider organizations that serve One Care and Senior Care Options (SCO) members across Massachusetts. This role manages the performance ... provider-specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation Partnerships and Provider Engagement. The Provider… more
- Commonwealth Care Alliance (Boston, MA)
- …strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This role ensures providers are well-informed, engaged, ... also oversee corporate and business-as-usual (BAU) communications, support regulatory compliance , and champion digital innovation in provider engagement The Manager… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …the State Departments of Health, Diabetes Prevention and Control Programs, Medicaid , public employee benefit administrators, Insurance Commissioner and other state ... diabetes or obesity advocacy groups and other health-related coalitions, professional associations, vendors, consultants, contract lobbyists and customers, as… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening ... as a key liaison, proactively addressing provider needs, ensuring regulatory compliance , and supporting operational excellence to enhance provider satisfaction and… more
- Somatus (Mclean, VA)
- …a company transforming kidney care?** Somatus is on the hunt for a visionary ** Senior Vice President of Finance** to lead at the crossroads of strategy, innovation, ... timely, reliable financial analysis and performance metrics **to executive and senior ** **leadership** and the Board, including forecasting, budgeting, and resource… more
- Commonwealth Care Alliance (Boston, MA)
- …oversight, and efficiency of UM processes and functions. - Ensures compliance with all contract requirements, state and federal regulatory requirements and ... health care delivery Required Knowledge, Skills & Abilities: - Medicare and Medicaid managed care experience - Demonstrated knowledge of federal and state… more
- Jobleads-US (Annapolis, MD)
- …caring community and help us put health first The Lead Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and ... performance. The Lead Technology Leadership Professional works on problems of diverse scope and complexity ranging from moderate to substantial. Work on solving… more
- Alameda Health System (Oakland, CA)
- …Required Experience: Familiarity with healthcare reimbursement models (eg, Medicare, Medicaid , value-based care) and regulatory compliance . Required Experience: ... Operational Transformation + Full Time - Day + Business Professional & IT + $44.15 - 73.56/ Hour +...line performance. + Prepare detailed reports and presentations for senior management, integrating financial, market, and growth data to… more
- Commonwealth Care Alliance (Springfield, MA)
- …require intensive care management and care delivery. Within the CIC Program, The Senior Clinician, Behavioral Health (SBHC) serves as a leader for behavioral health ... across assigned catchment area. + COVID-19 vaccination is required + Compliance with all Community Clinician Occupational Health Requirements. **Other:** **Equipment… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Senior Data and Reporting Professional generates ad hoc reports and regular datasets ... using system tools and database or data warehouse queries and scripts. The Senior Data and Reporting Professional work assignments involve moderately complex to… more
- Prime Healthcare (Inglewood, CA)
- …actively seeking new members to join our corporate team! Responsibilities The Senior Medicare- Medicaid Biller/Collector is responsible for both billing and ... in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Medicare- Medicaid . This includes maintaining the… more
- CVS Health (Chicago, IL)
- …utilization/performance, network growth, and efficiency targets. Manages and oversees compliance within our network responsibilities as provided within the state ... Medicaid contractual requirements. This position holds a variety of...have access to necessary resources, training, and support for compliance and operational success. Develop and implement training programs… more
- CVS Health (Columbus, OH)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... and enhance provider networks while meeting and exceeding accessibility, compliance , quality, and financial goals and cost initiatives. Collaborates… more
- Humana (Boston, MA)
- …claims operations, and other business teams involved in the administration of Medicaid business at Humana. The Senior Business Intelligence Engineer will ... development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root… more
- Prime Healthcare (Redding, CA)
- …their family. For more information, visit www.shastaregional.com . Responsibilities The Senior Medicare- Medicaid Biller/Collector is responsible for both billing ... in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Medicare- Medicaid . This includes maintaining the… more
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