• COOLSOFT (Raleigh, NC)
    …of the product enhancements. - Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for business solutions. - ... - Collaborates and communicates with the PBM Business stakeholders ( Product Managers, Product Owners, Business Leads.) -...Preferred to have experience with Medicaid , managed care, and Pharmacy Benefit Manager more
    DirectEmployers Association (10/25/25)
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  • Clever Care Health Plan (Arcadia, CA)
    …consultant will educate prospective members on Clever Care products and enroll into product of choice over the phone/in person or other sales enrollment channels. ... initiatives. Carry out appropriate sales activity standards as directed by their manager . Manage allocated budget for sales events, sponsorship activities, and key… more
    Upward (08/10/25)
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  • Medicaid Senior Product

    Humana (Sacramento, CA)
    **Become a part of our caring community and help us put health first** The Medicaid Senior Product Manager leads all phases of the Clinical Operations ... and performance insights inform investment decisions and process innovation. The ** Medicaid Senior Product Manager ** exercises significant autonomy in… more
    Humana (11/01/25)
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  • North Carolina Medicaid Account…

    Prime Therapeutics (Jefferson City, MO)
    …our passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The ... Senior Account Manager is responsible for providing complex level support for...Medicaid business by driving communications, client-facing initiatives, and product and program recommendations. This position leads client initiatives… more
    Prime Therapeutics (09/23/25)
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  • Senior Program Manager - DC Market…

    CareFirst (Washington, DC)
    **Resp & Qualifications** **PURPOSE:** The Sr. Program Manager , DC Market Operations provides leadership for the operation of a single jurisdiction Medicaid ... profitability, growth, and stability of the business. The Sr Program Manager will have responsibility for business direction, financial performance, growth strategy,… more
    CareFirst (09/19/25)
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  • Senior Program Manager - Quality…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …to improve health care delivery and member outcomes, with a primary focus on Medicaid product lines. It is responsible for implementing and evaluating quality ... Blue Cross and Blue Shield of Minnesota Position Title: Senior Program Manager - Quality Improvement Location:...with policy or other advocacy tactics. ⦁ Experience with Medicaid Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00… more
    Blue Cross and Blue Shield of Minnesota (10/23/25)
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  • Nurse Case Manager - Senior Care…

    Fallon Health (Barnstable, MA)
    …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...care, group adult foster care, and other programs per product benefits and guidelines. The NCM may utilize an… more
    Fallon Health (10/28/25)
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  • Senior Contract Manager Analyst…

    Mount Sinai Health System (New York, NY)
    …Facility and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a ** Senior Contract Manager Analyst** will play a critical role in testing, ... 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise. MSHP is a fast growing business unit within… more
    Mount Sinai Health System (10/29/25)
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  • Advocacy Relations Senior Manager

    Amgen (Washington, DC)
    …and transform the lives of patients while transforming your career. **Advocacy Relations Senior Manager , Respiratory** **What you will do** Let's do this. Let's ... change the world. In this vital role the Advocacy Relations Senior Manager , Respiratory will lead the execution of Amgen's external engagement and patient… more
    Amgen (10/18/25)
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  • Senior Manager , Market Access…

    Ascendis Pharma (Princeton, NJ)
    …and develop their skills. Position Summary: We are seeking a highly motivated Senior Manager (Contractor) to support our Contracting Operations function within ... and managing BPO service providers. + Familiarity with government pricing implications ( Medicaid , 340B, Medicare Part D) is a plus. + Excellent project management,… more
    Ascendis Pharma (10/18/25)
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  • Senior Manager , Ethics & Compliance

    Centene Corporation (Jefferson City, MO)
    …requirements for assigned products across the entire company + Ensure all Medicare and Medicaid product and services are being tested for compliance with program ... preferably in a healthcare environment with at least 3+ years of Medicaid , Medicare or Commercial Managed Care experience. + Previous experience demonstrating… more
    Centene Corporation (10/24/25)
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  • Product Manager , Government…

    CVS Health (Austin, TX)
    …we do it all with heart, each and every day. **Position Summary:** As a Product manager , you will provide technical, analytical, and business support for all ... assigned programs for Medicare, Medicaid , and Commercial products. Programs currently include End-Stage Renal Disease (ESRD), Hospice, Transplant, Transition Fill… more
    CVS Health (10/16/25)
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  • Senior Manager , Audit and Business…

    CVS Health (Springfield, IL)
    …+ Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare- Medicaid Integrated Product Experience + Experience with Part D Coverage ... Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and audit management + Experience with Part C & D reporting requirements + 3+ years serving as project lead + Adept at problem solving and decision making +… more
    CVS Health (10/25/25)
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  • Health Aide Supervisor - Great Manager Role…

    Fallon Health (Worcester, MA)
    …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:** ... medical equipment; aide service requirements). + Initiates and makes changes/updates to product and service orders with vendors + Initiates and manages required… more
    Fallon Health (10/21/25)
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  • Navigator, Senior Care Options

    Fallon Health (Lawrence, MA)
    …provider sheets as applicable + **Access to Care** + Depending upon the product , generates requests and authorizations for Medicaid covered services per the ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in… more
    Fallon Health (10/22/25)
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  • Senior Contracting Analyst Lead - Mount…

    Mount Sinai Health System (New York, NY)
    …400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise. MSHP is a fast growing business unit within ... within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
    Mount Sinai Health System (10/21/25)
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  • Manager , Risk Adjustment Operations…

    Point32Health (Canton, MA)
    …and reporting activities for risk adjustment programs and initiatives that impact Medicare, Medicaid , and Duals product members. This individual will lead the ... complete and accurate capture of risk adjustment data. To be successful, the Manager will need to rely on strong analytic, consultative and communication skills to… more
    Point32Health (10/24/25)
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  • Senior Analyst, Actuarial

    CVS Health (Hartford, CT)
    …it all with heart, each and every day. **Position Summary** Support the Medicaid Pharmacy team, including forecasting, reporting and pharmacy analytics across all ... Medicaid states. Perform actuarial functions by applying expanded quantitative...and reasonability. Communicates clear written and oral results to mentor/ manager . Anticipates questions and formulate responses. + Utilizes advanced… more
    CVS Health (10/23/25)
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  • Senior Analyst, Market Research

    AbbVie (Mettawa, IL)
    …businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. This role requires collaboration with stakeholders including Finance, ... pipeline products. Key Job Responsibilities Responsible for working with hiring manager to perform payer contract analysis, communicate results/ recommendations from… more
    AbbVie (10/02/25)
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  • Associate Manager , Clinical Trial…

    Abbott (Austin, TX)
    …than 500,000 people with diabetes from routine fingersticks. The **Associate Manager of Clinical Trial Reimbursement** is responsible for implementing and managing ... + Review clinical investigative plan and payer policies (Medicare, Medicare Advantage, Medicaid and Private Payer) to provide coverage and reimbursement guidance for… more
    Abbott (10/25/25)
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