- Sumitomo Pharma (Hartford, CT)
- …dynamic, highly motivated, and experienced individual for the position of Sr. Manager , Medicaid Contract Administration. This position is responsible for ... managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting ...with internal departments (Internal Audit, Commercial Insights, Contracting, SOX Compliance , and Legal) to clarify policy compliance … more
- Humana (Hartford, CT)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Prime Therapeutics (Hartford, CT)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Sanofi Group (Hartford, CT)
- **Job Title:** Field Reimbursement Manager Tzield- Northeast Region **Location:** Remote **About the Job** The individual in this role will need to demonstrate a ... requires dedicated and knowledgeable customer facing support. Field Reimbursement Manager /Director for TZIELD. This is a regionally aligned, field-based position… more
- Molina Healthcare (Springfield, MA)
- …of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and oversight of integrated ... more direct report supervisors, facilitates integrated, proactive HCS management, ensuring compliance with state and federal regulatory and accrediting standards and… more
- National Health Care Associates (Wethersfield, CT)
- …to join our team! **-** **What You'll Do:** As a Regional A/R Account Manager , you will be responsible for identifying the collectability of the accounts receivable ... operations, ensuring accuracy, efficiency, and compliance with company policies and procedures. Your work will...our operations. **Key Responsibilities of a Regional A/R Account Manager :** * Manage and oversee the accounts receivable reporting… more
- Datavant (Hartford, CT)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Humana (Hartford, CT)
- …a part of our caring community and help us put health first** The Manager , Technology Solutions devises an effective strategy for executing and delivering on IT ... business initiatives. The Manager , We are seeking a highly skilled and motivated...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Lundbeck (Springfield, MA)
- …anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. **Pharmaceutical Environment/ Compliance ** ... Multi-Specialty Account Manager - Springfield, MA Requisition ID: 6437 Location:...the primary care and neurology settings. As an Account Manager , you lead the promotion of our psychiatry portfolio,… more
- Humana (Hartford, CT)
- …us put health first** We're seeking a strategic, results-driven Lead Product Manager to design and deliver innovative clinical solutions that improve health outcomes ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Cardinal Health (Hartford, CT)
- …* Process all patient applications in accordance to set policy, procedures and PHI compliance * Speak with manufacturer field team members on case updates via phone ... benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred… more
- Fallon Health (Springfield, MA)
- …who have MassHealth Standard, and may have Medicare. It combines MassHealth ( Medicaid ) and Medicare benefits, including prescription drug coverage. At Fallon Health, ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:** This… more
- CVS Health (Hartford, CT)
- …Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid . As a member of the care team, you will collaborate with members, the ... coordinating care for our members through close collaboration with the Care Manager , Social Worker, and other interdisciplinary team members. This role involves… more
- Hartford HealthCare (Farmington, CT)
- …of documentation of Evaluation and Management o Experience with interpreting Medicare, Medicaid and third-party billing and compliance regulations necessary. . ... Researches literature from regulatory groups such as; HHS/OIG, Medicare, Medicaid , NGS, etc., professional and peer organizations' practices/policies/guidelines to… more
- Hartford HealthCare (Hartford, CT)
- …Worker, Nutritionist, Pharmacy Liaison, APRNs, RNs, MA/MAAs, Case Managers and Program Manager who provide compassionate care to a diverse population of patients. ... being their primary language, and have healthcare coverage under Medicaid . Our specialists are skilled at treating many infectious...and/or vapers quit. Working under the direction of the Manager of Tobacco Cessation of the STOP Smoking &… more
- CenterWell (Hartford, CT)
- …CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and future models. Under general ... operations including program administration, contract oversight, process, performance improvement, compliance , governance, training, and more. Additionally, this role will… more
- CenterWell (Hartford, CT)
- …of outcome data, policy, procedure, and records issues. . Assure personal compliance with licensing, certification, and accrediting bodies. **Use your skills to make ... Medicine . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Excellent verbal and written communication skills . Superior… more
- Humana (Hartford, CT)
- …campus and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network infrastructure environment ... for future budget forecasting and planning needs. + Communicate status updates to Manager of IT and other Senior business leaders where necessary. + Research and… more
- Humana (Hartford, CT)
- …information to the application at Humana's secure website. + Position reports to Manager , Technology Solutions, IT HPE - Digital Channels & Contact Centers + ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CenterWell (Hartford, CT)
- …health and human services field + Prior experience with Medicare & Medicaid recipients + Previous experience with electronic case note documentation and experienced ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more