• Medicaid Consultant

    City of New York (New York, NY)
    …is recruiting for one (1) Principal Administrative Associate II, to function as a Medicaid Consultant within the Central Intake Unit, who will: - Interpret ... TITLE. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to...Medicaid policies and procedures for assigned cases for individuals… more
    City of New York (05/14/25)
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  • Legal Nurse/Medical Analyst: Medicaid Fraud…

    New York State Civil Service (New York, NY)
    …HELP No Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst: Medicaid Fraud Control Unit (6388) Occupational Category Legal Salary Grade NS ... NY Zip Code 10005 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - New York City Medical...managed care; * Prior experience as a legal nurse consultant ; and * Knowledge of state and federal rules… more
    New York State Civil Service (05/14/25)
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  • Behavioral Health Medical Director- Psychiatrist-…

    Elevance Health (Woodbridge, NJ)
    **Behavioral Health Medical Director- Psychiatrist- NJ Medicaid ** Location: The successful candidate will be a board-certified psychiatrist licensed and residing in ... or other ordering providers to discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May be required to represent the… more
    Elevance Health (07/08/25)
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  • Medical Consultant

    City of New York (New York, NY)
    …with essential benefits such as Cash, Food and Rental Assistance as well as Medicaid . The Office of the Medical Director aims to improve the health and well-being ... one (1) City Medical Specialist (Per Diem) to function as a Medical Consultant who will: - Indirectly supervise contracted clinical staff, share policies and… more
    City of New York (05/14/25)
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  • Transformation Program Consultant

    Humana (New York, NY)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
    Humana (07/02/25)
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  • Manager Rebate Pharmacy Operations

    Prime Therapeutics (Trenton, NJ)
    …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each...discussion for these periodic meetings. + Acts as a consultant to Rebate Director for RFPs and implementations when… more
    Prime Therapeutics (05/07/25)
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  • Senior Director Clinical Account Management…

    Prime Therapeutics (Trenton, NJ)
    …of growth and retention strategies; support the development and execution of consultant engagement strategies necessary to grow the market. + Manage budgets and ... client services experience in healthcare or pharmacy benefit management, preferably in Medicaid . + 5 years of leadership / people management experience. + Must… more
    Prime Therapeutics (07/09/25)
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  • Deputy Commissioner, Office Of Audit & Quality…

    City of New York (New York, NY)
    …towards monitoring the performance and compliance of Cash Assistance, SNAP, and Medicaid programs. Ensure that all projects lead to improved efficiency, which result ... reduction, cost saving and avoidance of fiscal sanctions. - Act as internal consultant to the Agency's Senior Leadership Team regarding the following: identify and… more
    City of New York (04/18/25)
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  • Senior Behavioral Economics Professional

    Humana (Trenton, NJ)
    …design projects from start to finish. They act as an internal consultant within cross-functional teams, leading evaluation of program impacts by: initial project ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal… more
    Humana (07/14/25)
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  • Senior Clinical Pharmacist

    CenterWell (Trenton, NJ)
    …others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over. ... practice residency or similar pharmacy practice experience + Knowledge of Medicare and Medicaid as it relates to pharmacy + Six Sigma and/or Project Management… more
    CenterWell (07/12/25)
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  • Vice President Client Engagement - Large Plan…

    Prime Therapeutics (Trenton, NJ)
    …state leaders, industry trade associations, and Centers for Medicare and Medicaid Services (CMS); establish an effective communication and collaboration cadence to ... these requests; lead market-based planning and execution initiatives with the sales, consultant relations and the broader client engagement teams + Lead market-based… more
    Prime Therapeutics (07/02/25)
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