• Manager , Compliance

    Humana (Frankfort, KY)
    …and help us put health first** Humana Healthy Horizons is seeking a Manager , Compliance - Medicaid State Reporting to ensure compliance with ... to determine approach, resources, schedules, and goals. The Manager , Compliance - Medicaid State Reporting develops and implements compliance more
    Humana (10/04/25)
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  • Medicaid Insurance Product Manager

    Humana (Frankfort, KY)
    Medicaid is seeking a dynamic and strategic Senior Insurance Product Manager to join our Medicaid Product Strategy Organization, supporting the continued ... growth and innovation of our Medicaid and Dual Eligible lines of business. This is...resources and drive growth. As a Senior Insurance Product Manager , you will: + Serve as a strategic partner… more
    Humana (10/10/25)
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  • Account Manager Sr - NC Medicaid

    Prime Therapeutics (Frankfort, KY)
    …It fuels our passion and drives every decision we make. **Job Posting Title** Account Manager Sr - NC Medicaid - Remote Raleigh, NC **Job Description** The ... Senior Account Manager is responsible for providing complex level support for...for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product… more
    Prime Therapeutics (09/23/25)
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  • Compliance Audit Manager

    Cardinal Health (Frankfort, KY)
    …of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **_What is ... industry best-practices. + Develops and implements compliance training to ensure compliance with federal and state regulations and laws, CMS and other… more
    Cardinal Health (08/27/25)
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  • Bilingual RN Care Manager - Remote,…

    Humana (Frankfort, KY)
    …of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare, Medicaid , and/or and Group ... community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies,...advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The… more
    Humana (09/26/25)
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  • Care Manager , Behavioral Health

    Humana (Frankfort, KY)
    …health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs and requirements ... to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with...the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are varied and… more
    Humana (09/26/25)
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  • Sr. Product Manager - Claims Management

    Waystar (Louisville, KY)
    …closely with User Experience team and Technology teams. The Sr. Product Manager will coordinate with key stakeholders in sales, marketing, design, development, and ... healthcare industry standards and staying up-to-date on industry changes and compliance issues + Gathering inspiration and ideas by visiting customers regularly… more
    Waystar (08/08/25)
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  • Care Manager , Telephonic Compact…

    Humana (Frankfort, KY)
    …part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs ... resources appropriate for the care and wellbeing of members. The Care Manager , Telephonic Nurse 2 work assignments are varied and frequently require interpretation… more
    Humana (09/26/25)
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  • CAHPS Operations & Improvement Lead Product…

    Humana (Louisville, KY)
    …us put health first** Humana seeks a strategic and results-driven Lead Product Manager to oversee the end-to-end lifecycle of the Patient Experience Survey product. ... an organization focused on continuously improving customer experiences. The Lead Product Manager will work to develop a product strategy that delivers insights and… more
    Humana (09/25/25)
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  • Program Manager , Healthcare Services…

    Molina Healthcare (Louisville, KY)
    …for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and ... ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes. + May engage and oversee the… more
    Molina Healthcare (10/10/25)
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  • Manager , Revenue Cycle Management

    Cardinal Health (Frankfort, KY)
    **Job Summary:** The Manager , Revenue Cycle Management, is responsible for overseeing the insurance collection follow-up team to ensure timely and accurate ... initiatives to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage… more
    Cardinal Health (09/17/25)
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  • Product Manager , Risk Adjustment Coding…

    Datavant (Frankfort, KY)
    …and compliant onboarding and management of client data for MA, ACA, and Medicaid plans, ensuring HIPAA and CMS compliance + **Standard Data Specifications:** ... to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Coding Data Integration, you will own the data strategy and… more
    Datavant (08/20/25)
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  • Social Services Care Manager

    Humana (Frankfort, KY)
    …of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' ... for the care and wellbeing of members The Care Manager , Telephonic Behavioral Health 2 is a **Licensed,** **Masters...Associates who live and work from home in the state of California, Illinois, Montana, or South Dakota will… more
    Humana (10/10/25)
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  • Marketing Automation Manager (Adobe…

    Humana (Frankfort, KY)
    …put health first** Humana's Marketing organization is seeking a Marketing Automation Manager who specializes in Adobe Experience Platform (AEP) and Next Best Action ... execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist...Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will… more
    Humana (10/10/25)
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  • Senior Manager , MarketPoint Sales

    Humana (Frankfort, KY)
    …licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of Medicare Sales Field ... and train a team of sales individuals. The Senior Manager , Medicare Sales, must have a solid understanding of...and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability… more
    Humana (09/16/25)
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  • BioPharmaceutical Account Manager

    Lundbeck (Lexington, KY)
    BioPharmaceutical Account Manager - Lexington North, KY Requisition ID: 6852 Location: Lexington, KY, KY, US **Territory: Lexington North, KY - Neurology** Target ... the way in creating positive customer experiences! As a BioPharmaceuticals Account Manager , you lead the promotion of our infusion product, driving demand creation… more
    Lundbeck (09/13/25)
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  • Healthcare Analytics Business Consultant (SQL…

    CVS Health (KY)
    …into actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor ... in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid regulatory & compliance reports in accordance with prescribed guidelines and… more
    CVS Health (10/07/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (Covington, KY)
    …of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/ state Medicaid payment rules. + Skilled in Excel and SQL, with ... + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits,… more
    Molina Healthcare (09/28/25)
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  • Senior Market Development Professional

    Humana (Frankfort, KY)
    …well as, partnering effectively with stakeholders across Humana. + Acts as project manager for Midwest Region's annual bid cycle + Analyzes the competitive landscape ... processes **Preferred Qualifications** + Master's Degree + Knowledge of Medicare/ Medicaid benefits + Project management experience + Cross functional leadership… more
    Humana (10/04/25)
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  • Specialist, Member & Community Interventions…

    Molina Healthcare (Owensboro, KY)
    …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ) Executes health plan's member and community quality focused interventions ... (eg, removing barriers to care) and other federal and state -required quality activities + Monitors and ensures that key...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
    Molina Healthcare (09/07/25)
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