- Highmark Health (Augusta, ME)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Augusta, ME)
- …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
- CVS Health (Augusta, ME)
- …an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, ... conditions. The CMS collaborates closely with the Registered Nurse Care Manager , Care Coordinator, Social Worker, and other interdisciplinary care team participants… more
- Humana (Augusta, ME)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Augusta, ME)
- …of Case Management team on cases with support needs. Ensures regulatory compliance by aligning care management policies, procedures, and processes to maintain ... initiatives to maintain focus on performance goals and standards, quality and compliance measures with development of action plans to improve results. + Ensures… more
- Humana (Augusta, ME)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Datavant (Augusta, ME)
- …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
- Cognizant (Augusta, ME)
- **Credentialing Account Manager (remote)** **This is a remote position open to any qualified applicant in the United States.** **Summary:** The Credentialing Account ... Manager oversees the end-to-end credentialing process for healthcare providers,...coordinates with internal teams to resolve issues and maintain compliance . **Key Responsibilities:** + Act as the primary liaison… more
- Humana (Augusta, ME)
- …plans. Key Accountabilities We are seeking a highly skilled Lead Digital Program Manager to oversee the development and execution of a new eCommerce business. This ... independently, ensuring alignment with strategic objectives. The Lead Digital Program Manager will play a key role in establishing the structure, frameworks,… more