• Medicaid and State Government

    Public Consulting Group (Frankfort, KY)
    …. Employee will be responsible for Medicaid , SNAP, WIC and other state government programs . They will be analyzing business requests, making ... + Experience with CMS, Medicaid , SNAP, WICK, and other state government programs **Supervisory Responsibility** + None **Working Conditions** + Remote… more
    Public Consulting Group (11/04/25)
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  • VP Government Programs - Medicare…

    Prime Therapeutics (Frankfort, KY)
    …and drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is...to execute the strategy + Establish key relationships with Government Program owners at the plans, and… more
    Prime Therapeutics (10/08/25)
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  • North Carolina Medicaid Account Manager…

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

    Intermountain Health (Frankfort, KY)
    …Specialist is responsible for supporting and improving the quality performance of Government programs , particularly Medicare, with a strong focus on clinical ... is also tasked with identifying and engaging members in programs that enhance adherence and overall health outcomes, building...constructive and actionable feedback. + Represents the team in government meetings or special projects as assigned by a… more
    Intermountain Health (11/04/25)
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  • Regional Manager, Value-Based Programs

    Molina Healthcare (Louisville, KY)
    …sufficient to meet requirements. + Responsible for reviewing internal dashboard of Value Based Programs & Contracts by state by LOB for assigned markets each ... value-based program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment,… more
    Molina Healthcare (10/29/25)
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  • Audit & Reimbursement Senior - Appeals

    Elevance Health (Louisville, KY)
    … contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs ._ The **Audit and Reimbursement ... Senior** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of… more
    Elevance Health (10/31/25)
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  • Program Management Lead, Offshore Coding…

    CenterWell (Frankfort, KY)
    …to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore Coding Operations works on ... caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance...inquiries and issues. + May participate in coder education programs on coding compliance. + Follows state more
    CenterWell (10/23/25)
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  • Senior Program Delivery Professional HOS…

    Humana (Frankfort, KY)
    …the HOS program in all aspects of Humana's Medicare Advantage government business segment. + Lead and manage strategic initiatives, including the development of ... caring community and help us put health first** The Senior Program Delivery Professional HOS Strategic Initiatives strategically identifies enterprise partners to… more
    Humana (11/01/25)
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  • Medicare Appeals & Grievances Specialist (PST…

    Molina Healthcare (Louisville, KY)
    …a managed care organization ( Medicaid , Medicare, Marketplace and/or other government -sponsored program ), or medical office/hospital setting. + Completion of ... + Strong understanding of CMS regulations, Medicare MMP regulations and state specific requirements + Impeccable attention to detail + AOR/IRE understanding… more
    Molina Healthcare (11/01/25)
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  • Business Analyst II - Payment Integrity

    Elevance Health (Louisville, KY)
    …. + **Leverage external and internal resources** such as the **CMS website** , ** State Medicaid websites** , and the **Knowledge Library** to validate recovery ... facilitation skills, and analytical skills. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive… more
    Elevance Health (10/30/25)
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  • OCM Consultant

    Public Consulting Group (Frankfort, KY)
    …public better. We provide the full spectrum of technology consulting services to help state and local agencies meet operational and program needs that enhance ... * Responsible for organizational migration, gap analysis, and coordination of program improvement, communications, and training activities related to MEMS Modules,… more
    Public Consulting Group (10/04/25)
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  • Child Welfare Financial Consultant

    Public Consulting Group (Frankfort, KY)
    …better serve populations in need by making meaningful and lasting changes in government organizations. Services: + Program Consulting + Finance Consulting and ... and other tools. + Develop expertise in federal and state funding requirements, including Title IV-E, Medicaid ,...strategies. + Ability to interpret and apply federal and state policy to financial planning and program more
    Public Consulting Group (09/13/25)
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  • Associate Director, Market Access Engagement…

    Sumitomo Pharma (Frankfort, KY)
    …Disease products to ensure access for patients through various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove ... escalations as needed to ensure timely access for patients + Engage with government stakeholders, including state and federal health agencies, to ensure… more
    Sumitomo Pharma (10/31/25)
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  • Vendor Manager, Business Consultant (Aetna Dental)

    CVS Health (Frankfort, KY)
    …vendor management experience (preferably benefit administrators)** **5+ years of experience in government programs ( Medicaid , Medicare)** **Adept at problem ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation… more
    CVS Health (11/03/25)
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  • Manager, FP&A

    CVS Health (Frankfort, KY)
    …**Preferred Qualifications** + Experience working with healthcare payors and/or government programs such as Medicare and Medicaid + CPA License + SQL ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation… more
    CVS Health (10/23/25)
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  • Supervisory Orthotist-Prosthetist

    Veterans Affairs, Veterans Health Administration (Louisville, KY)
    …orthotics and prosthetics from a Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited program . -OR- A bachelor's degree or higher ... requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state -issued dentification cards that are not REAL ID compliant… more
    Veterans Affairs, Veterans Health Administration (10/30/25)
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  • Medication Therapy Management Specialist

    Prime Therapeutics (Frankfort, KY)
    …Word, and system operations (eg workflow processes and case management) + Government programs (Medicare) knowledge **Preferred Qualifications** + Contact Center ... of business to review the benefits of the MTM program . This position speaks with members to gather and...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
    Prime Therapeutics (10/31/25)
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  • Carelon Sales Executive

    Elevance Health (Louisville, KY)
    …services related to mental health is preferred. + Extensive knowledge of government payers/processes such as Medicaid /Medicare is preferred. + Experience selling ... and impactful industry developments. + Translates strategy into defined tactics, programs /projects priorities, and timelines and ensures alignment and attainment of… more
    Elevance Health (10/29/25)
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  • Payer Relations Specialist

    Waystar (Louisville, KY)
    …with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, mutually beneficial data exchanges that drive ... and understanding of the driving forces in the local, state , and national healthcare markets and the ability to...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
    Waystar (09/29/25)
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  • Software Engineer 2

    Humana (Frankfort, KY)
    …help us put health first** The Software Engineer 2 within Humana Government Business codes software applications based on business requirements. The Software ... skills and teamwork abilities. + Successfully receive interim approval for government security clearance (NBIS- National Background Investigation Service) + Our… more
    Humana (11/04/25)
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