- Highmark Health (Carson City, NV)
- …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 (Carson City, NV)
- …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 (Carson City, NV)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Carson City, NV)
- … 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
- Prime Therapeutics (Carson City, NV)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- Pearson (Carson City, NV)
- …path through this shifting environment to achieve continued success.** _Purpose Summary_ _The Medicaid and Vendor Implementation Manager will act as the main ... Pearson Virtual Schools' Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing… more
- Prime Therapeutics (Carson City, NV)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Walgreens (Las Vegas, NV)
- …growing the business at the site. Performs all duties of the Pharmacy Manager in their absence **.** **Customer Experience** + Ensures that store personnel provide ... eligibility and all required reporting and documentation. + Responsible for ensuring compliance of team members with regard to the documentation of patient… more
- CenterWell (Las Vegas, NV)
- …food insecurity, navigation of and application for benefits including, Medicaid , HCBS, working to reduce costs associated with prescription medications, ... Las Vegas Metro area_** **Preferred Qualifications** . Familiarity with state Medicaid guidelines and application processes . Experience working with patients with… more
- Humana (Carson City, NV)
- …our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. ... The Senior Data Manager work assignments involve moderately complex to complex issues...Migration -- Planning and executing data migration projects. + Compliance -- Ensuring compliance with data protection… more
- Humana (Carson City, NV)
- …organization and will be critical in our growth plans. The Principal Product Manager Leads all phases of the product life cycle, from inception to introduction ... Curiosity and a human-centered approach will drive the Product Manager to find relevant data and turn it into...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Molina Healthcare (Las Vegas, NV)
- **Job Description** **Job Summary** The Manager , Quality Program Management and Performance oversees and leads activities to maintain compliance with state ... with quality leadership. Manages quality program management activities to ensure compliance with regulatory requirements, including managing staff. **Job Duties** +… more
- Humana (Carson City, NV)
- …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
- Prime Therapeutics (Carson City, NV)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- Healthfirst (NV)
- …case philosophies and reporting requirements to NY state and federal agencies. ** Compliance & Regulatory Responsibilities:** The Manager is responsible for ... settings for high risk, complex populations + Certified Case Manager + Interqual, Milliman, and/or TruCare knowledge + Knowledge...TruCare knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS), New York State Department of Health… more
- Datavant (Carson City, NV)
- …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
- Elevance Health (Las Vegas, NV)
- …for the development and ongoing management of Justice Support Transitions for Nevada Medicaid members in the Urban Washoe and Urban Clark regions. Program managers ... portfolio of external clients facing projects or initiatives. A program manager may have responsibility for a larger enterprise/regional external client facing… more
- Humana (Carson City, NV)
- …organization, and will be critical in our growth plans. The Lead Product Manager - Growth & Operations will champion the customer lifecycle, drive growth ... 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
- Humana (Carson City, NV)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- HCA Healthcare (Las Vegas, NV)
- …rosters, and notifications + Work with payors and providers to ensure compliance with enrollment process + Initiate contact with payors and practices via ... files prior to committee presentation + Work closely with Provider Enrollment Manager to resolve credentialing file issues + Ensure payor requirements for submission… more