• Medicaid and State Government

    Public Consulting Group (Madison, WI)
    …. 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 (10/22/25)
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  • North Carolina Medicaid Account Manager…

    Prime Therapeutics (Madison, WI)
    …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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  • VP Government Programs - REMOTE

    Prime Therapeutics (Madison, WI)
    …Qualifications** + Strong skills in developing comprehensive strategy to drive growth in government programs (Medicare and/or Managed Medicaid ) + Proven ... drives every decision we make. **Job Posting Title** VP Government Programs - REMOTE **Job Description** The...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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  • Director, Federal Government Affairs

    WelbeHealth (Madison, WI)
    …federal regulators and elected officials; experience at more than a single level of government (local, state , federal) preferred + Minimum of seven (7) years of ... care option to our most vulnerable senior population. The Director, Federal Government Affairs will lead a bold advocacy strategy to advance the WelbeHealth… more
    WelbeHealth (09/17/25)
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  • Sr Dir Pharmacy Trade Relations - Remote

    Prime Therapeutics (Madison, WI)
    …This position is also responsible for the management of the Trade Client Strategy government programs team, which is responsible for the communication and pull ... Trade Relations is responsible for managing Prime's Trade Relations program (s) for medical and pharmacy formulary and market access...modeling and pull through execution activities. + Lead the government programs negotiator and client team. +… more
    Prime Therapeutics (08/08/25)
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  • Program Management Lead, Offshore Coding…

    CenterWell (Madison, WI)
    …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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  • Specialist, Appeals & Grievances

    Molina Healthcare (Madison, WI)
    …a managed care organization ( Medicaid , Medicare, Marketplace and/or other government -sponsored program ), or medical office/hospital setting. * Completion of ... the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and… more
    Molina Healthcare (10/16/25)
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  • OCM Consultant

    Public Consulting Group (Madison, WI)
    …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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  • Financial Consultant

    Public Consulting Group (Madison, WI)
    …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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  • Remote Medical Director - Missouri - Ohio - Kansas

    Centene Corporation (Madison, WI)
    …preferred)** as a MD or DO without restrictions, limitations, or sanctions from government programs . Pay Range: $221,300.00 - $420,500.00 per year Centene offers ... expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state , corporate, and accreditation… more
    Centene Corporation (08/16/25)
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  • Telephonic Nurse Case Manager

    Humana (Madison, WI)
    …and behavioral health spectrum. They will also coordinate with other Medical Management programs (DM/PN) as needed, in addition to MTF UM / CM staff, physicians ... the Case Manager will collaborate with other care management programs until the beneficiary's needs are met, and case...and unrestricted Registered Nurse (RN) license in the (appropriate state ) with no disciplinary action. + An active designation… more
    Humana (10/23/25)
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  • Manager, FP&A

    CVS Health (Madison, WI)
    …**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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  • Appeals Nurse

    Humana (Madison, WI)
    …requires US Citizenship + Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing) ... authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates...care delivery system + Knowledge of TRICARE policies and programs + Bachelor's degree **Additional Information** **Work Style** :… more
    Humana (10/23/25)
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  • Software Engineer 2

    Humana (Madison, WI)
    …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 (10/22/25)
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  • Field Medical Director, Cardiology

    Evolent (Madison, WI)
    …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... medical necessity guidelines, as well as other requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
    Evolent (10/01/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Madison, WI)
    …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... + **This position is 100% Remote and can be completed from any state . Multiple opportunities for a flexible schedule and both part-time and full-time options… more
    Evolent (07/30/25)
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  • Field Medical Director- (MD/DO)

    Evolent (Madison, WI)
    …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
    Evolent (09/26/25)
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  • Field Medical Director, Oncology

    Evolent (Madison, WI)
    …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
    Evolent (08/19/25)
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  • Care Manager, Telephonic Compact Registered Nurse

    Humana (Madison, WI)
    …**Required Qualifications** + Unrestricted Registered Nurse (RN) license in state of residency, with active multistate (compact) status, without disciplinary ... With the ability to quickly learn and navigate software programs and applications. + Demonstrated ability to provide autonomous...Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will… more
    Humana (09/26/25)
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  • Senior Medical Director (Medicare)

    Molina Healthcare (Madison, WI)
    …of medical staff services. Maintains a working knowledge of applicable national, state and local laws and regulatory requirements affecting the medical and allied ... of assigned team and responds to inquiries, issues and complaints from government and accreditation regulators. + Directs the team in providing physician leadership… more
    Molina Healthcare (09/12/25)
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