- Kaiser Permanente (Arlington, VA)
- …inappropriate utilization of medical services. In close collaboration with the nurse case manager and other members of the health care team, develops and monitors a ... Ensures consistent and reliable documentation of case management activities in compliance with all organization and department standards. Analyzes patient and… more
- ARTHRITIS & RHEUMATISM ASSOCIATES P (Chevy Chase, MD)
- …care and patient care management. SUPERVISION RECEIVED: Reports directly to the MA Manager /Clinical Quality Assurance Manager , Office Manager , and Director ... current with the policies mandated by Federal and local governments, Medicare/ Medicaid programs and other private healthcare programs regarding handling of… more
- Sumitomo Pharma (Washington, DC)
- …dynamic, highly motivated, and experienced individual for the position of Sr. Manager , Medicaid Contract Administration. This position is responsible for ... managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting ...with internal departments (Internal Audit, Commercial Insights, Contracting, SOX Compliance , and Legal) to clarify policy compliance … more
- Humana (Washington, DC)
- …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 (Washington, DC)
- … 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
- Humana (Fairfax, VA)
- …our caring community and help us put health first** The Field Care Manager , Behavioral Health performs primarily face to face and telephonic assessments with ... members. The Field Care Manager serves as the primary point of contact. providing...behavioral health outcomes, reducing care gaps, and supporting Virginia's Medicaid population with comprehensive, integrated behavioral health care management..… more
- Service Source (Lorton, VA)
- …services being provided by assigned personnel. + Maintain participant files in compliance with Medicaid , Licensing, and CARF standards, etc. Coordinate with ... and serve humanity. Join Our Team! ServiceSource is proudly hiring a Program Manager to oversee the daily services of one department within the Lorton Community… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- **Next Generation Desktop Program Manager ** **Category:** Project Management **Main location:** United States, Virginia, Fairfax **Position ID:** J0425-0109 ... . **Position Description:** CGI Federal is seeking an experienced Program Manager to lead the Department of Health and Human Services (HHS),… more
- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Sr. Manager , Quality, reporting to the AVP, Quality, is responsible for supporting the ... and oversight to all lines of business including Commercial, Medicaid , Medicare, and Special Need Plans (SNPs). The Sr...., Medicare, and Special Need Plans (SNPs). The Sr. Manager , Quality will work closely with Sr. Manager… more
- Humana (Fairfax, VA)
- …of our caring community and help us put health first** The Field Care Manager , ARTS assesses and evaluates member's needs and requirements to achieve and/or maintain ... the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are varied and...needs. + Will follow processes, and procedures to ensure compliance with regulatory requirements by the Virginia Department of… more
- Gentiva (Woodbridge, VA)
- **Overview** We're looking for a **Patient Care Manager / Clinical Manager ** **RN** to join our team. This is a primarily office-based position providing ... report directly to the Executive Director, Administrator, or Senior Patient Care Manager . You will be responsible for maintaining a high performing hospice program… more
- Genesis Healthcare (Silver Spring, MD)
- …this sound like you? If so, apply to join our team as a **Business Office Manager ** and take the lead in driving financial excellence at the center level! This is ... mission of delivering exceptional care. **What You'll Do:** As a Business Office Manager , you'll oversee the full spectrum of revenue cycle management functions -… more
- Datavant (Washington, DC)
- …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
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Manager , Technology Solutions devises an effective strategy for executing and delivering on IT ... business initiatives. The Manager , We are seeking a highly skilled and motivated...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Washington, DC)
- …help us put health first** Humana's Marketing organization is seeking a Senior Product Manager who specializes in Next Best Action (NBA) execution to join the team ... 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 (Washington, DC)
- …us put health first** We're seeking a strategic, results-driven Lead Product Manager to design and deliver innovative clinical solutions that improve health outcomes ... 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
- Cardinal Health (Washington, DC)
- …* Process all patient applications in accordance to set policy, procedures and PHI compliance * Speak with manufacturer field team members on case updates via phone ... benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …their families by providing information about county programs, community resources, and Medicaid Waiver services. Ensure compliance with Medicaid timelines, ... vital for success in this position. Key Competencies: + Strong knowledge of Medicaid Waiver services and associated compliance requirements. + Ability to… more
- Service Source (Oakton, VA)
- …to social, community inclusion, communication, behavior, and skill development. Ensure compliance with all State and Federal regulatory guidelines, including ... Medicaid , Licensure, and Commission on Accreditation of Rehabilitation Facilities...report any unsafe conditions, medical concerns to the Program Manager or designee. Follow established written protocols and plans.… more
- Compass Maryland (Beltsville, MD)
- …Engagement programs. This cross-functional role ensures program integrity, documentation compliance , data system accuracy, and team collaboration, while assisting ... new systems and procedures as needed to ensure improved efficiency and compliance with overall program operations including data collection, attendance recording and… more
