- Sumitomo Pharma (Augusta, ME)
- …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 (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
- Sanofi Group (Augusta, ME)
- **Job Title:** Field Reimbursement Manager Tzield- Northeast Region **Location:** Remote **About the Job** The individual in this role will need to demonstrate a ... requires dedicated and knowledgeable customer facing support. Field Reimbursement Manager /Director for TZIELD. This is a regionally aligned, field-based position… 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
- Humana (Augusta, ME)
- …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 (Augusta, ME)
- …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 (Augusta, ME)
- …* 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
- CenterWell (Augusta, ME)
- …CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and future models. Under general ... operations including program administration, contract oversight, process, performance improvement, compliance , governance, training, and more. Additionally, this role will… more
- CenterWell (Augusta, ME)
- …of outcome data, policy, procedure, and records issues. . Assure personal compliance with licensing, certification, and accrediting bodies. **Use your skills to make ... Medicine . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Excellent verbal and written communication skills . Superior… more
- Humana (Augusta, ME)
- …campus and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network infrastructure environment ... for future budget forecasting and planning needs. + Communicate status updates to Manager of IT and other Senior business leaders where necessary. + Research and… more
- Humana (Augusta, ME)
- …information to the application at Humana's secure website. + Position reports to Manager , Technology Solutions, IT HPE - Digital Channels & Contact Centers + ... 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
- CenterWell (Augusta, ME)
- …health and human services field + Prior experience with Medicare & Medicaid recipients + Previous experience with electronic case note documentation and experienced ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Evolent (Augusta, ME)
- …Responsible for coordinating education and findings with matrixed Physician Business Manager . + Provides medical direction to the support services review process. ... state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person"...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more