- Highmark Health (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- … 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
- Hartford HealthCare (Hartford, CT)
- …across the system. *_Position Summary:_* Reporting to the System Director of Revenue Compliance , the Program Manager of Revenue Compliance contributes to ... hospitalization, home care, inpatient rehabilitation, and others. In addition, the Program Manager of Revenue Compliance will have a firm understanding of… more
- Humana (Hartford, CT)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Prime Therapeutics (Hartford, CT)
- …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
- Prime Therapeutics (Hartford, CT)
- …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
- Hartford HealthCare (Farmington, CT)
- …workpapers and filing of annual Medicare Cost Reports ensuring strict compliance with all Medicare regulations, policies, procedures and guidelines. Acts as ... analysis calculation and ensuring that reserve balances are in compliance with policies and procedures 4. Serves as a...as a resource in the areas of Medicare and Medicaid regulatory/settlement matters for the system, including Medicare DSH,… more
- Humana (Hartford, CT)
- …of Case Management team on cases with support needs. Ensures regulatory compliance by aligning care management policies, procedures, and processes to maintain ... initiatives to maintain focus on performance goals and standards, quality and compliance measures with development of action plans to improve results. + Ensures… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …relationship management, Compliance oversight, Auditing, and projects as assigned. Senior Manager - Vendor Management is a high impact role, you will lead ... all with heart, each and every day. **Position Summary** The Senior Manager Medicare Product, Vendor Management Contract Lead is responsible for contracting,… more
- Datavant (Hartford, CT)
- …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
- Cognizant (Hartford, CT)
- **Credentialing Account Manager (remote)** **This is a remote position open to any qualified applicant in the United States.** **Summary:** The Credentialing Account ... Manager oversees the end-to-end credentialing process for healthcare providers,...coordinates with internal teams to resolve issues and maintain compliance . **Key Responsibilities:** + Act as the primary liaison… more
- CVS Health (Hartford, CT)
- …into actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor ... in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid regulatory & compliance reports in accordance with prescribed guidelines and… more
- Wheeler Clinic (Hartford, CT)
- …required. The Client Care Coordinator also assists uninsured clients in applying for Medicaid and assists in the eligibility process as required by program. Hourly ... clear explanation of CSSD funds for services per contract and Medicaid application process, and provides other assistance as needed. Maintains accountability… more
- Hartford HealthCare (Farmington, CT)
- …HCPCS and ICD-10 coding conventions required. Experience with interpreting Medicare, Medicaid and third-party billing and compliance regulations necessary. ... adjustment program requirements and ICD 10 coding guidelines. Reporting to Manager of Audit and Education *_Position Responsibilities:_* *Key Areas of… more
- Hartford HealthCare (Hartford, CT)
- …Worker, Nutritionist, Pharmacy Liaison, APRNs, RNs, MA/MAAs, Case Managers and Program Manager who provide compassionate care to a diverse population of patients. ... being their primary language, and have healthcare coverage under Medicaid . Our specialists are skilled at treating many infectious...and/or vapers quit. Working under the direction of the Manager of Tobacco Cessation of the STOP Smoking &… more
- Humana (Hartford, CT)
- …plans. Key Accountabilities We are seeking a highly skilled Lead Digital Program Manager to oversee the development and execution of a new eCommerce business. This ... independently, ensuring alignment with strategic objectives. The Lead Digital Program Manager will play a key role in establishing the structure, frameworks,… more