• Manager , Business Consultant…

    CVS Health (Madison, WI)
    …projects based on resource requirements. **Required Qualifications** Strong knowledge of Medicaid to include experience with the Member Call Centers Experience with ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our… more
    CVS Health (08/22/25)
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  • Payment Integrity Program Manager

    Molina Healthcare (Milwaukee, WI)
    …QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... should be knowledgeable of and have experience with South Carolina Medicaid **Job Summary** Provides subject matter expertise and responsibility for oversight,… more
    Molina Healthcare (08/14/25)
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  • Health Plan Operations, Payment Integrity…

    Molina Healthcare (Milwaukee, WI)
    **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable ... 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization...experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects… more
    Molina Healthcare (08/14/25)
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  • Clinical Program Manager - Payment…

    Molina Healthcare (Madison, WI)
    …goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits & ... Guidelines, MCG, InterQual or other medically appropriate clinical guidelines, Medicaid , Medicare, CHIP and Marketplace, applicable State regulatory requirements,… more
    Molina Healthcare (08/14/25)
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  • Assistant Operations Manager - Cattails…

    Marshfield Clinic (Marshfield, WI)
    …most exciting missions in the world!** **Job Title:** Assistant Operations Manager - Cattails Cottage/Place Program **Cost Center:** 301351548 ... States of America) **Job Description:** **JOB SUMMARY** The Assistant Manager supports leadership with the management of staff and...or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is… more
    Marshfield Clinic (08/21/25)
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  • Manager Rebate Pharmacy Operations

    Prime Therapeutics (Madison, WI)
    …compliance with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program . + Ensures compliance with each State ... and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position...and regulations as they pertain to rebate processing and Medicaid Drug Rebate Program . + Ability to… more
    Prime Therapeutics (08/08/25)
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  • RN Program Manager , Healthcare…

    Molina Healthcare (Milwaukee, WI)
    …of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Serves as ... years supervisory/management experience in a managed healthcare environment. + Medicaid /Medicare Population experience with increasing responsibility. + 3+ years of… more
    Molina Healthcare (08/21/25)
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  • Behavioral Health Community Case Manager

    Walworth County (Elkhorn, WI)
    …plan and that the documentation is complete in compliance with all Medicaid , state and program requirements. Communicate to division leadership, and ... development, marketing and outreach. Work closely with the division manager and direct supervisor on personal development, program...and ensure that standards are achieved and that all Medicaid guidelines are met. Take a leadership role in… more
    Walworth County (08/12/25)
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  • Lead Product Manager - Dual Population

    Humana (Madison, WI)
    …practices, and design clinical solutions for members who have Medicare and Medicaid . The Lead Product Manager partners across various multi-disciplinary teams ... members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in...ambiguous problem solving and strategy setting to develop clinical program + Use data and insight to identify the… more
    Humana (08/23/25)
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  • RN Care Manager - Remote, nationwide

    Humana (Madison, WI)
    …of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare, Medicaid , and/or and Group ... community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies,...This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care… more
    Humana (08/22/25)
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