• Manager , Special Investigation

    CVS Health (Richmond, VA)
    …years of leadership experience + A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / ... lost funds, and to comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the planning and execution of… more
    CVS Health (08/01/25)
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  • Assistant Program Manager

    Service Source (Lorton, VA)
    …location. Assists in purchasing commodity products, equipment, and supplies. The Assistant Program Manager is responsible for supporting all aspects of daily ... with 5 years' experience may be substituted for bachelor's degree. + Two ( 2 ) years of related experience working with disabilities required. + Inventory Management… more
    Service Source (08/01/25)
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  • Case Manager

    Childrens Hospital of The King's Daughters (Norfolk, VA)
    …must live in the Virginia area and able to be in Norfolk, VA for a minimum of 2 weeks of training. + + GENERAL SUMMARY + The Case Manager is responsible for ... a safe discharge in a timely manner. The Case Manager is responsible for the facilitation of clinically pertinent...standards are in compliance with Centers for Medicare and Medicaid Services (CMS) standards. + Facilitates options and services… more
    Childrens Hospital of The King's Daughters (06/25/25)
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  • RN, Field Care Manager (Ltss)

    Humana (Chesapeake, VA)
    …us put health first** Humana Healthy Horizons in Virginia is seeking a RN, Field Care Manager (Field Care Manager Nurse 2 ) who will perform telephonic and ... long-term services and support (LTSS) members. The RN, Field Care Manager , supports achieving and/or maintaining optimal wellness by guiding members/families toward… more
    Humana (08/08/25)
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  • Fortify Licensed Care Manager

    University of Virginia (Charlottesville, VA)
    …REQUIREMENTS Education: Bachelor's degree or graduate of an accredited Registered Nursing program Experience: 2 years of relevant care management experience, CCM ... The Fortify Cares Licensed Care Manager has the opportunity to leverage clinical expertise...assigned. The job includes the following essential functions: + Program development and refinement in support of the Fortify… more
    University of Virginia (06/12/25)
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  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Richmond, VA)
    …it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit ... reviews for medical, behavioral, transportation, and other healthcare providers. The CPC Manager will be responsible for guiding the team in determining correct… more
    CVS Health (08/08/25)
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  • Cloud FinOps Manager

    General Dynamics Information Technology (Fairfax, VA)
    …impact as a **Cloud FinOps Manager ** supporting the _Center for Medicare and Medicaid (CMS) Cloud Products Tools (CPT) Program ._ GDIT is your place to make ... GDIT, people are our differentiator. As a Cloud FinOps Manager you will assist in leading our Cloud FinOps...on optimizing cloud financial operations and engineering efficiencies supervising 2 teams of roughly 10 employees + Oversees the… more
    General Dynamics Information Technology (08/08/25)
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  • Clinical Account Manager - Georgia PDL…

    Prime Therapeutics (Richmond, VA)
    …passion and drives every decision we make. **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote in Georgia **Job Description** Innovative business ... with pharmacy department or designated customer contacts. + Directs operations account manager in resolving customer service issues and actions supportive of the… more
    Prime Therapeutics (07/24/25)
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  • Developmental Disability Specialist II- Support…

    Fairfax County Sheriff's Office (Fairfax, VA)
    …families by providing information about county programs, community resources, and Medicaid Waiver services. Ensure compliance with Medicaid timelines, ... for success in this position. Key Competencies: + Strong knowledge of Medicaid Waiver services and associated compliance requirements. + Ability to collaborate… more
    Fairfax County Sheriff's Office (07/17/25)
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  • Clinical Quality Program Administrator

    Elevance Health (Ashburn, VA)
    …Virigina **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to ... and knowledge highly preferred. + HEDIS experience preferred. + Medicaid Stars and Value Capture knowledge preferred. Please be...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (08/01/25)
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