• Medicaid Quality Control Case Review…

    City of New York (New York, NY)
    …Within DSS-AO, resides an area called the Office of Quality Assurance & Fiscal Integrity , the Medicaid Quality Control Unit (MAQC). They conduct complex internal ... DSS Accountability Office (DSS-AO) is responsible for protecting the integrity of social services programs administered by the New...Reviewers in their eligibility review findings. - Assist the Medicaid Audit and Quality Control director with… more
    City of New York (10/04/25)
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  • Legal Nurse: Investigate Medicaid…

    New York State Civil Service (New York, NY)
    …ensuring the financial integrity of New York state's $96 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies, ... legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage to millions of New Yorkers,… more
    New York State Civil Service (10/15/25)
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  • Medicare/ Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a ... scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the… more
    Commonwealth Care Alliance (08/31/25)
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  • Special Consultant - Medicaid Eligibility

    Staffing Solutions Organization (Albany, NY)
    … evaluation, quality assurance, and monitoring processes and recommending additional program integrity activities for consideration + Providing guidance and ... its key responsibilities, which include: + Collaborating with other program stakeholders while representing the Director and...with other program stakeholders while representing the Director and other DEMI executive staff in meetings +… more
    Staffing Solutions Organization (10/15/25)
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  • Director , Clinical and Revenue…

    Waystar (Atlanta, GA)
    **ABOUT THIS POSITION** The Director , Clinical and Revenue Integrity Operations is responsible for the oversight and management of our team of Revenue ... Integrity and DRG Auditors. Drawing on clinical and technical...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
    Waystar (09/25/25)
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  • Program Director - Jurisdiction

    ICF (Baltimore, MD)
    …program , ICF will investigate potential fraud, waste, and abuse in Medicare and Medicaid programs. The Program Director will fulfill its contract ... and extending offers in anticipation of the award._ Jurisdiction Program Director Position (onsite, Midwestern Region) ICF...enforcement. + Customer familiarity with the CMS Center for Program Integrity (CPI) + Expertisein the Medicare… more
    ICF (10/08/25)
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  • Deputy Director of EISG: Position for Expr.…

    New York State Civil Service (Albany, NY)
    …support to the EISG team members they supervise. This position reports to the Director of EISG.The Medicaid program provides health coverage to millions ... NY Zip Code 12224 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - Albany-areaDeputy Director ,... integrity of New York state's $96 billion Medicaid program by investigating healthcare providers, such… more
    New York State Civil Service (10/10/25)
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  • Associate Director , US Policy

    Bristol Myers Squibb (Washington, DC)
    …personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Associate Director will help shape policy and payment strategies across state ... Medicaid programs and demonstration models including CMMI. This role...Wellbeing support such as the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources… more
    Bristol Myers Squibb (10/10/25)
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  • Associate Director - Immunology,…

    Bristol Myers Squibb (Princeton, NJ)
    …in their personal lives. Read more: careers.bms.com/working-with-us . **SUMMARY:** The Associate Director , PASS Program Strategy and Marketing will play a ... medications and treatment. As a key contributor, the Associate Director will lead complex and high-volume program ...and payer policies related to Medicare, Medicare Part D, Medicaid , and private insurance) to educate matrix partners, field… more
    Bristol Myers Squibb (10/12/25)
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  • Director Monitoring and Auditing

    AdventHealth (Orlando, FL)
    …applicable Federal, State, and local regulatory and/or accrediting agencies including Medicare, Medicaid , and the OIG. The Director is conversant on generally ... Drug program requirements, and HIPAA laws and regulations. The Director actively participates in outstanding customer service and accepts responsibility in… more
    AdventHealth (10/07/25)
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