• Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Fresno, CA)
    …to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future ... solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the highest ethical,… more
    J&J Family of Companies (12/18/25)
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  • Manager, VBC Analytics, Medicaid

    CVS Health (Hartford, CT)
    …handling financial data - claim, revenue, restatement, etc. + Prior experience in Medicaid managed care and/or value based care , or medical underwriting. ... Knowledge of managed care , provider contracts and provider reimbursement methodologies. + Understanding...provider contracts and provider reimbursement methodologies. + Understanding of managed care and how provider reimbursement policies… more
    CVS Health (12/17/25)
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  • Verification Specialist - PMPH

    Penn Medicine (Plainsboro, NJ)
    …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... and requirements + Ability to develop a good working relationship with managed care organizations, and provide excellent customer service + Ability to be… more
    Penn Medicine (12/03/25)
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  • Vice President Provider Network Management

    AmeriHealth Caritas (Southfield, MI)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... physician practice chief executive officers, chief financial officers, directors of managed care , other high-level executives, and AmeriHealth Caritas's… more
    AmeriHealth Caritas (11/11/25)
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  • Controller

    System One (Tulsa, OK)
    Controller - Managed Care / Health Plan Salary: $150,000 - $175,000 annually MUST HAVE Managed Care and Health Plan experience Candidates without this ... confidentiality of financial data and business plans Required Qualifications + Managed Care / Health Plan accounting experience - REQUIRED + CPA required… more
    System One (12/23/25)
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  • Senior Program Manager - DC Market Operations…

    CareFirst (Washington, DC)
    …capacity. **Preferred Qualifications:** + Master's Degree + Experience in Medicaid or Medicare managed care , managed care insurance, finance, government, ... health care setting or related field. + DC Managed Care experience. **Knowledge, Skills and Abilities (KSAs):** + Advanced analytical and financial modeling… more
    CareFirst (12/18/25)
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  • Capture Director, Medicaid Proposals

    CVS Health (Richmond, VA)
    …necessary to meet deadlines - 7+ years of experience leading and driving Medicaid managed care proposals. - Capture management experience in Medicaid managed ... Experience developing competitive analyses - Developing executive presentation decks - Managed care operations experience **Education** Bachelor's degree or… more
    CVS Health (12/16/25)
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  • Lead SIU Investigator

    Centene Corporation (Frankfort, KY)
    …investigations with audit and risk analysis. 1+ year of experience in managed care or health insurance company. **Candidate Skills:** In-depth knowledge ... of government programs, the managed care industry, Medicare, Medicate laws and requirements, federal, state, civil and criminal statutes. Reading, analyzing and… more
    Centene Corporation (12/10/25)
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  • Provider Engagement Professional

    Humana (Oklahoma City, OK)
    …interactions with Humana's Oklahoma Medicaid plan + Ensure compliance with Oklahoma's managed care contractual requirements for provider relations, such as ... frequent travel to providers and Humana locations + 2+ years of health care or managed care experience working with providers (eg, provider relations, claims… more
    Humana (12/07/25)
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  • Cluster Nurse Manager - CMC - Galveston County…

    UTMB Health (Galveston, TX)
    Care Management UTMB Health Requisition # 2505552 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... for health services in compliance with ACA standards and UTMB Correctional Managed Care systems policies and departmental procedures. **_ESSENTIAL JOB… more
    UTMB Health (11/16/25)
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