- NTT DATA North America (Albany, NY)
- …The Senior Quality Assurance (QA) Analyst will work with the Continuing Medicaid Eligibility Modernization initiative team to establish and execute QA tasks for ... management, coordinate hardware/software sourcing and ensure compliance with federal and state standards. This person will be responsible for reviewing budget burn… more
- Public Consulting Group (Trenton, NJ)
- …strategic goals to serve the public better. We provide the full spectrum of technology consulting services to help state and local agencies meet operational and ... sector. To learn more, visit www.publicconsultinggroup.com . Collaborating with our Technology Consulting team, you will help organizations streamline operations and… more
- Humana (San Juan, PR)
- …additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent ... of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/… more
- Humana (Carson City, NV)
- …us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead ) is responsible for overseeing the monitoring and enforcement of the Fraud, ... prevent and detect potential FWA activities in accordance with state and federal regulations. The individual in this position...position acts as the primary liaison for the Virgina Medicaid . They coordinate all Medicaid FWA activities… more
- Humana (Indianapolis, IN)
- …payment programs. The Chief Psychiatrist will be based in Illinois and will also lead the development of new products and services in Humana's Medicaid BH ... of Public Health (IDPH) + Adheres to and complies with federal and state laws and programmatic requirements + Collaborates with Provider relations personnel to… more
- Humana (Madison, WI)
- …consortiums, in compliance with contract requirements for long term care Medicaid waiver programs. The Billing & Enrollment Representative 3 applies member ... follow up, including collection activities for past due balances, that will lead to their resolution. Provides exceptional customer service, ensuring that all… more
- Humana (Madison, WI)
- …for members enrolled in iCare and Inclusa long term care Medicaid programs. The Billing & Reconciliation Representative 3 performs advanced ... during reconciliation, provides appropriate plans and conducts follow up that will lead to their resolution. Provides exceptional customer service, ensuring that all… more
- Humana (Richmond, VA)
- …in Virginia is seeking a Manager, Care Management (Maternal-Child Health) who will lead teams of nurses and health professionals responsible for maternal and child ... two (2) years of management/supervisory experience. + Experience serving Medicaid , Medicaid /Medicare, TANF, and/or CHIP populations. +...Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will… more
- J&J Family of Companies (Titusville, NJ)
- …the Supplier Management & Operations Excellence (SMOx) team within PECS and lead the strategy and end-to-end implementation, adherence, and adoption of compliant J&J ... Area (TA) patient support programs (PSP). The Director will lead a team of 2 direct reports that collectively...stakeholders to drive adoption of CET process improvements and technology . + **Launch Excellence:** Manage the end-to-end CAC review… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Plan, lead and manage the day-to-day operation of the Compliance Program with respect to Government programs compliance requirements. Responsible, ... Government programs compliance oversight and regulations may be specific to Medicare, Medicaid , Office of Personnel Management (OPM) the Affordable Care Act (ACA) or… more