• Manager, Risk Adjustment Operations and Provider…

    Point32Health (Canton, MA)
    …vendor-driven) that optimize performance across our provider networks serving Point32Health's Medicare , Medicaid , Duals and Commercial small and individual group ... and reporting activities for risk adjustment programs and initiatives that impact Medicare , Medicaid , and Duals product members. This individual will lead… more
    Point32Health (10/24/25)
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  • Delegation Partnerships Performance Manager

    Commonwealth Care Alliance (Boston, MA)
    …field preferred. Required Experience (must have): * 5+ years * Experience with Medicaid and Medicare products and programs * Value-based program oversight and ... systems and databases that CCA implements. * Working knowledge of Medicare and Medicaid (MassHealth) * Demonstrated skills in Excel and PowerPoint * Polished,… more
    Commonwealth Care Alliance (10/18/25)
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  • Medical Director

    Molina Healthcare (Tampa, FL)
    …the medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid , NCQA and other regulatory requirements. + Reviews quality ... Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare . **PREFERRED EDUCATION:** Master's in Business Administration,… more
    Molina Healthcare (10/17/25)
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  • Compliance Analyst Principal - Remote

    Prime Therapeutics (Jefferson City, MO)
    …+ Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned **Education & ... organization, or within a highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be eligible… more
    Prime Therapeutics (10/06/25)
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  • Senior Investigator

    Public Citizen (Washington, DC)
    …(FDA), the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), and other HHS agencies and government ... (b) corporate influence at HHS and subagencies; (c) the undermining of Medicare and Medicaid , including through the expansion of Medicare Advantage; (c)… more
    Public Citizen (10/02/25)
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  • Billing Specialist

    Presbyterian Villages of Michigan (Chesterfield, MI)
    …resident's accounts. 7. Collects, organizes and maintains appropriate documentation for Medicare , Medicaid orprivate insurance companies. 8. Contact customers to ... information. 9. Answer resident or resident family inquiries regarding private, Medicare , Medicaid orprivate insurance billings. 10. Admits, discharges or… more
    Presbyterian Villages of Michigan (09/02/25)
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  • Medical Specialist 2 (Geneticist) - IBR EOA

    New York State Civil Service (Staten Island, NY)
    …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... to the degree necessary to allow for your services to be billed through Medicare and Medicaid . If you are appointed and you lose the ability to bill through … more
    New York State Civil Service (11/15/25)
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  • Medical Specialist 2

    New York State Civil Service (Schenectady, NY)
    …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... to the degree necessary to allow for your services to be billed through Medicare and Medicaid . If you are appointed and you lose the ability to bill through … more
    New York State Civil Service (10/29/25)
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  • Medical Specialist 2

    New York State Civil Service (Thiells, NY)
    …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... to the degree necessary to allow for your services to be billed through Medicare and Medicaid . If you are appointed and you lose the ability to bill through … more
    New York State Civil Service (09/23/25)
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  • Medical Specialist 1

    New York State Civil Service (Rochester, NY)
    …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... to the degree necessary to allow for your services to be billed through Medicare and Medicaid . If you are appointed and you lose the ability to bill through … more
    New York State Civil Service (09/23/25)
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