- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of the Administrator,. As a Management ... & Program Analyst, GS-0343-12, you will apply qualitative and quantitative methods for the analysis and evaluation of both internal, organizational administrative operations and line health care program(s) to determine their efficiency and effectiveness.… more
- Highmark Health (Buffalo, NY)
- …improvement models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, ... office based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement… more
- CareFirst (Baltimore, MD)
- …applicable, corporate audit, HRD and the Corporate Compliance Office. Ensures that all Medicare and/or Medicaid requirements for training are met by internal ... experience. **Experience:** + 8 years progressively responsible corporate compliance, Medicare / Medicaid or government work experience and/or related experience,… more
- Humana (Indianapolis, IN)
- …and Dual Eligible Special Needs Plans (DSNP), which serve members who qualify for both Medicare and Medicaid . They will lead the state Medicaid executive ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- CVS Health (Downers Grove, IL)
- …analytical and communication skills to support, manage and develop and execute Medicare and Medicaid compliance programs and processes that promote compliant ... Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, applicable Medicaid rules and government… more
- Humana (Helena, MT)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an approved… more
- Humana (Indianapolis, IN)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
- CVS Health (Blue Bell, PA)
- …best practices of Aetna's SNP segment, across all Aetna geographies, Medicare Advantage market actuaries, and associated Medicaid actuaries. Establish ... Qualifications** + Previous Medicare experience + Previous work with Medicare / Medicaid regulators + FSA designation **Education** + Bachelors degree **Pay… more
- Humana (Madison, WI)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... of our caring community and help us put health first** The Wisconsin Medicaid Market CFO provides strategic financial leadership for Humana's Medicaid operations… more
- Humana (Louisville, KY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical… more