• Sr. Clinical Strategist - Aetna MPPS…

    CVS Health (Columbus, OH)
    …And we do it all with heart, each and every day. **Position Summary** The Senior Clinical Strategist is a key member of Aetna's Medical Policy and Program Solutions ... Legislative and Regulatory guidance, CMS directives, policies and processes. The Senior Clinical Strategist will partner with legal, compliance, and regulatory… more
    CVS Health (09/13/25)
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  • VP Clinical Operations Care At Home

    Tufts Medicine (Lowell, MA)
    …discovery. **Job Overview** This position serves as a key member of the senior management team to provide leadership, analysis, planning and support, and to ensure ... 1. Demonstrated understanding and experience of trends and developments with Medicare , Medicaid and federal/state programs. 2. Demonstrated success in operations… more
    Tufts Medicine (09/13/25)
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  • Compliance Chart Auditor - Integrity…

    Guthrie (Sayre, PA)
    Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and procedures and accepted guidelines for ... insurance regulations as well as The Guthrie Clinic policies, as applicable, Medicare , Medicaid, and LCD (Local Coverage Determinations), and NCD (National Coverage… more
    Guthrie (09/13/25)
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  • Manager Physician Contracts

    Dignity Health (Redding, CA)
    …Contracting. The incumbent works closely with the Chief Physician Executive, Senior Legal Counsel, Executive Leadership, Hospital Presidents, as well as other ... contract terms and financial arrangements and collaborates with and supports senior executives with negotiating and managing contracts with physicians and physician… more
    Dignity Health (09/13/25)
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  • Vice President, Compliance

    Centene Corporation (New York, NY)
    …implement corrective action plans, and report on achievement of action plans to senior management and Board of Directors + Develop strategic relationships with state ... state legislative public policy concerning state insurance, Managed Care Organization, Medicare and Medicaid regulations and initiatives + Identify, evaluate and… more
    Centene Corporation (09/13/25)
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  • Principal, Financial Planning & Analysis,…

    Humana (Boston, MA)
    …that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of home health services, and ... and professional well-being, all from day one. Our services: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness… more
    Humana (09/12/25)
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  • Care Center Billing Specialist

    Presbyterian Homes and Services (Roseville, MN)
    …Skilled Nursing billing experience highly preferred. + Detailed knowledge of Medicare , Medicaid and third party reimbursement policies required. + Proficient ... serving more than 26,000 older adults through 60+ PHS-affiliated senior living communities in Minnesota, Iowa and Wisconsin, and...well-being. PHS is now one of the largest nonprofit senior housing and services providers in the US.Our strong… more
    Presbyterian Homes and Services (09/12/25)
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  • Claims Specialist

    BrightSpring Health Services (Louisville, KY)
    …where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, ... Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid… more
    BrightSpring Health Services (09/12/25)
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  • Sr. Manager Government Rebate Operations

    J&J Family of Companies (Raritan, NJ)
    …of America **Job Description:** Johnson & Johnson is currently hiring for a ** Senior Manager Government Rebate Operations** . This position will be based in Raritan ... in base and supplemental Medicaid, Manufacturer Discount Program (MDP), Medicare Part D Coverage Gap Discount Program (CGDP), State...issues pertinent to Federal and State rebate programs. The Senior Manager, GRO is responsible for leading a team… more
    J&J Family of Companies (09/12/25)
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  • Sr. Pricing Strategy Manager

    Medtronic (Los Angeles, CA)
    …in a more connected, compassionate world. **A Day in the Life** As a Senior Manager, US Strategic Pricing, you will be responsible for developing and implementing ... Medtronic diabetes brands and customer channels, including Commercial, Medicaid, Medicare , Distribution, etc. The position supports the Pricing Committee Approval… more
    Medtronic (09/12/25)
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