• Medical Director - Medicaid (IL)

    CVS Health (Springfield, IL)
    …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California, Florida, Illinois, ... "Work from Home" position primarily supporting the Aetna Illinois Medicaid plan and the UM team; but part of...Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a… more
    CVS Health (11/09/25)
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  • Medical Director - Kentucky Medicaid

    CVS Health (Frankfort, KY)
    …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, California, Florida, Illinois, ... working at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a Plus **Preferred Qualifications:**… more
    CVS Health (11/19/25)
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  • Revenue Cycle Management Billing Configuration…

    Genesis Healthcare (PA)
    …and payer-specific trends; develop and execute corrective action plans. + Supervise Market Medicaid Advisor , Market Eligibility Advisor , Market Business ... Responsibilities Genesis HealthCare is seeking a **Market Revenue Cycle Advisor ** to lead and improve revenue cycle operations across...center teams on all payer types, with priority on Medicaid Pending and Private accounts. + Oversee and train… more
    Genesis Healthcare (11/05/25)
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  • Vice President, Population Health & Clinical…

    Centene Corporation (Columbus, OH)
    …may also include additional forms of incentives. Benefits may be subject to program eligibility . Centene is an equal opportunity employer that is committed ... clear metrics and accountability. + Serve as a trusted advisor on population health strategy as part of the...+ Build and maintain strong partnerships with the state Medicaid regulator to ensure compliance and program more
    Centene Corporation (09/18/25)
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  • Bilingual Growth & Community Engagement Specialist…

    Molina Healthcare (Los Angeles, CA)
    …Employer (EOE) M/F/D/V. Key Words: health care, insurance, health insurance, Medicaid , Medicare, health coach, community health advisor , family advocate, ... Health Worker, Equity, DPBH, HMO, SDOH, ICF/DD, Cal Fresh, DHCS, Access Program , MCAP, eligibility , benefits, providers Same Posting Description for Internal… more
    Molina Healthcare (11/12/25)
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  • Director, Market Access Contract Operations - Job…

    Ascendis Pharma (Princeton, NJ)
    …Oversee the administration of rebate programs, including government rebates (eg, Medicaid , Medicare), managed care rebates, and commercial rebates. Ensure accurate ... access, finance, procurement, legal, and contracting partners. Serve as a trusted advisor on contracting and pricing matters, providing guidance and support as… more
    Ascendis Pharma (09/09/25)
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  • Senior Director, Financial Clearance-Patient…

    Mount Sinai Health System (New York, NY)
    …Surgery) + Registration (Clinic - New Registrations) + Insurance Verification and Eligibility Determination + Medicaid Eligibility and Enrollment + ... serves on the High-Risk Evaluation Committee and acts as a trusted advisor to: + Transfer Services Department + International Services Department + Rehabilitation… more
    Mount Sinai Health System (11/14/25)
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  • Pediatrician Faculty Physician

    Dignity Health (Phoenix, AZ)
    …and possibly family medicine). + May have roles as Core Faculty and Advisor , support and maintain residency program curricula. + Oversees, prepares and ... and needs of the comumnity. + Single practice. 60% Medicaid . Approximately 40% Private. + General pediatrics age 0-18...**Job Requirements** + MD or DO Degree + Board Certification/ Eligibility + Must have or be eligible for medical… more
    Dignity Health (09/27/25)
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  • Utilization Review Specialist Nurse (RN) | Case…

    Houston Methodist (Houston, TX)
    …continued stay, and resource use, appropriate level of care and program compliance. Identifies when services no longer meet evidence-based criteria, initiates ... to facilitate efficient use of resources and seeks assistance from the Physician Advisor when necessary. Informs management of the possible need for issuing Medical… more
    Houston Methodist (11/02/25)
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  • Case Manager - PRN

    Houston Methodist (The Woodlands, TX)
    …admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Millman l criteria, ... case manager to facilitate discharge planning, seeks assistance from the physician advisor , if needed, and informs management of the possible need for issuing… more
    Houston Methodist (11/07/25)
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