- Humana (Richmond, VA)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- CenterWell (Richmond, VA)
- …for multiple Medicaid markets. This role is responsible to ensure compliance with client contracts, as well as to identify opportunities and implement program ... us put health first** The Lead - Medicaid Customer Success oversees strategy and operations...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Humana (Richmond, VA)
- …a Care Manager /Care Coach/Care Coordinator/Service Coordinator in a Medicare or Medicaid market **OR** two (2) or more years of professional training experience ... have met all company training requirements for company, quality, and regulatory compliance . + Analyzes course evaluations to judge the effectiveness of training… more
- CVS Health (Richmond, VA)
- …accreditation from the National Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance , Medicaid Investigations, MCO Medicaid FWA ... Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role...Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and written communication skills.… more
- Prime Therapeutics (Richmond, VA)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Humana (Virginia Beach, VA)
- …our caring community and help us put health first** The Field Care Manager , Behavioral Health performs primarily face to face and telephonic assessments with ... members. The Field Care Manager serves as the primary point of contact. providing...behavioral health outcomes, reducing care gaps, and supporting Virginia's Medicaid population with comprehensive, integrated behavioral health care management..… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- **Next Generation Desktop Program Manager ** **Category:** Project Management **Main location:** United States, Virginia, Fairfax **Position ID:** J0425-0109 ... . **Position Description:** CGI Federal is seeking an experienced Program Manager to lead the Department of Health and Human Services (HHS),… more
- Childrens Hospital of The King's Daughters (Norfolk, VA)
- …other payers to ensure that the admission and continued stay standards are in compliance with Centers for Medicare and Medicaid Services (CMS) standards. + ... of training. + + GENERAL SUMMARY + The Case Manager is responsible for coordinating the case management care...+ Demonstrates an understanding of the authorization process with Medicaid and other insurances as well as knowledge of… more
- Humana (Falls Church, VA)
- …of our caring community and help us put health first** The Field Care Manager , ARTS assesses and evaluates member's needs and requirements to achieve and/or maintain ... the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are varied and...needs. + Will follow processes, and procedures to ensure compliance with regulatory requirements by the Virginia Department of… more
- WelbeHealth (Richmond, VA)
- …core values and our participant-focus lead the way no matter what. The Accounting Manager , Revenue and Reporting will have a unique opportunity to bridge the gap of ... Fulfillment of the role will also include driving efficiency in compliance reporting/revenue rate filings and leveraging insights to improve financial performance… more