Remote Policy Governance Professional Medicaid UM
Humana
Humana Inc. is seeking a Policy Governance Professional to manage the end-to-end Medicaid UM Rates and Timeliness evaluation and reporting across Medicaid markets, coordinating with diverse teams to ensure accuracy and timely delivery.
The role involves partnership with operational, analytical, clinical, quality, compliance, accreditation, and market teams, developing written evaluations, and supporting governance bodies. Remote US nationwide with periodic travel.
#J-18808-Ljbffr- ...Humana Inc. is seeking a Policy Governance Professional to manage end‑to‑end Medicaid UM Rates and Timeliness reporting across applicable markets, including coordination... ...compliance, and continuous improvement within a remote US nationwide setting. You will collaborate with...Remote workPolicy
- ...Humana Inc. is seeking a Policy Governance Professional to oversee the Medicaid UM Rates and Timeliness reporting across markets, coordinating data validation,... ...committee materials, and ensure audit-ready records. Remote US nationwide with occasional travel; 40 hours...Remote workPolicyWeekly pay
- ...Humana Inc. seeks a Policy Governance Professional to manage end-to-end Medicaid UM Rates and Timeliness evaluation across applicable markets, coordinating data validation, performance trends, and stakeholder reviews. You will work with operational, clinical, quality...Remote workPolicy
- ...Humana Inc. is seeking a Policy Governance Professional to support the Medicaid Utilization Management Policy Governance program. Reporting to the Policy Governance Lead, you will manage end-to-end NCQA UM Rates and Timeliness evaluation and reporting across Medicaid...Remote workPolicy
- ...Humana is seeking a Policy Governance Professional to support the Medicaid Utilization Management Policy Governance program. You will manage end-to-end Medicaid UM Rates and Timeliness evaluation across applicable markets, coordinating data validation, analyzing trends...Remote workPolicy
- ...Humana Inc. is seeking a Policy Governance Professional to manage end-to-end Medicaid Utilization Management (UM) Rates and Timeliness evaluation and reporting across markets. Reporting to the Policy Governance Lead, you will coordinate data validation, analyze trends,...Remote workPolicy
- ...Humana Inc. is seeking a Policy Governance Professional to manage the Medicaid UM Rates and Timeliness evaluation across Medicaid markets. Reporting to the... ...clear evaluations for governance committees. This remote US nationwide role requires collaboration with operational...Remote workPolicy
$65k - $88.6k
...part of our caring community The Policy Governance Professional supports the Medicaid Utilization Management Policy... ...to manage the end-to-end Medicaid UM Rates and Timeliness evaluation and... ...Additional Information Location: Remote US Nationwide Travel: While this...Remote workPolicyFull timeTemporary workApprenticeshipWork at officeWork from homeHome office- ...Support policy governance and compliance in Medicaid UM. Coordinate reporting, data validation, and corrective actions. Accountabilities: Own NCQA reporting... ...k). PTO, parental leave, disability, life insurance, remote work. Partner Company Healthcare operations company...Remote workPolicy
- Partner Company is seeking a dedicated professional to support Medicaid utilization management policy governance and compliance. You will own NCQA reporting and governance... ..., analytical, and coordination skills, with remote work options and a comprehensive benefits package...Remote jobPolicy
- ...Project Manager, Quality and Professional Governance based in the United States.... ..., and organizational policy development. You will also... ...JC), Centers for Medicare & Medicaid Services (CMS), National Committee... ...leaders. Remote flexibility: Remote position...Remote workPolicyFull timeWork at office
- ...PiTech Solutions, Inc. Location: Remote About PiTech Solutions PiTech Solutions delivers data governance, security excellence, and... ...federal business development professionals with established networks and... ...alignment with organizational policies Required Qualifications...Remote workPolicyContract workFor contractors
$188.9k - $359.8k
...all business units. Lead enterprise UM portfolio strategy and governance, partnering with clinical technology... ...duties as assigned. Complies with all policies and standards. Education/Experience:... ...a flexible approach to work with remote, hybrid, field or office work schedules...Remote workPolicyFull timePart timeWork at officeFlexible hours- ...possible when the brightest professionals dedicate themselves to... ...Management (UM) Nurse, you are the primary... ...compliance. Unlike remote roles, this position relies... ...of Medicare/Medicaid regulations* Meet in person... ...Wellstar Health System policies, standards of work, and...Remote workPolicyFull timeImmediate startShift work
- ...Director of Professional Services - PIAM Physical Identity and Access... ...Management (PIAM) United States Remote Full-Time 15+ Years About... ...physical identity, access governance, workforce identity, Visitor... ...management and consistent access policies across locations. Serve as a...Remote workPolicyFull timeFor contractors
$97.5k - $162.5k
...an Operations Manager to join the Professional Practice Group and lead the governance, administration, and continuous... ...develop and enforce operational policies, manage legal and licensing workflows... ...working environment including remote and hybrid options What's in...Remote workPolicyFull timeWork at officeLocal areaFlexible hours- ...when the brightest professionals dedicate... ...oversight of staff UM RNs to ensure coordination... ...processimprovements, policies and procedures.It... .... Unlike remote roles, this position... ...compliance of Medicare/Medicaid regulations (e.g.... ...participates in shared governance at all levels in...Remote workPolicyFull timeImmediate startShift work
- ...Description Job Description Job Title: Professional - Data Analyst V(Senior Data Governance Specialist) Location: Houston... ...-Thursday in person; Fridays remote Duration: 12 months,... ...lineage, DQ, access governance, policies, MDM, compliance, and change management...Remote workPolicyWork from homeFlexible hours
$72.8k - $104k
...days) to receive an alert: Senior Professional C#/.NET Developer, Medicaid Systems Date: Oct 21, 2026 Location... ...enjoying a generous, flexible vacation policy and educational assistance. We also... ...should expect in this role Fully remote opportunity with the option to work...Remote workPolicyFull timeFlexible hours$86.7k - $123.9k
...generous, flexible vacation policy and educational assistance. We... ...Pharmacy Testing Manager (PBM/Medicaid) at Gainwell, you can... ...plans, schedules, and execution governance, ensuring alignment with business... ...expect in this role Fully Remote Opportunity – Work from...Remote workPolicyFull timeFlexible hours$95.1k - $135.8k
...generous, flexible vacation policy and educational assistance. We... ...and modernization vision for a Medicaid account, ensuring alignment... ...objectives. Lead architecture governance, establish standards and best... ...in this role Fully Remote Opportunity – Work from...Remote workPolicyFull timeFlexible hours- ...when the brightest professionals dedicate... ...oversight of staff UM RNs to ensure coordination... ...process improvements, policies and procedures. It... .... Unlike remote roles, this position... ...compliance of Medicare/Medicaid regulations (e.g.... ...in shared governance at all levels in the...Remote workPolicyImmediate startShift work
- ...President, Data Strategy & Governance is a senior executive... ...governance — from policy design and sensitive data... ...valued.Relevant professional certifications (e.g.,... ...people with Medicare and Medicaid, families, individuals... ...Louisville, KY; Chicago, IL; Remote District of Columbia;...Remote workPolicyFull timeApprenticeship
$165k - $198k
...while maintaining security and governance throughout the entire... ...lifecycle with governance and policy-driven controls embedded throughout... ...Position Summary As a Professional Services Engagement Manager,... ...technologies. Work Location Remote within the U.S. Travel...Remote workPolicyFull timeLocal areaImmediate startFlexible hoursShift work$72.8k - $104k
...enjoying a generous, flexible vacation policy and educational assistance. We also... ...capabilities. Summary As a Senior Professional C#/.NET Developer, Medicaid Systems at Gainwell, you will be a... ...should expect in this role Fully remote opportunity with the option to work...Remote workPolicyFull timeFlexible hours$91.19k - $116.27k
...Auditor II (Full-time Remote, North Carolina Based)... ...of various functions, policies, and programs for soundness... ...and improving governance, risk management, and... ...guidance on planning and due professional care Maintain and... ...of state and federal Medicaid laws, administrative rules...Remote workPolicyFull timeContract workWork at officeHome officeFlexible hours$142.3k - $195.7k
...implementation, modernization, and governance of NoSQL database... ...levels, indexing policies, monitoring, and... ...compliance-driven environments.Professional certifications in... ...: While this is a remote position, occasional travel... ...with Medicare and Medicaid, families, individuals...Remote workPolicyBi-weekly payFull timeTemporary workWork at officeWork from homeHome office- ...Maine State Library seeks a knowledgeable reference and governance specialist to deliver statewide consultation to public... ...provide training, and support library management and policy initiatives. This professional role requires collaboration within the Library...Remote workPolicy
- ...engagement and institutional governance, the Director plans... ...and procurement policy and the management of... ...operational services to UM Health-Sparrow and UM... ...education, continuing professional development or accredited... ...for hybrid or mobile/remote work mode are at the discretion...Remote workPolicyWork at office
$136k - $184k
...lives better. As a member of the Government Programs team, our Strategic Account Manager-Medicaid will provide dedicated... ...productivity and decision-making in professional settings highly desiredStrong... ...information is available in our Privacy Policy.SummaryLocation: Fargo, ND;...PolicyFull timeWork at officeImmediate startWork from homeRelocationFlexible hours3 days per week
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