Remote Health Policy & Payments Lead (Medicaid/Duals)
4004 Aetna Medicaid Administrators
4004 Aetna Medicaid Administrators is seeking a Senior Manager, Health Services. This role plays a critical part in leading clinical and claims-focused initiatives that drive program effectiveness within Medicaid and Duals lines. The position is fully remote, with candidates eligible from anywhere in the contiguous United States. The ideal candidate will have over 5 years of payment policy experience, including certified coding. The responsibilities include ensuring compliance, managing a policy project team, and collaborating with health plan leaders. Comprehensive benefits are available. #J-18808-Ljbffr
$67.9k - $149.33k
...member of the Medical Policy & Program... ...Senior Manager, Health Services plays a... ...the business by leading clinical and claims... ...management across Medicaid and Duals lines of business... ...position is fully remote and eligible candidates... ...as it relates to payment policies....Remote workPolicyHourly payFull timeTemporary workWork at officeLocal area- ...is seeking a highly skilled Pre-Payment Review Nurse Consultant to conduct... ...compliance reviews. The role is 100% remote and requires a current Wisconsin... ...to combat fraud and waste in the Medicaid program while developing relevant policies and guidelines. The successful...Remote workPolicy
$83.25k - $155.51k
Job Summary Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and... ...ensure Centers for Medicare and Medicaid Services (CMS) and state... ...trends. Responsible for documenting policies and procedures related to concept...Remote jobPolicyTemporary workWork experience placementWork at office- ...Health Research, Inc is seeking an AIDS Program Manager I to oversee Medicaid programs related to the care of people living with HIV. This position involves policy formulation, program design, and overseeing the... ...arrangements combining remote and on-site work. #J-188...Remote workPolicyFlexible hours
- ...Claim Payment Policy Lead Bring your drive for excellence, teamwork, and customer commitment to... ...as we renew and reimagine the future of health care. Together we will achieve our... ...the criticality of issues. Fully Remote: This role is designated by Independence...Remote workPolicyFor contractorsWork experience placementWork at office
$155k - $170k
...Brigit Financial Health Company Hi, we're Brigit! A holistic financial health company... ...Brigit processes billions of dollars in payments. In this role, you'll sit at the intersection... ..., and vision insurance ~ Flexible PTO Policy ~401k plan ~ Paid Parental Leave ~...Remote workPolicyLocal areaFlexible hours$147.6k - $196.8k
...Monitoring And Compliance Lead, Healthcare... ...challenges of health care quality, costs... ...design, alternative payment models, and federal... ...for Medicare & Medicaid Services (CMS) and... ...position may work remotely within the United... ...model goals, and policy developments. Lead...Remote workPolicyFixed term contractWork experience placementWork at officeLocal area$189.26k - $270.37k
...immunology and women's health. Through our... ...Purpose & Scope The Lead, US Contract... ...Sales leadership, and Policy and Government... ...annually in rebate payments that are verified,... ...commercial, Medicare, Medicaid, other government,... ..., Illinois. Remote work from anywhere...Remote workPolicyContract workWork at officeLocal areaWork from homeWorldwideFlexible hours- 340B Health is seeking a Medical Director in Pennsylvania to lead clinical strategy for our Medicaid line of business. This role involves regulatory performance... ...management and medical policy. The position offers onsite/hybrid/remote work with travel within the state...Remote workPolicy
$154.4k - $242.55k
...Lead, Contract Management As a member... ...requirements and company policies, and in alignment... ...customers include health plans, Pharmacy... ...encompasses State Medicaid and the VA Federal... ...focus on payment accuracy, forecasting... ...Takeda's Hybrid and Remote Work policy. Takeda...Remote workPolicyMinimum wageOngoing contractFull timeContract workTemporary workLocal area- ...engaging with clients remotely (occasionally... ...you will be leading project work,... ...arrangement. Medicare/Medicaid Dual-Eligible... ...& Frontier Health • Integrated... ...model design, payment reform, workforce... .... This is a policy and program... ...suited to rural duals populations—PACE...Remote workPolicyPermanent employmentFor contractorsLong distanceFlexible hours
$147.6k - $196.8k
...intertwined challenges of health care quality,... ...and save lives by leading rigorous research... ..., alternative payment models, and federal... ...Centers for Medicare & Medicaid Services (CMS) and... ...position may work remotely within the United... ...model goals, and policy developments....Remote workPolicyFull timeFixed term contractWork experience placementH1bWork at officeLocal area$86.3k - $118.7k
...Dental Fraud and Waste Lead for the Humana... ...WORK STYLE: Remote/work at home. While... ...~ Knowledge of Medicaid regulations Additional... ...will be provided payment for their internet... ...their best health – delivering the care... ...Employer It is the policy of Humana not to...Remote workPolicyFull timeTemporary workFor contractorsWork from homeHome officeMonday to Friday$83.25k - $155.51k
Molina Healthcare is seeking a Lead Level Analyst to provide support for health plan payment integrity activities. You will partner with leaders to enhance financial... ...strong data analysis skills, and experience with Medicaid and Medicare programs. Competitive benefits and...Remote job- Molina Healthcare is seeking a Lead Business Analyst to enhance health plan financial performance. The role involves... ...operational initiatives for payment integrity and provider claims accuracy... ...understanding of Medicare and Medicaid programs. A competitive benefits package...Remote job
- ...medical coding and Medicaid program integrity.... ...and improper payments are recovered. The... ...overseeing behavioral health and recovery spending... ...manager and is a lead. The position... ...complex health data, policies, and guidelines, and... ...in classrooms, remote settings, or recorded...Remote workPolicyContract workWork at office
- ...Healthcare is seeking a skilled Business Analyst in Tampa, Florida to lead initiatives in health plan payment integrity. This role requires extensive experience in managed care, particularly with Medicaid and Medicare programs. The ideal candidate will spearhead...Remote job
$83.25k - $155.51k
Molina Healthcare is seeking a Lead Analyst for health plan payment integrity in Columbus, Ohio. The role involves managing operational initiatives and... ...4 years of business analyst experience, knowledge of Medicaid/Medicare, and strong data analysis skills. This position...Remote job- ...consultant to advise clients on reimbursement strategies in Medicaid and rural health. You will manage teams, ensure quality delivery of complex... ...stakeholders. The ideal candidate has a strong background in Medicaid payment strategies and payment reform. The position offers a...
$104k - $143k
...Value-Based Programs Lead (Medicaid Strategy) supports successful... ...with population health and quality priorities... ...Workstyle: This is a remote position. Travel: This... ...provided a bi-weekly payment for their internet expense... ...Employer It is the policy of Humana not to discriminate...Remote workPolicyBi-weekly payWeekly payFull timeTemporary workWork at officeWork from homeHome officeMonday to Friday- ...Term Care Auditor I for a fully remote position in the US. This role... ...identifying and recovering Medicaid improper payments while conducting audits and analyzing... ...skills. Benefits include health coverage from Day 1, a flexible vacation policy, and career advancement opportunities...Remote jobPolicyFlexible hours
$75.11k - $100.98k
...Time - Permanent Remote Employment:... ...9 Department: Health Care Authority... ...Description Lead Medical Coder (MPS... ...medical coding and Medicaid program integrity.... ...identified and improper payments are recovered. The... ...complex health data, policies, and guidelines, to...Remote workPolicyPermanent employmentFull timeContract workPart timeWork at officeImmediate startFlexible hoursShift work$100k - $115k
BerryDunn is seeking a Senior Consultant for their Medicaid Practice Group to improve Medicaid agency operations. This role requires 5... ...3 years with a State Medicaid agency. The position allows for remote work or working from one of the offices, with a travel expectation...Remote jobPolicy$100k - $115k
BerryDunn in the United States is seeking a Senior Consultant for their Medicaid Practice Group. This role focuses on improving Medicaid agency operations and requires 5 years of relevant experience, with a strong emphasis on project management and communication skills...Remote jobPolicy- ...Claims Payment Policy Lead Our direct client is looking for a Claims Payment Policy Lead for remote work. Position is remote but candidate must reside in the tri-state area.... ...Knowledge of healthcare reimbursement concepts, health insurance business, industry terminology,...Remote workPolicyFull timeTemporary workFor contractorsWork experience placement
- ...UnitedHealth Group is seeking a C&S Compliance Officer to join their team remotely from Idaho. This role involves managing compliance programs,... ...closely with regulatory affairs, and promoting compliance with Medicaid requirements. The ideal candidate has at least 3 years of...Remote work
- ...will be considered for remote employment: Alabama, Colorado... ...at this time The Lead Outpatient Coder is an... ...Hire Registered Health Information Administrator... ...and Medicare and Medicaid guidelines. Proficient... ...Knowledge of organizational policies and procedures; skill...Remote workPolicyWork experience placement
- ...Coding Supervisor (Remote) Location: Tampa, Florida... ...: Tampa Family Health Centers (TFHC) At Tampa... ...payer guidelines, and TFHC policies Qualifications... ...billing experience ~ Prior lead or supervisory... ...Experience with Medicare, Medicaid, and third-party payers...Remote workPolicyWork at office
- ...Medical Coder (Behavioral Health, E/M) Brellium's mission is to... ...experienced coder who enjoys shaping policy, improving systems, and... ...Prior experience as a Coding Lead, Coding Manager, or senior coder... ...stakeholders Familiarity with Medicaid and commercial payer...Remote workPolicy
- ...nation’s most complex health systems, O.R. TRAX supports... ..., support, payments, badges, and renewals;... ...accurately, quickly, and within policy to prevent churn or vendor... ...center operations or remote field support exposure... ...with vendor workflows. ●Leading ops inside organizations...Remote workPolicyFull time
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