Manager, Payment Model Implementation (CMS/CMMI) - Remote
$112.7k - $193.2kOptum
- Remote job
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors. In the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise. Currently, OSC/Lewin has more than 300 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin's core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction. At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. The Senior Consultant will provide support on a number of payment model implementation contracts including leading operations support, analytics, and policy analysis. In collaboration with current staff across the organization, the Senior Consultant will work to provide unparalleled client service, produce the highest quality deliverables, and innovate across the market. From a relationship and business growth perspective, s/he will support the development of new client relationships, attaining new contracts, and broadening the firm's work. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Schedule Monday - Friday, daylight shift in your time zone Primary Responsibilities Lead multi-disciplinary project teams and workstreams, provide direction, prioritization and coordination across analysts, consultants, and client stakeholders to ensure successful delivery of strategic initiatives Engage, develop, and cultivate existing client relationships through policy consultation and thought leadership Lead payment model operations and technical assistance activities, including oversight of analytics to inform model operations, for value-based care initiatives Support the development of payment calculations, conduct financial and trend analysis, calculate quality metrics, and perform fast-paced ad-hoc analysis to quickly address client needs Mentor other staff to develop their technical and analytical problem-solving skills Maintain a consistently high degree of accuracy and attention to detail in all tasks Work effectively and cooperatively as a member of a project team Efficiently query large databases of healthcare claims and eligibility data Perform a broad range of quantitative analysis to inform the design, implementation, and evaluation of Medicare and Medicaid payment models You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications 6+ years of experience using SQL, R, Python, or SAS in a research, consulting, or business environment 4+ years of experience working on federal health policy issues, including Medicare and Medicaid value-based payment, working in multiple areas serving as a subject matter expert Experience translating complex findings to non-technical audiences in both written and verbal contexts Experience successfully leading cross-functional project teams Experience working on implementing or evaluating value-based payment programs Experience working in Snowflake or Databricks environments Preferred Qualifications Experience supporting multi-year payment model implementation contracts Experience with databases having complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environment All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. a comprehensive benefits package incentive and recognition programs equity stock purchase 401k contribution (all benefits are subject to eligibility requirements) The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr Optum
$134.6k - $230.8k
...informed policy choices, and implement critical initiatives. OSC/... ...'s citizens.The Director of Payment Model Technical Assistance will guide... ...the flexibility to work remotely * from anywhere within the U... ...multidisciplinary project teams Manage stakeholder relationships...Remote workImplementationMinimum wageFull timeFor contractorsWork experience placementFor subcontractorWork at officeLocal area- ...in the U.S. Location: Remote or Hybrid in New Orleans, LA... ...Summary Description: The Payment Posting Manager oversees all aspects of... ...Denials, Client Services, and Implementation teams to streamline workflows... ...HIPAA, billing compliance, CMS regulations, and fraud/...Remote workCmsImplementationWork at officeFlexible hours
$104.04k - $137.84k
...to the Director of Payment Integrity, the Manager, Payment Integrity Enablement... ...oversee the design, implementation, and continuous... .../state regulations (CMS, DHCS, and/or... ...onsite, as needed Work Model Location This position... .... (Mon & Fri - remote, Tues - Thurs onsite...Remote workCmsImplementationDaily paidTemporary workWork at officeFlexible hoursShift work- ...patients alike. About the Role The Manager is accountable for the day-to... ...Change Adoption Support implementation of new tools, processes, and... ...current on changes to CMS guidance, regulations, and operational... ...obligations US remote-based colleagues are not permitted...Remote workCmsImplementationPermanent employmentShift work
- ...Medicare SME- Payment Integrity Analyst This resource will implement a process to test end-to-end common Medicare Advantage leakage scenarios across multiple... ...claims payment (medical policy, authorization, benefits, CMS rules, reimbursement policy, provider contracts, fee...Remote workCmsImplementation
- ...(OSC/Lewin) seeks a Senior Consultant to lead multi-disciplinary teams on payment model implementation contracts, deliver analytics, and policy analysis for health programs across the U.S. Remote work is supported, with in-office requirements in Minneapolis or Washington...Remote jobImplementationWork at office
- Optum is seeking a Senior Consultant for OSC/Lewin to support payment model implementation, analytics, and policy analysis. The role involves leading... ...relationships, and delivering high-quality deliverables. Remote work across the U.S. is allowed, with in-office four days...Remote jobImplementationWork at office
$139k - $175.4k
...Technical Customer Success Manager plays a pivotal role... ...their goals during implementation. Collaborating... ...NoLocationLos Angeles, or remote with travelTravelUp... ...Savings Arrangements, and CMS ACO models including claims,... ...advanced value-based payment and improves quality...Remote workCmsImplementation- ...disciplinary project teams across federal health policy and value-based payment initiatives. You will drive analytics, policy analysis, and client engagement while supporting new contract development. Remote work is available nationwide, with in-office requirements in...Remote jobImplementationFull timeContract workWork at office
- ...and security testing, the full-time remote Testing Manager will oversee the quality assurance strategy for the CMS Drug Data Processing System and Payment Reconciliation System, ensuring... ...frameworks Perform regression and post-implementation validation testing, integrating...Remote workCmsImplementationFull time
- ...Description Hybrid Model - dependent on the... ...schedule. During implementation and training, it... ...for an IT Project Manager position # 1066.... ...in Phoenix, AZ and remote . If you are... ...customizable Adult Probation CMS. The candidate... ...and milestone payments. Prepare and...Remote workCmsImplementationHourly payContract workLocal areaImmediate startTrial period
- ...Benefits (DHB) Location Remote, with periodic on‑... ...The Change Manager (CM) ensures that... ...acceptance-linked payment milestones. Author... ...satisfy Department and CMS reviewers. Report... ...testing, implementation, and production deployment... .../SaaS release models, CI/CD pipelines,...Remote workCmsImplementationContract workFor contractorsWeekend work
- ...Seeking an experienced Delivery Manager to support the Centers for Medicare & Medicaid Services (CMS) Security Operations program.... ...from concept through implementation, establish structure where needed... ...to government organizations. A CMMI Level 3-appraised company, Precise...Remote workCmsImplementationTemporary workFlexible hours
$110k - $130k
...International SEO/AEO Manager at BetterHelp, you... ...the operational model for multilingual... ...indexation, hreflang implementation, Core Web Vitals,... .... Can I work remotely? Yes. We... ...Background in CMS internationalization... ...cards, or any form of payment during our hiring...Remote workCmsImplementationFull timeWork experience placementFreelanceWork at officeImmediate start- ...Time$110k - $125kA fast-growing payments integration start-up headquartered... ...hiring a Senior Project Manager to lead enterprise payment platform implementations for partners such as Lenovo and... ...infrastructures. This role is hybrid with remote flexibility and offers benefits...Remote workImplementationFull timeImmediate start
$180k
...subcontractor coordination, and management of all Project... ...alignment across CMS, VA, subcontractors, and... ...performance standards, and implementation needs. This role... ...in a lean, remote environment, balancing... ...involving healthcare payment, policy, operations, data...Remote workCmsImplementationFull timeContract workFor contractorsFor subcontractorWork at office- ...Augusta, ME, 04330, United States (Remote)Experience: 10-30... ...assessment and oversight of the CMS-required modifications to the... ...testing activities, and change management processes.ResponsibilitiesProvide... ...Vendor Management, and implementation vendor staff.Review change management...Remote workCmsImplementation
- ...Job Description This is a remote position. Contract Manager (Contract Monitor)... ...Deputy Account Director, Implementation Director, and Project Manager... ...lifecycle for contractual and payment purposes: Deliverable... ...and respond to Department, CMS, and State Auditor’s...Remote workCmsImplementationContract workFor contractorsFor subcontractorInterim roleWork at office
$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote) CGI is seeking a results-... ...a Senior Analyst, you will manage the full lifecycle of edit... ...Responsibilities: 1. Edit Development & Implementation Identify Opportunities: Use... ...: Convert medical policy, CMS rules, and coding guidance...Remote workCmsImplementationLocal area- ...Eleos Health is seeking a Customer Insights Manager for Home Health and Hospice, US remote. You will translate CMS COPs and regulatory frameworks into actionable... ...driven compliance prompts, and support end-to-end implementations while staying current with CMS changes and...Remote workCmsImplementation
$82k - $111k
Overview The Client Services Manager (CSM) is responsible... ...for the Prospective Payment PPM and CV products.... ...the operational implementation and execution of client... ...required. Knowledge of CMS guidelines and other regulatory... ...work with on‑site and remote cross‑functional...Remote workCmsImplementation$101.4k - $211.25k
...seeking a MMIS Project Manager to join our team in... ...Alabama. This can be a remote position with limited... ...methodology, process and implementation guidance Assist... ...with Certification and CMS procurement requirements... ...recruiters will never ask for payment or banking information...Remote workCmsImplementationContract workTemporary workFor contractorsWork experience placementWork at officeFlexible hours- ...with respect to care management activities. The... ...product teams, and implementation stakeholders to design... ...requirements (e.g., HEDIS, CMS, value‑based care models). Collaborate with... ...with online & remote schedules. Preferred... ...charge fees or require payment from individuals or...Remote workCmsImplementationTemporary workLocal areaImmediate start
$65 - $70 per hour
...consulting firm is seeking a Senior Project Manager with extensive experience in digital payments within the banking sector. This remote contract position requires strong... ...with various teams to ensure successful implementation. Competitive compensation of $65-70/hr is...Remote jobImplementationContract work- Senior Growth Marketing Manager, LPO & Conversion Optimization Location: Remote (Bay Area Preferred)... ...hypothesis creation through implementation, analysis, and... ...digital experiences within a CMS environment. Experience... ...We will never ask for payment of any kind during the...Remote workCmsImplementationImmediate start
- ...as a Operations Planner & Configuration Manager supporting our USAF Base Infrastructure... ...The operations and configuration manager implements and maintains the configuration management... ..., briefing leadership and working with remote team members globally. ITIL foundation,...Remote workCmsImplementationContract work
- ...Kentucky’s Rural Health Transformation Program. The Director will coordinate a complex portfolio, serving as PI for CMS-funded grants and overseeing implementation, reporting, and stakeholder engagement with UK HealthCare and external partners. #J-18808-Ljbffr University of...Remote jobCmsImplementation
- ...Project Manager/Release Manager The Project Manager/Release Manager must have experience managing a diverse portfolio of projects... ...Five or more years of managing multiple IT systems implementation projects, particularly projects in infrastructure and operations...Remote workCmsImplementation
- ...Quality Manager Our leaders shape strategic initiatives, develop... ...Manages the development and implementation of quality initiatives. Owns... ...Medicare/Medicaid Services (CMS), Anthem, ISDH and other 3rd... ...This is a hybrid role with one remote day per week Monday-Friday day...Remote workCmsImplementationMonday to FridayDay shift1 day per week
$103.8k - $218.1k
Job Title: Senior Systems Manager - E-DiscoveryJob Category: Information... ...Case Management Specialists (CMS) to define system... ...development, testing, validation, and implementation.Manage technical risks and... ...logs.Troubleshoot end-user and remote-access issues and provide...Remote workCmsImplementationContract workWork experience placementFlexible hours
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