Remote Provider Contracting Director (Medicare & Medicaid)
Humana
- Remote job
Humana is seeking a Director of Provider Contracting to initiate, negotiate, and execute provider contracts across the state, including Medicare Advantage and Medicaid products. You will analyze financial impact, lead a contracting team, and drive strategic programs with travel within the region as needed. The role requires extensive provider contracting experience, strong leadership, and deep knowledge of reimbursement methodologies. #J-18808-Ljbffr Humana
- ***Remote and must live in or be willing to travel to Washington***JOB DESCRIPTIONJob... ...and leadership for health plan provider network complex contracting activities. Supports network... ...methodologies, primarily across Medicaid and Medicare lines of business, including but not...Remote workContract workLive inWork at office
- ...Gainwell Technologies is seeking a Provider Enrollment Specialist to support Nevada Medicaid enrollment remotely. The role involves reviewing enrollment, revalidation, and documentation, with outreach to providers to ensure complete submissions and timely approvals....Remote work
$48.3k - $69k
Gainwell Technologies is hiring a Provider Publications / Communications Lead to manage provider-facing communications supporting Medicaid operations. This remote role involves coordinating with teams to ensure accuracy in publications and educating providers about regulatory...Remote job- ...care plans, coordinate services, and support members with Medicare/Medicaid in a remote, home-based role with 25-50% travel within Monmouth/Ocean... ...position emphasizes holistic care, collaboration with providers, and adherence to regulatory standards. The role requires...Remote jobWork from home
- Texas Health and Human Services Commission (HHSC) Medicaid & CHIP Services seeks a highly qualified candidate for the Program Specialist VI (Provider Enrollment Policy Analyst) in the Provider Enrollment unit. The PE analyst develops policy, interprets regulations, and...Remote job
$100.3k - $172k
...care experiences and partner closely with providers to ensure members are genuinely cared... ...business partners. Evaluates and negotiates contracts in compliance with company contract... ...viable option This position is a Remote role. To be eligible for consideration,...Remote workContract workWork experience placement$120k - $225k
Job Details 100% REMOTE Salary: $120,000 - $225,000 per year Why Join Us Comprehensive... ...) with match Work from home equipment provided Paid paternity leave Responsibilities... ...at least two years of experience with Medicare/Medicaid fraud/FCA claims. The attorney should...Remote workWork from home- A leading legal services provider is seeking a motivated attorney to work remotely in Phoenix, Arizona. The ideal candidate will have at least two years of experience in Medicare/Medicaid fraud and FCA claims, along with strong writing, research, and analytical skills....Remote jobWork from home
$126.3k - $173.7k
...Program Delivery Associate Director, Provider Operations Become a part of our caring community... ...Additional Information This is a remote position. Work at Home... ...better quality of life for people with Medicare and Medicaid, families, individuals, military service...Remote workTemporary workApprenticeshipWork at officeWork from homeHome office$115.2k - $158.4k
...Program Delivery Lead, Provider Operations Become a part of our caring community... ...Additional Information This is a remote position. Work at Home Requirements... ...better quality of life for people with Medicare and Medicaid, families, individuals, military service...Remote workTemporary workApprenticeshipWork at officeWork from homeHome office$90k - $120k
...the first 25 applicants This range is provided by Lumenalta. Your actual pay will be... ...healthcare ecosystem, with a strong focus on Medicaid, Medicare, and payer/provider operations. You’ll... .... Location: This is a fully remote position ; however, candidates must be...Remote workFull timeMonday to FridayFlexible hours- ...to lead the development and support of provider networks and unit cost management activities... .... You will guide pricing modeling and contract negotiations, partnering with senior... ...efficient, geographically balanced networks. Remote work is available from anywhere within...Remote jobContract work
$221.85k - $258.83k
...Parsippany, New Jersey; remote candidates may be considered... ...location preferred.As Director / Senior Director of Medicaid Revenue Optimization & Automation... ...guidance, and any new contracts or amendments, promptly... ..., and results. Provide strategic direction, performance...Remote workLocal areaWorldwideFlexible hours- ...A leading health insurance provider is seeking a Licensed Medicare Insurance Agent to work remotely from home in Cincinnati, OH. In this role, you’ll educate clients, help them navigate Medicare options, and build lasting relationships. You must possess a valid health...Remote workWork from home
$86.3k - $118.7k
...team as a Manager, Provider Engagement. Reporting to the Director, Provider... ...Humana’s Virginia Medicaid plan - Work with... ...or more years of contract negotiation and implementation... ...is defined as remote but will use Humana... ...life for people with Medicare and Medicaid,...Remote workFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Project Manager (Medicaid / Medicare) Location: Remote Duration: 8+ Months Interview Process: 2 Video Rounds (No Technical Interview) Client Notes Recent Medicaid and Medicare experience is mandatory Government Healthcare Programs...Remote work
- ...Management (ICM) Care Manager to advocate for dually eligible Medicare/Medicaid members. This remote-friendly role requires 25-50% travel within Ocean... ...care using clinical tools, collaborating with members, providers and community organizations to improve outcomes and...Remote job
- ...CVS Health is seeking an AVP, Regional CFO to provide strategic financial leadership across Medicaid markets. You will coach Market CFOs, ensure risk mitigation, and drive sustainable margin improvement. Remote work from home is open, with leadership responsibilities...Remote jobWork from home
$48.9k - $66.2k
...Provider Engagement Professional - Network Development and Relations... ...performance within the contracted working relationship with... ...Travel: While this is a remote position, occasional travel... ...quality of life for people with Medicare and Medicaid, families, individuals,...Remote workContract workTemporary workApprenticeshipWork at officeWork from homeHome office- ...involves creating test cases and scenarios, executing tests, and providing UAT support. Key skills include a strong knowledge of Medicaid, CHIP, SNAP, and TANF programs. The position is contract-based and remote, geared towards candidates with mid-senior level expertise in...Remote jobContract work
- Gainwell Technologies is seeking a remote customer service specialist to assist Medicaid providers and members with coverage, claims, and benefit inquiries. The ideal candidate has at least one year of call center experience, with strong communication and problem-solving...Remote jobWork from homeHome office
- ...members. This home-based role requires travel within Passaic/Sussex Counties to meet members face to face and coordinate care across providers and community resources. The role emphasizes proactive care planning, assessment, and collaboration with the interdisciplinary...Remote jobWork from home
- ...County, New Jersey, with standard M-F hours. The RN will assess, plan, and coordinate care for dual eligible members enrolled in Medicare and Medicaid, addressing medical and social determinants of health. The role requires 3+ years of clinical practice, NJ RN licensure, and...Remote jobWork from home
$91.7k - $163.7k
...3,700/yearJob Area: Network Contracting & PricingCompany: UnitedHealth... ...development and support of Provider Networks as well as unit... ...have the flexibility to work remotely* as you take on some tough challenges... ...-depth knowledge of Medicare Resource Based Relative Value...Remote workMinimum wageFull timeContract workWork experience placementLocal area- ...reviews, care coordination, and discharge planning for Kentucky Medicaid members. You will use clinical judgment to decide on level of care and communicate decisions with providers and members. The role is remote/work-from-home with weekend shifts and some travel to the...Remote jobWork at officeWork from homeShift work
- ...Health is seeking an experienced Integrated Care Management (ICM) Care Manager to assess and coordinate care for members with Medicare/Medicaid needs. You will develop proactive plans, collaborate with healthcare teams, and leverage data to address health and social determinants...Remote jobFull timeWork from home
- Med-Care Providers is seeking a Medical Billing / Credentialing Specialist in Las Vegas... ...in medical billing with a focus on Medicare and Medicaid claims. Responsibilities include preparing... ...certifications. Flexibility for remote or hybrid work may be available. #J-18...Remote workPart time
- ...Providing senior-level support for government contracts activities, the full-time Senior Specialist, Government Contracts will develop and administer contracts with state and federal governments for Medicaid, Medicare, and Marketplace programs while ensuring compliance...Remote workFull timeContract work
$177.48k
...REQUISITIONCapital Projects & Contracts (Construction) Associate... ...Belong Here The Protiviti Career provides opportunity to learn, inspire... ...is looking for an Associate Director to join our Capital Projects... ...person with a purpose and working remotely. This model creates...Remote workFull timeContract workTemporary workFor contractorsFor subcontractorLocal areaFlexible hours$110k - $130k
...empower specialized autism care providers to seamlessly start, run, and... ..., systems-fluent, and contract-proficient Group Contracting... ...under a permanent, full-time remote configuration open across the... ...handles complex commercial and Medicaid relationships, manages distributed...Remote workPermanent employmentFull timeContract workWork at officeLocal areaShift work
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