Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Medicaid Policy & Governance Specialist

Humana

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, and drive improvements with clinical and operational stakeholders. The role requires a bachelor’s degree, healthcare industry experience, and proficiency with Excel, PowerPoint, Word, and SharePoint.

#J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Medicaid Policy & Governance Specialist in United States vacancy
  •  ...Humana Inc. seeks a Policy Governance Professional to manage the Medicaid Utilization Management Rates and Timeliness evaluation and reporting process across applicable markets, including both physical and behavioral health. You will coordinate schedules, validate data... 
    Remote work
    Policy

    Humana

    United States
    2 days ago
  •  ...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 work
    Policy

    Humana

    Ewing, NJ
    2 days ago
  •  ...Company is seeking a dedicated professional to support Medicaid utilization management policy governance and compliance. You will own NCQA reporting and...  ...strong Excel, analytical, and coordination skills, with remote work options and a comprehensive benefits package including... 
    Remote job
    Policy

    Partner Company

    New York, NY
    2 days ago
  •  ...seeking a Professional Field Representative to support Wisconsin Medicaid providers as a key liaison for education, issue resolution, and...  ...to research and resolve complex issues, deliver training on policies, and ensure clear, timely communication across teams in a fast-... 
    Remote work
    Policy

    Gainwell Technologies LLC

    United States
    2 days ago
  •  ...Peraton is seeking a policy analyst to support Medicaid initiatives under the SGS NE UPIC contract. You will research and articulate Federal and State regulations, serving as a subject matter expert to educate the team and respond to referrals. The role requires translating... 
    Remote work
    Policy
    Contract work

    Peraton

    New York, NY
    4 days ago
  •  ...Technologies is seeking a Provider Enrollment Specialist to support WV Medicaid enrollment, maintenance, and renewal...  .... The role emphasizes following policies, strong research abilities, and...  ...and verbal communication, with a remote work setup and occasional on-site... 
    Remote work
    Policy

    Gainwell Technologies

    United States
    5 days ago
  •  ...Improvement Professional position based in the United States. This remote role supports Medicaid implementation across new state markets and focuses on...  ...teams to develop scalable, compliant processes, policies, and training materials that support members and providers... 
    Remote work
    Policy

    Jobgether SRL

    New York, NY
    3 days ago
  •  ...Medicaid SpecialistDo you enjoy using your knowledge and skill set to help make a...  ...you to work as a full-time (40hrs/wk.) Remote Medicaid Specialist where your work directly supports positive...  ...s), and/or email. You will implement policies, procedures and instructions for... 
    Remote work
    Policy
    Full time
    Work at office
    Local area

    Integrated Services of Kalamazoo

    Kalamazoo, MI
    3 days ago
  • $95k - $105k

     ...support and analytical expertise for a Government Medicaid Disproportionate Share Hospital, or DSH...  ...consultant will assess regulatory and policy developments, evaluate program administration...  ...Ability to work independently in a remote environment and travel on-site when... 
    Remote work
    Policy
    Temporary work
    Local area

    TeleSolv Consulting

    Pierre, SD
    3 days ago
  • $21 - $22.75 per hour

     ...Position: Medicaid Enrollment & Intake Specialist (Onsite) Mosaic Location: St. Joseph, MO Remote Status: On-Site Job Id: 140 # of...  ...act as liaisons between government entities and patients to...  ...organizational standards, policies, and procedures. Perform... 
    Remote work
    Policy
    Hourly pay
    Work at office
    Monday to Friday

    RSI

    St Joseph County, IN
    3 days ago
  •  ...Field Representative to support Wisconsin Medicaid providers as a primary liaison for...  ...complex issues, and deliver training on policies and procedures. The role requires at least 2 years of Medicaid/Medicare or government healthcare program experience, strong analytical... 
    Remote job
    Policy

    Gainwell Technologies LLC

    King, WI
    4 days ago
  • $45.43k - $52k

     ...lives of others! We are looking for a Medicaid Eligibility Specialist for our Pennsylvania Team....  ...knowledge and understanding of Medicaid policies, regulations, and procedures. Every...  ...or coverage Work with government agencies and other stakeholders to address... 
    Remote work
    Policy
    Full time

    FreedomCare

    Remote
    6 days ago
  • $70.1k - $126.2k

     ...Purpose: Leads the integrity and governance of Centene's and/or its...  ...have the flexibility to work remote from home anywhere in the Continental...  ...regulatory updates impacting Medicaid and Marketplace regulatory...  ...assigned. Complies with all policies and standards. Education/... 
    Remote work
    Policy
    Full time
    Contract work
    Part time
    For subcontractor
    Work at office
    Work from home
    Flexible hours

    Centene Management Company LLC

    New York, NY
    1 day ago
  •  ...The Maine State Library seeks a knowledgeable reference and governance specialist to deliver statewide consultation to public libraries, trustees...  ..., provide training, and support library management and policy initiatives. This professional role requires collaboration... 
    Remote work
    Policy

    State of Maine

    United States
    4 days ago
  •  ...Humana Inc. is seeking a Policy Governance Professional to manage end-to-end Medicaid UM Rates and Timeliness evaluation across markets, reporting to the Policy Governance Lead. You will coordinate schedules, validate data, and collaborate with operational and clinical... 
    Remote work
    Policy

    Humana

    United States
    3 days ago
  •  ...Humana Inc. seeks a Policy Governance Professional to manage Medicaid Utilization Management reporting across markets, coordinating calendars, validation, and deliverables. You will collaborate with operational, clinical, quality, and governance teams to drive timely... 
    Remote work
    Policy

    Humana

    United States
    2 days ago
  •  ...who have experience navigating Medicaid referrals, submitting service...  ...as designated in the Policy and Procedure Manual and obtain...  ...internet connection to facilitate remote workdays; otherwise, working...  ...Training and Qualified Brain Injury Specialist training are required upon... 
    Remote work
    Policy
    Full time
    Contract work
    Work at office
    Local area
    Work from home
    Flexible hours
    Shift work
    Afternoon shift

    Brain-Injury-Services-

    Fairfax, VA
    3 days ago
  •  ...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 work
    Policy

    Humana

    United States
    2 days ago
  • $48.48k - $71.3k

     ...deficiencies. Evaluate regulations and policies, providing expert recommendations for...  ...in E-Verify and will provide the federal government with your Form I-9 information to confirm...  ...SKILLS: Four years of experience in Medicaid or Medicare program administration, health... 
    Remote work
    Policy
    Full time
    Work at office
    Work from home

    Commonwealth of Kentucky

    Frankfort, KY
    5 days ago
  •  ...audits and implement ISO 27001 end-to-end for customers. Create policies, automated checks, and training content to support customers...  ...skills, with the ability to break down complex tasks. ~100% remote work, competitive salary, and generous equity. ~ Annual development... 
    Remote work
    Policy
    Local area
    Home office

    Secfix

    United States
    4 days ago
  •  ...Family: Compliance, Counsel, Governance & Security (CCGS)Job Function...  ...Principal Program Subcontracts Specialist will be responsible for all...  ...NH; Roanoke, VA; #hybrid; or #remote. Responsibilities and Tasks:...  ...compliance with all business policy and procedure and Federal Acquisition... 
    Remote work
    Policy
    Contract work
    Temporary work
    Flexible hours
    Night shift

    Elbit Systems of America

    Merrimack, NH
    2 days ago
  • $79k - $89k

     ...leadership, shared infrastructure, and clear governance, the ODSAI will align and amplify AI...  ...and recommends program frameworks, policies, practices, and operating models that support...  ...a hybrid schedule (mix between 3 days remote and 2 days in-person work), subject to change... 
    Remote work
    Policy
    Traineeship
    Work experience placement
    Work at office
    Flexible hours

    disABLEDperson Inc

    Indianapolis, IN
    3 days ago
  • $30 - $35 per hour

     ...Sustainability Reporting Specialist - Seasonal About Measurabl Measurabl...  ...ESG (environmental, social, governance) data management solution for...  ...Paid Time Off 100% fully remote $400 office set up fund for new...  ..., state and local laws. This policy applies to all terms and conditions... 
    Remote work
    Policy
    Temporary work
    Seasonal work
    Work at office
    Local area
    Flexible hours

    Measurabl

    New York, NY
    15 hours ago
  •  ...Job Description Accounting Governance Controls Specialist \n \n Hybrid – Downtown Chicago, IL (2 days onsite, 3 days remote) \n Start Date: ASAP (2 weeks from point of...  ...agreements and in accordance with established policies, processes and procedures. \n... 
    Remote work
    Policy
    Contract work
    Local area
    Immediate start
    Visa sponsorship
    Work visa

    Calculated Hire

    Chicago, IL
    18 days ago
  •  ...connectivity, and access issues across on-site and remote employees \n Manage the MSP...  ...MFA enforcement, and conditional access policies \n Monitor M365 security and...  ...policies \n Manage security and access governance for AI/LLM tools in use across the org,... 
    Remote work
    Policy
    For contractors
    Work at office
    Immediate start

    Trailhead Biosystems

    Beachwood, OH
    19 days ago
  • $85k

     ...practices that align with the customer's mission. Location Remote Clearance/Certifications Ability to obtain Public...  .... Ensure compliance with federal regulations, policies, and data governance standards throughout process redesigning efforts. Required... 
    Remote work
    Policy
    Temporary work
    Flexible hours

    The Newberry Group Inc

    Missouri
    2 days ago
  •  ...will have deep expertise in managing and governing Microsoft 365 services, including...  ...Compliance: Implement and enforce governance policies across M365 workloads, including data loss...  ...functional collaboration in a hybrid or remote environment. Experience with AvePoint... 
    Remote work
    Policy
    Work at office

    Aone Talent

    Reston, VA
    1 day ago
  • $125k - $160k

    Title: Change Control Specialist Belong. Connect. Grow. with KBR! KBR...  ...(TRMC). Operating in a fully remote capacity, this specialist manages...  ...functions and formal change governance. The candidate must possess...  ...or levels, per internal policy or contractual designation. Additional... 
    Remote work
    Policy
    Temporary work
    Local area
    Worldwide
    Home office
    Relocation package
    Flexible hours

    KBR

    Tallahassee, FL
    2 days ago
  •  ...Title:  Revenue Cycle Management Specialist I Reports to:  Revenue...  ...Part-Time Work Setting:  Remote Position Overview:...  ...payer requirements, and internal policies Protect PHI and follow all...  ...settings Familiarity with Medicaid, Medicare, and commercial payers... 
    Remote work
    Policy
    Part time
    Monday to Friday

    Heritage Behavioral Health Center

    Decatur, IL
    3 days ago
  • $104k - $208k

     ...consent flows, access controls, privacy policies, and user-facing privacy notices Help...  ...improve review efficiency, and optimize governance operations Help establish...  ...English level Advanced Work Type: Remote Location: United States Working Hours... 
    Remote work
    Policy
    Full time
    Contract work
    Work experience placement
    Local area

    Exadel Inc (Website)

    Remote
    5 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medicaid Policy & Governance Specialist. Be the first to apply!