Remote Policy Governance Specialist - Medicaid UM
Humana
Humana Inc. is seeking a Policy Governance Professional to manage end‑to‑end Medicaid UM Rates and Timeliness reporting across applicable markets, including coordination with clinical, operational, and governance teams.
The role emphasizes documentation, compliance, and continuous improvement within a remote US nationwide setting. You will collaborate with multiple stakeholders, schedule reporting, validate data, and support committee oversight while ensuring audit‑ready records and alignment
#J-18808-Ljbffr- ...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. 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. 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 manage the end-to-end Medicaid UM Rates and Timeliness evaluation and reporting across Medicaid markets,... ...evaluations, and supporting governance bodies. Remote US nationwide with periodic travel. #J-18808-LjbffrRemote workPolicy
- ...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 jobPolicy
- ...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 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
$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 workPolicyFull timeTemporary workLocal area$20 - $36 per hour
...Medicaid SpecialistOptum is a global organization that delivers care... ....Optum is seeking Medicaid Specialist to join our growing team. At... ...have the flexibility to work remotely* as you take on some tough challenges... ...Group's Telecommuter Policy.Pay is based on several factors...Remote workPolicyHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to Friday- ...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 jobPolicy
$23 - $25 per hour
...Position: Medicaid Enrollment & Intake Specialist (Onsite) St. Francis Location: Tulsa, OK Remote Status: On‑Site Job Id: 368 # of... ...act as liaisons between government entities and patients to... ...organizational standards, policies, and procedures. Perform...Remote workPolicyHourly payWork at officeMonday to Friday- ...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 workPolicyFull timeContract workWork at officeLocal areaWork from homeFlexible hoursShift workAfternoon shift
- ...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 workPolicy
- ...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 workPolicyContract workTemporary workFlexible hoursNight shift
- ...Accounting Governance Controls Specialist Hybrid – Downtown Chicago, IL (2 days onsite, 3 days remote) Start Date: ASAP (2 weeks from point of offer) Contract: 6-Month... ...agreements and in accordance with established policies, processes and procedures. Provides...Remote workPolicyContract workLocal areaImmediate startVisa sponsorshipWork visa
$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 workPolicyFull timeWork at officeWork from home$92.96k - $123.94k
...position allows for up to four days of remote work per week. About the Office:... ...Act, collections, contracts, copyright, governance, labor and employment, legislation, regulations... ..., and application of State Bar policies, rules, regulations, and procedures....Remote workPolicyContract workWork at office$75k - $82k
...Title: HSE Specialist Location: Remote, USA Hours: 8:30 am - 5:00 pm EST Salary: $75,000 – $82,000 /... ...ownership, meaning client relationships, governance, and program growth, and operational... ...on active files (broker and carrier policy-level contact sits with Risk), and support...Remote workPolicyPermanent employmentFull timeFor contractors$28.28 - $48.08 per hour
...31, US (On-site) Job Schedule Full time Remote Work Schedule Availability? None Export-... ...lift/move 30 lbs. (may not exceed per EHS policies) Must be able to stand for long periods... ..., and usage are discretionary and governed by applicable policies) Paid parental leave...Remote workPolicyFull timeTraineeshipFlexible hoursAfternoon shift$110k - $135k
...Senior Corporate Governance Specialist - Medina, MN ATTENTION MILITARY AFFILIATED JOB SEEKERS... ...with Committee charters and governance policies, collection and coordination of Board... ...environment with flexibility to work remote, limited travel for quarterly board meetings...Remote workPolicyWork at officeWork from home$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 workPolicyFull timeTraineeshipWork experience placementWork at officeFlexible hours$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 workPolicyFull timeContract workWork experience placementLocal area$66.5k - $122.23k
...Board Governance ParalegalJoin our Legal Governance team as a Board... ...documents.Create checklists, policies and procedures to ensure... ...software.Location:This is a remote role.Role Classification:This... ...actuaries to clinicians, technology specialists to plan administrators, we...Remote workPolicyHourly payFull timeTemporary workWork experience placementLocal areaWorldwideFlexible hours- ...Job OverviewThis REMOTE Lead CMDB Specialist plays a critical role in designing, implementing, and maintaining... ...(CMDB) to ensure data accuracy, governance, and alignment with business and IT... ....Strategy & Governance: Establish policies and standards for CI data management...Remote workPolicyTemporary workRelocation package
$53.3k - $82k
...enterprises. The OSP Controls & Governance team is seeking a detail-... ...Project Management Launch Specialist to oversee the accurate and... ...environment. Location : Remote within the United States.... ...Plan Generous paid time off policy including paid parental leave...Remote workPolicyFull timeWork experience placementH1bWork at officeLocal area- ...Guidelines, ASAM, Medicare Guidelines, Federal Employee Program and Policy Guidelines, Medical Policy, and other accepted medical/... ...Licensure And/or Compact State Licensure Upon Hire.LPN - Licensed Practical Nurse - State Licensure.CNS-Clinical Nurse Specialist Preferred....Remote workPolicyWork experience placementWork at office
- ...communications, leveraging insights from Governance program metrics, Global Cybersecurity... ...stakeholders to adopt and adhere to cybersecurity policies, standards, and governance processes... ...at our Miami campus #Corp #LI-Hybrid Remote #LI-SH1 #J-18808-Ljbffr CARNIVAL...Remote workPolicyFull timePart timeWork at officeLocal areaWork from homeRelocationMonday to Thursday
- ...Hospital Utilization Management (UM) Nurse, you are the primary... ...administrative compliance. Unlike remote roles, this position relies... ...for compliance of Medicare/Medicaid regulations* Meet in person with... ...with all Wellstar Health System policies, standards of work, and code...Remote workPolicyFull timeImmediate startShift work
$85k
...practices that align with the customer's mission. Location Remote Clearance/Certifications Ability to obtain Public Trust... ...and techniques. Ensure compliance with federal regulations, policies, and data governance standards throughout process redesigning efforts. Required...Remote workPolicyTemporary workFlexible hours$56.2k - $101k
...role is looking for RN's with UM experience; Prior Authorization... ...Reviews program descriptions, policies and procedures, step actions,... ...Familiarity with Medicare and Medicaid programs preferred. Licenses... ...approach to work with remote, hybrid, field or office work...Remote workPolicyFull timePart timeWork at officeFlexible hours
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