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Job Description The Pharmacist Director – Californa Medicaid develops and leads clinical pharmacy organization and selects and builds a strong team through training, diverse assignments, coaching, risk-taking, empowerment, performance management and other development techniques. The Director is responsible for achieving financial results consistent with KPM objectives and will champion strategic direction and tactical game plans for delivery of pharmaceutical care. Will improve operational efficency by directing and changing enhancements to business processes, policies, and infra-structure. The Pharmacy Director plans and executes clinical pharmacy budget, participates in and influences external and internal pharmaceutical/health development efforts, and actively supports Aetna sales and on-going customer relations efforts. Required Qualifications – A current, unrestricted clinical license to practice pharmacy in the State of California is required- Candidate must reside within California, ideally near or within the Sacramento market- Degree in Pharmacy; Business degree a plus.- 3+ years experience in managed care or completion of a managed care pharmacy residency- 5+ years administrative experience- Ability and willingness to travel up to 30% – Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel. COVID Requirements COVID-19 Vaccination Requirement CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. Preferred Qualifications – 5+ years Managed Medicaid Pharmacy Experience- Completion of Accredited Residency Program specific to Medicaid Pharmacy Education B. S. Pharmacy at minimumPharm. D. preferred Business Overview At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart. We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Location San Jose, CA, United States of America

Industry Science

Employment Agency CVS Health

Contact Click apply

Reference JS11167_2031112523

Posted Date 3/30/2022 1:11:03 PM

Permalink http://www.careerboard.com/P28qQ

 
 

Clipped from: https://www.careerboard.com/us/en/search-jobs-in-San-Jose,-California,-USA/PHARMACY-DIRECTOR-CALIFORNIA-MEDICAID-AADC4E0AD159F39A24/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description

The Market Development Advisor – Medicaid Provider Service Operations provides support to assigned health plan and/or specialty companies relative to Medicaid Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Market Development Advisor – Medicaid Provider Service Operations is responsible for driving operational excellence for end to end Provider Service and Experience in the Ohio Department of Medicaid Managed Care Contract. Ensures that assigned health plans are meeting or exceeding corporate Medicaid performance benchmarks. Maintains relationships with internal and external key stakeholder including the Ohio Department of Medicaid. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision as the provider services Medicaid subject matter expert. Uses independent judgment requiring analysis of variable factors and determining the best course of action. This position works on problems of diverse scope and complexity ranging from moderate to substantial. This is a highly collaborative role requiring critical thinking and problem solving skills, independence, tactical execution on strategy, and attention to detail. This position reports to the Director of Provider Experience and Network Transformation.

Key Responsibilities

• Contributes to the operational success of Humana Healthy Horizons Provider Service and Experience Organization in accordance with the Ohio Department of Medicaid Managed Care contract
  
• Serve as Lead/Chief of Staff to drive provider relations strategy, process improvement and project management
  
• Supports Director in the oversight of the Ohio Medicaid’s plan’s provider relations and practice transformation to ensure Perfect Provider Experiences and compliance with all provider services requirements of the ODM Managed Care contract
  
• Solve complex business challenges and seeks to alleviate provider service disruptions and provider abrasion
  
• Supports Director in the development and execution of Physician Advisory Councils
  
• Works collaboratively with key stakeholders across the enterprise and externally with community and business partners including the Ohio Department of Medicaid
  
• Analyze internal and external data in support of development of policy, process, strategy and improvement
  
• Monitors performance against key performance indicators, contract requirements and compliance.
  

Required Qualifications

• Bachelor’s Degree
  
• 5+ years experience with Medicaid managed care operations, provider relations, network operations, claims knowledge and/or operations, and knowledge of value based provider arrangement and reimbursement methodology
  
• 3 – 5 years managing mid-large scale projects and cross functional teams
  
• Proven expertise in driving operational efficiencies and management of processes and procedures. Adept at managing processes from concept to completion ensuring timely on-target, on-budget results
  
• Ability to analyze data and make informed recommendations
  
• Demonstrated skills in executing on strategic playbooks or roadmaps in alignment with organizational goals
  
• Ability to identify, structure and solve complex business problems
  
• Highly developed computer skills in Microsoft Office applications
  
• Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience developing and delivering presentations to members of the leadership team
  
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  
• WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required.
  

Preferred Qualifications

• Master’s degree
  
• Experience responding to state and/or federal government Request of Proposals, Readiness Review and other solicitations
  
• Experience developing relationships with key stakeholders to understand and improve the market
  

Additional Information

Position can be Office/Remote/WAH

Occasional travel may be required

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are ahealthcarecompany committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

• Provide proof of full vaccinationor commit to testing protocols.OR*
  
• Provide proof of applicable exemption including any required supporting documentation
  

Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

40

Clipped from: https://it.jobserve.com/job-in-Louisville-Kentucky-USA/MARKET-DEVELOPMENT-ADVISOR-MEDICAID-PROVIDER-SERVICE-OPERATIONS-2cf54d5dce312b9739/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

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ConduentLexington, KY Full-time

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• About ConduentThrough our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them.
  
• You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
  
• Executes routine inbound and outbound call center activities concerning the business products/services, using a standard script and established guidelines and under supervision, in order to meet SLAs+ Ascertains nature of the transaction/call and assesses whether it can be handled in place, needs to be transferred, or further follow-up is required, in order to provide client with appropriate resolution.
  
• + Provides customer with appropriate standard information requested.
  

+ Derives all necessary information from customer to update database.

• + Understands when to seek help and/or escalate to a more senior role.
  

QualificationsDiploma or GED+ Call Center experience+ Medicaid Eligibility or Insurance enrollment experience is a plus+ Computer Proficiency a mustJob Track Description:+ Performs business support or technical work, using data organizing and coordination skills.

• + Performs tasks based on established procedures.
  
• + In some areas, requires vocational training, certifications, licensures, or equivalent experience.
  
• General Profile+ Ability to perform in an analytical and operational process.
  
• + Entry-level position with limited requirements for licenses, training, and certifications.
  

+ Applies experience and skills to complete assigned work.

+ Works within established procedures and practices.

+ Works with a close degree of supervision.

• Functional Knowledge+ Has basic skillset in a range of processes, procedures, and systems.
  
• Business Expertise+ Supports in the achievement of company goals by understanding how teams integrate for the best outcome.
  
• + Impacts a team through quality of the services and information provided.
  
• + Follows standardized procedures and practices and receives close supervision and guidance.
  
• + For consistency, methods and tasks are described in detail.
  
• Leadership+ Has no supervisory responsibilities.
  
• Problem Solving+ Ability to problem solve, self-guided.
  
• + Evaluates issues and solutions to provide the best outcome for the client and end-users.
  
• + Has limited opportunity to exercise discretion.
  
• Interpersonal Skills+ Exchanges information and ideas effectively.
  
• Responsibility Statements+ Assesses calls to provide service immediately, be transferred, or require follow-up for client resolution.
  
• + Identifies customer needs by referring to case notes and examining each as a specific case.
  
• + Performs routine call center activities concerning business products and services.
  
• + Uses standard scripts and established guidelines and under supervision, to meet SLAs.+ Provides customers with information that is specialized.
  
• + Communicates in a warm and empathetic manner.
  
• + Gathers all necessary information to update the database.
  
• + Escalates issues to senior levels, based on complaints or concerns.
  
• + Explains company policies to customers.
  
• + Performs other duties as assigned.
  
• + Complies with all policies and standards.
  
• ClosingConduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
  
• People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the “Submit” button at the bottom of the form.
  
• For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form (.
  
• You may also click here to access Conduent’s ADAAA Accommodation Policy (.
  
• Associated topics: call center associate, call center specialist, customer care representative, customer care specialist, customer service representative, internship, platform support, service agent, service representative, technical support
  

 
 

 
 

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Found in: S US – 9 hours ago

Chicago, United States Health Care Service Corporation Full time

Job ID: FIW-1049150 Description:

**POSITION IS FOR THE CHICAGO OFFICE, WITH A HYBRID/FLEX WORK SCHEDULE**

Project Management (not IT related), Utilization Management, Care Management PREFERRED

BASIC FUNCTION:
This position is responsible for monitoring Medicaid and related regulations and policy changes impacting operations; participating in audits; supporting tracking and submission of Medicaid State Contract(s) related deliverables, including fulfillment of internal and contractual reporting requirements; working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the Medicaid program are met; and assisting MCO in coordination of the contract with the State/CMS enterprise-wide.

JOB REQUIREMENTS:
*Bachelor Degree in Business OR 2 years experience with health insurance.
*1 year of experience with health insurance benefits and/or operations.
*Knowledge of Medicaid and Medicare product(s).
*Verbal and written communication skills.
*Experience presenting trends and findings in meetings with management.
*Experience organizing multiple tasks and responsibilities.
*Experience analyzing data reports.
*Experience developing and running queries in a database.
PC proficiency to include Microsoft Word, Excel, PowerPoint, and Outlook.

#LI-Hybrid
*CB
DICE 14
*CA

Relocation assistance will not be provided for this position.
Sponsorship will not be provided for this position.

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements: Expertise

1. Government Programs, Regulatory & Compliance
   

Government Programs, Regulatory & Compliance Job Type

1. Full-Time Regular
   

Full-Time Regular Location

1. IL – Chicago
   

IL – Chicago
BCBSTX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

 
 

Clipped from: https://us.trabajo.org/job-1373-20220324-6eb7e2c35f975a85073dde70c9862d5e?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Bridgeport, WV

Abbott

Company Culture Rating

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4.1 out of 5

Abbott’s ranking compared to similar size companies: Top 25%

Top 3 Categories

Pace Of Work

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3.7

Perk And Benefits

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•  
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3.8

Compensation

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3.6

Abbott is a large company with a workforce of over 10,000 full-time employees in the United States. Based on Employee reviews, Abbott has an average rating of 72 out of 100 for overall culture score. Compared to other companies of this size the dimensions of company culture for which Abbott ranks the best are CEO Rating (top 5th percentile), Sentiment (top 15th percentile), and Team (top 20th percentile).

Rating & Reviews Provided by Comparably

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 113,000 colleagues serve people in more than 160 countries.

     
 

JOB DESCRIPTION:

At Abbott, we believe people with Diabetes should have the freedom to enjoy active lives. That’s why we’re focused on helping people with diabetes manage their health more effectively and comfortably, with life-changing products that provide accurate data to drive better-informed decisions. We’re revolutionizing the way people monitor their glucose levels with our new sensing technology.

What You’ll Do

Regional Account Manager, Medicaid: A Unique Opportunity

As a Regional Account Manager, Medicaid, you will be responsible for selling the entire line of ADC Products to regional based and/or key accounts. The selling process includes developing and maintaining new pharmacy and medical business in defined Fee-for-Service Medicaid accounts with specific account plans and tactics for ADC. Improving access and criteria for CGM with FFS Medicaid both in medical benefit and pharmacy coverage and partnering with internal stakeholders to drive growth for ADC products (i.e Field Sales, Contracting and Pricing, Trade, Marketing etc.). This is a field based opportunity.

PRIMARY FUNCTION:

• Gaining and retaining product formulary access for ADC’s current product portfolio
  
• Increasing profitability by growing market share, new pharmacy lives and improving access (medical and pharmacy) through strategic planning, leadership, execution and collaboration/coordination with marketing and sales
  
• Selling, including collaboration with field sales, marketing, contracting, and the overall market access and trade teams
  
• Working to ensure optimal contract value and efficient implementation and pull through
  
• Account Management
  
• Leadership and self-development.
  
• This position will be responsible for developing business in accounts that are regional in scope.
  

Experience You’ll Bring

Required

• Four-year degree from an accredited university required. Master’s degree a plus.
  
• Business background will aid in determining profitability of account specific strategies and relating to customer business issues.
  
• Life sciences background will be helpful due to technical nature of products.
  
• Previous pharmaceutical or medical sales experience is required.
  
• Previous pharmaceutical or medical sales experience is required.
  
• The position will generally require a minimum 4 years of successful sales experience with 3+ years of experience in an account management role.
  
• Also critical for success are demonstrated analytical capabilities and problems solving skills, negotiation skills, and contract/legal experience, excellent oral and written communication skills (including presentation and listening skills).
  
• Incumbent will demonstrate the necessary, self-motivation, attitude, confidence and leadership to work collaboratively with other commercial channels, across functions, with other divisions, functional peers and ancillary support groups such as Marketing,
  
• Contract Marketing, Credit/Finance and Account Sales & Services to deliver business results and solutions.
  

Preferred

• Master’s degree is desired and considered a plus.
  
• Current FFS Medicaid experience with established FFS Medicaid relationship within the Region
  

This position may be hired at different levels depending on the experience of the candidate.

What We Offer

At Abbott, you can have a good job that can grow into a great career. We offer:

• Training and career development, with onboarding programs for new employees and tuition assistance
  
• Financial security through competitive compensation, incentives and retirement plans
  
• Health care and well-being programs including medical, dental, vision, wellness and occupational health programs
  
• Paid time off
  
• 401(k) retirement savings with a generous company match
  
• The stability of a company with a record of strong financial performance and history of being actively involved in local communities
  

Learn more about our benefits that add real value to your life to help you live fully: www.abbottbenefits.com

Follow your career aspirations to Abbott for diverse opportunities with a company that provides the growth and strength to build your future. Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews and @AbbottGlobal.

     
 

JOB FAMILY:Sales Force

     
 

DIVISION:ADC Diabetes Care

        
 

LOCATION:United States of America : Remote

     
 

ADDITIONAL LOCATIONS:

     
 

WORK SHIFT:Standard

     
 

TRAVEL:Yes, 50 % of the Time

     
 

MEDICAL SURVEILLANCE:No

     
 

SIGNIFICANT WORK ACTIVITIES:Driving a personal auto or company car or truck, or a powered piece of material handling equipment, Keyboard use (greater or equal to 50% of the workday)

     
 

Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.

     
 

EEO is the Law link – English: http://webstorage.abbott.com/common/External/EEO_English.pdf

     
 

EEO is the Law link – Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf

 
 

 
 

Clipped from: https://www.ziprecruiter.com/c/Abbott/Job/Regional-Account-Manager,-Medicaid-Midwest-Region/-in-Bridgeport,WV?jid=d21874611dba671b&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Clipped from: https://www.recruit.net/job/director-jobs/B6185E05E427556F?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Responsible for product strategy as it pertains to Medicaid Operations bid responses. -Collaborates and coordinates work with other departments within the business unit, and many matrix partners within the company, including but not limited to FinancDirector, Operation, Growth, Manufacturing, Healthcare, Business

 
 

Description
SHIFT: Day JobSCHEDULE: Full-timeBe part of an extraordinary team!We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change.

Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?Provider Network Manager – Medicaid/Medicare (PS70008)Location: Remote. Must reside in Louisiana. Prefer commutable distance to New Orleans or Baton Rouge.

How you will make an impact:The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is:Provider contracting and negotiating contract terms.Typically works with less-complex to complex providers.

Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required.Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Value based concepts understanding.

Fee schedules can be customized.Works with increased independence and requires increased use of judgment and discretion.May work on cross-functional projects requiring collaboration with other key areas.

Serves as a communication link between professional providers and the company.Conducts more complex negotiations and drafts documents.Assists in preparing financial projections and conducting analysis as required.

Qualifications Minimum Requirements:BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.Requires some travel within the state of Louisiana.Preferred Qualifications:Managed Care/health insurance industry experience.

Knowledge of Medicaid and Medicare provider contracting preferred.Experience negotiating provider contracts.We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate.

Anthem will also follow all relevant federal, state and local laws.Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com.

Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance..

 

Web Reference : AJF/312030716-202
Posted Date : Wed, 23 Mar 2022

 
 

Please note, to apply for this position you will complete an application form on another website provided by or on behalf of Anthem Inc.. Any external website and application process is not under the control or responsibility of IT JobServe

 
 

 
 

Clipped from: https://it.jobserve.com/job-in-Fort-Polk-Louisiana-USA/PROVIDER-NETWORK-MANAGER-MEDICAID-MEDICARE-7afca48352b24499b4/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Requisition Number: 75293 – 8


Description


The KPMG Advisory practice is currently our fastest growing practice. We are seeing tremendous client demand, and looking forward we don’t anticipate that slowing down. In this ever-changing market environment, our professionals must be adaptable and thrive in a collaborative, team-driven culture. At KPMG, our people are our number one priority. With a wealth of learning and career development opportunities, a world-class training facility and leading market tools, we make sure our people continue to grow both professionally and personally. If you’re looking for a firm with a strong team connection where you can be your whole self, have an impact, advance your skills, deepen your experiences, and have the flexibility and access to constantly find new areas of inspiration and expand your capabilities, then consider a career in Advisory.


KPMG is currently seeking a Director State and Local CA Medicaid in Customer & Operations for our Consulting practice.


Responsibilities

• Manage and deliver large, complex public services and state/local government engagements that identify, design and implement creative business and technology services for Medicaid government clients
  
• Develop and execute methodologies and solutions specific to the public sector and state/local government industry coupled with proven experience with Medicaid and MMIS modernization, with preference for prior work with large Medicaid programs in the western United States
  
• Handle engagement risk, project economics, planning and budgeting, account receivables and definition of deliverable content to help to ensure buy-in of proposed solutions from top management levels
  
• Develop and maintain relationships with many senior managements at state/local government agencies, positioning self and the firm for opportunities to generate new business
  
• Evaluate projects from a technical stance, helping to ensure that the development methods used are correct and practical; evaluate risks related to requirements management, business process definition, testing processes, internal controls, project communications, training and organizational change management
  
• Manage the day-to-day interactions with client managers
  
  
  

Qualifications

• Minimum ten years of recent experience in the Health and Human Services Medicaid solution delivery market, working for a commercial off-the-shelf (COTS) solution provider or consulting organization with a minimum of eight years of experience managing large, complex technology projects on the scale of a State Medicaid Maintenance Management Information System (MMIS) solution along with proven experience with Medicaid and MMIS modernization
  
• Bachelor’s degree of technical sciences or information systems from an accredited university or college
  
• Prior experience and has served in a team supervisory role on at least one MMIS implementation and one MMIS M&O engagement such as Program Manager, Module Project Manager, Solution Architect, Technical Solution Lead, or Quality/Testing Manager
  
• Demonstrated experience leading teams of more than twenty staff, including staff from diverse organizations to successfully implement and operate technology-based solutions; experience and relationships with states in the western United States preferred
  
• Hands-on experience with the Center for Medicare and Medicaid Services (CMS) Medicaid Information Technology Architecture (MITA), Medicaid Certification Lifecycle, associated toolkit and CMS checklists
  
• Capable of presenting Medicaid topics to large, varied audiences in either written or verbal presentation format and experience in working on customer proposals or deal capture teams in the State Medicaid market
  
• Travel may be up to 80-100%
  
• Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future
  
  
  

KPMG LLP (the U.S. member firm of KPMG International) offers a comprehensive compensation and benefits package. KPMG is an affirmative action-equal opportunity employer. KPMG complies with all applicable federal, state and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other category protected by applicable federal, state or local laws. The attached link contains further information regarding the firm’s compliance with federal, state and local recruitment and hiring laws. No phone calls or agencies please.


At KPMG, any partner or employee must be fully vaccinated or test negative for COVID-19 in order to go to any KPMG office, client site or KPMG event. In some circumstances, individuals who are not fully vaccinated may also be required to have a reasonable accommodation to not be fully vaccinated for COVID-19.

 
 

 
 

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Change HealthcareCraley, PA

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• Senior Sales Executive Payment Integrity – Payment Accuracy – State Medicaid The Solution Sales Executive (State Medicaid focus) is responsible for acting as the sales lead in closing new opportunities in the State Medicaid Agency by demonstrating the unique value proposition of CHC Payment Accuracy Solutions.
  
• What will be my duties and responsibilities in this job?
  
• Identifying opportunities to sell CHC’s Payment Accuracy solutions into net new and existing customers Directing and conducting sales presentations with Solution Consultant’s and/or Client Executives Collaborating with Account Managers and SSE’s to coordinate efforts in identifying leads Maintaining thorough understanding of the State Medicaid Agency market nationally with emphasis on delivery of CHC Payment Accuracy solutions.
  
• Orchestrate and lead detailed pre-sales planning and strategy, post sales handoff to implementation and ongoing knowledge transfer to Client Executives Negotiate and close contracts and coordinate with CHC legal and product as needed.
  
• Professional and effective communication skills required including comfort with conversations that create clarity and improve collaboration at all levels within complex and diverse organizations Effective analytical, problem-solving, and decision-making skills What are the requirements needed for this position?
  
• Education/Training – BA/BS, MBA preferred.
  
• Minimum of 5 -10 years Sales experience selling Payment software/Payment services directly to State Medicaid Agencies and/or through Fiscal Intermediaries Experience upselling, nurturing business relationships, retaining and expanding our client’s footprint.
  
• Demonstrated track record & proven quota performance selling to the State Medicaid market Keeping all opportunities current within Salesforce and providing updates to CHC Management Experience with Excel, CRM tools, and Net Promoter Score preferred What other skills/experience would be helpful to have?
  
• Effective analytical, problem-solving and decision-making skills.
  
• What are the working conditions and physical requirements of this job?
  
• General office demands How much should I expect to travel?
  
• Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
  
• Willingness and ability to travel 70% of the time depending on COVID travel restrictions / Current State: We are visiting some clients and not travel 70%.
  
• National You can be based out of within 1 hour of major airport li-remote Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system COVID Vaccination
  
• We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities.
  
• As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles.
  
• In addition, some roles require full COVID-19 vaccination as an essential job function.
  
• Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.
  
• Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer.
  
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At CMS, we believe that at the core of our organization are the employees that carry out the Agency’s vision of advancing health equity, expanding coverage, and improving health outcomes.

 
 

About the role:

 
 

As a Nurse, you will be focusing on the areas of clinical quality improvement programs; utilization management and clinical standards impacting health service delivery.

 
 

What you’ll do:

 
 

-Provide recommendations about clinical aspects of nursing practice and programs that pertain to national-level programs affecting a variety of health care settings and clinicians.

-Provide clinical nursing perspective in the assessment of policies, projects, and data related to the measurement of quality, legislative and administrative proposals, and make recommendations to agency managers.

-Prepare issue papers, briefing materials, manuals, presentations, reports and correspondence for an assigned health policy area.

 
 

Where we’re hiring:

 
 

-Atlanta, GA

-Dallas, TX

-Denver, CO

 
 

Experience we’re looking for:

 
 

(1) researching policies regarding clinical aspects of program operations;

(2) interacting with internal and external stakeholders to provide clinical nursing advice or guidance.

 
 

AND

 
 

A graduate or higher level degree, bachelor’s degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained.

 
 

Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools.

 
 

AND

 
 

License/Registration Requirement:

 
 

Applicants must have active, current license/registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

 
 

Proof of Licensure/Registration is required at the time of application to verify possession of the license/registration listed above.

 
 

 
 

Expanded/Maximum Telework Posture:

 
 

Due to COVID-19, the agency is currently in a maximum telework posture. If selected, you may be expected to telework upon your appointment. As employees are permitted to return to the office, you may be required to report to the duty station listed on this announcement within 30 calendar days of receiving notice to do so, even if your home/temporary telework site is located outside the local commuting area. Your position may be eligible for workplace flexibilities which may include remote work or telework options, and/or flexible work scheduling. These flexibilities may be requested in accordance with the HHS Workplace Flexibilities policy.

 
 

Come see why over 6,000 employees say CMS is their employer of choice! In addition to dynamic and exciting opportunities, CMS offers generous compensation and benefits programs, an outstanding work-life balance, and most important, the opportunity to give back to your community, state and country by making a difference in the lives of Americans everywhere.

 
 

You MUST apply through USAJOBS to be considered.

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