-
Essential Duties and Responsibilities:
- Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements.
- Issue approvals, denials or recommendations based on contract requirements.
- Identify need for additional clinical documentation or consultation.
- Complete documentation of activities within contract systems.
- Communicate with providers, individuals and their designees, or state workers as required.
- Provide training and/or consultation to assigned Clinical Reviewers.
- Performs other related duties as assigned.
Minimum Requirements
- Current Registered Nurse (RN) license valid in the state of practice is required
- High School Degree or equivalent required
- Minimum 2 years of clinical experience required
- Associate degree in Nursing
- An active RN (Registered Nurse) license in the state of Colorado or a compact license is required
- Minimum 2 years of experience working with people with complex disabilities, including pediatric and geriatric populations
- Familiarity with Home and Community Based Services waivers (HCBS)
- Proficiency in Microsoft Office applications
Preferred Requirements:
- Prior experience conducting document-based reviews
- Excellent written and communication skills
- Previous experience working remotely
- Prior experience conducting document-based reviews
Home Office Requirements:
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
- Private and secure workspace
#ClinicalServices
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Annual salary is just one component of Maximus's total compensation package.
Other rewards may include short- and long-term incentives as well as program-specific awards.
Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off.
Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience.
An applicant's salary history will not be used in determining compensation.
Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Max...
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Type: Permanent Location: Birmingham, US-AL
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:33
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Cheyenne, US-WY
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:32
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Eau Claire, US-WI
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:31
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Milwaukee, US-WI
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:30
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Rock Springs, US-WY
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:30
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:29
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Richmond, US-VA
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:29
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Spokane, US-WA
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:28
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Roanoke, US-VA
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:27
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Charleston, US-WV
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:27
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Morgantown, US-WV
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:26
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Salt Lake City, US-UT
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:25
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:25
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:24
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Bennington, US-VT
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:23
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Tysons, US-VA
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:23
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:22
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:21
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:21
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:20
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:20
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Rapid City, US-SD
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:19
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Providence, US-RI
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:18
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:18
-
Essential Duties and Responsibilities:
- Oversee daily operations including staffing, performance monitoring, quality assurance oversight, training, subcontractor management, auditing, and compliance.
- Ensure project compliance with all applicable requirements of the client's regulations as well as corporate policies.
- Manage direct reports including developing performance goals and objectives.
- Manage subcontractors that provide services to program.
- Manage audits of operations.
- Collaborate with other managers to ensure effective coordination of activities.
- Develop and implement operational policies and procedures in collaboration with other key stakeholders.
- Establish and maintain effective relationships with clients and other external entities.
- Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency.
- Manage the project's quality assurance and training programs as well as corrective actions to ensure compliance.
- Monitor performance against key indicators established internally or by the clients.
- Develop solutions to issues or complex problems.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
Minimum Requirements
- Bachelor's Degree in related field.
- 7-10 years of relevant professional experience required.
- Equivalent combination of education and experience considered in lieu of degree.
- Experience with CMS Medicaid Streamline Modular Certification (SMC) and related outcomes required.
- Experience researching state Medicaid enrollment documentation and regulations required.
- Experience defining and designing Medicaid enrollment and reconciliation solutions ...
....Read more...
Type: Permanent Location: Pittsburgh, US-PA
Salary / Rate: Not Specified
Posted: 2026-03-11 08:17:17
