24 contracts manager jobs found

Utilization Management Medical Director - Indiana Medicaid Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered. The Medical Director is responsible for reviewing cases for IN Medicaid members. Responsible for the administration of physical health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide...

Utilization Management Medical Director - Indiana Medicaid Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered. The Medical Director is responsible for reviewing cases for IN Medicaid members. Responsible for the administration of physical health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide...

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered. The Medical Director is responsible for reviewing cases for IN Medicaid members. Responsible for the administration of physical health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to...

Job Description Are you looking to work at the next best company and organization? Are you craving the opportunity to make change and build new processes to improve a business and provide the best customer experience? Are you easygoing with a positive attitude even when under an extreme amount of pressure? If you answered yes to these questions, then we want you! Be a part of the Oracle Cloud Infrastructure, Data Center Supplier Management Business Services, and Sourcing team. We are combining the elasticity and utility of cloud services with the granular control, security, and predictability of on-premises infrastructure to deliver high-performance, high availability, and cost-effective infrastructure services. As we build and grow, we seek a high-energy individual to step into the Data Center Supplier Services & Business Operations team. This role requires a thinker with a strategic vision and tactical prowess. We need you to identify gaps and communicate ideas,...

Company : Highmark Health Job Description : GENERAL OVERVIEW Flexible Work Arrangements: At Highmark, we value both collaboration and flexibility. For this role, if you are located within 50 miles of Pittsburgh or any Highmark office, you'll enjoy a hybrid schedule, working from the office three days a week (Tuesday, Wednesday, and Thursday). If you live beyond this 50-mile radius, you'll primarily work remotely, with an expectation of traveling to an office location for team-focused building meetings a maximum of 1-2 times annually. This job is responsible for the successful definition, implementation and delivery of complex programs that requires cross-functional collaboration and interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. Manages a matrix group of employees and contractors who...

Company : Highmark Health Job Description : JOB SUMMARY The Director of Data Product Management is a leadership role responsible for developing, implementing, and continually refining our customer data product strategy from its foundational stages. This individual will define, develop, and execute the strategy for our core customer data products, ensuring they meet the evolving needs of Highmark and our customers. This individual will lead a team of product managers and analysts focused on specific areas of customer data, driving the realization of our Customer Data Product Strategy vision to empower downstream teams with personalized, high-quality, and timely interactions. This role requires a strong leader who can translate strategic opportunities into actionable product roadmaps, champion data quality and governance, and foster a data-driven culture. A robust technical background and the ability to effectively collaborate with engineering teams are paramount to...

Company : Highmark Health Job Description : JOB SUMMARY This is a hybrid role if you live within a 50 mile radius of one of our office locations in PA, NY or DE This role is responsible for contributing to the product strategy and roadmap for a defined product area, by managing a team while working under the direction of leadership. This role focuses on deeply understanding customer needs, market trends, and competitive landscape to inform product development decisions. The incumbent works cross-functionally to manage a team that is executing a portfolio roadmap or portfolio of product roadmaps and delivering high-quality products that meet business objectives. They will manage the product backlog for a specific product or feature set. ESSENTIAL RESPONSIBILITIES Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance...

Become a part of our caring community and help us put health first The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment. The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives. This role requires an in-depth understanding of Home Health...

Job Description Oracle's Global Physical Security (GPS) Systems Team is responsible for securing the corporation's global datacenter and facility footprint through advanced Physical Access and Identity Management (PIAM) technologies. We are seeking a seasoned Technical Program Manager - Video Management Systems. The Global Physical Security (GPS) Systems Team is responsible for deploying, maintaining, and continuously enhancing Oracle's physical security technology landscape. Oracle seeks a highly skilled Technical Program Manager (TPM) for Video Management Systems (VMS) who will own the end-to-end lifecycle of enterprise video systems, standards, and best practices for a complex and global security environment. Reporting to the Director, Physical Security Products & Services, you will lead the technical roadmap, policies, education, and integrations necessary for VMS excellence, partnering closely with security operations, integration partners, internal maintenance...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Compliance Analyst (Regulatory Change Management) - Remote Job Description The Compliance Analyst assists in the implementation of Prime's compliance programs within their designated areas and partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Develop solutions to moderately complex compliance problems by referring to precedence, policies and standard...

Company : Highmark Health Job Description : JOB SUMMARY *This will be a hybrid role if you live within a 50 mile radius a Highmark Office This senior-level job will lead and facilitate integrated process improvement and change management initiatives across multiple functional units Responsibilities encompass designing and implementing process optimization strategies, developing and executing comprehensive change management plans across all impacted stakeholders throughout the change lifecycle, coaching leaders and teams as applicable, and ensuring seamless alignment between people, process, and technology solutions - all while directly contributing to successful business outcomes and ongoing improvements. The successful candidate will leverage expertise in Lean Six Sigma, as well as change management methodologies to drive efficiency, effectiveness, and improved business outcomes. ESSENTIAL RESPONSIBILITIES Process Improvement and Change Management...

Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and...

Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Become a part of our caring community and help us put health first The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment. The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives. This role requires an in-depth understanding of Home...

Utilization Management Representative III Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Utilization Management Representative III is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: Responsible for providing technical guidance to UM Reps who handle correspondence and assist callers with issues concerning contract and benefit eligibility for requested continuing pre-certification and prior...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Regulatory Change Management) - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Lead project management efforts for highly sensitive...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under broad supervision, responsible for underwriting risks in a renewal book of business for Private/Non-Profit Management Liability. Works within limited authority on assignments of moderate technical complexity. Utilizes underwriting policies and guidelines, rating manual rules and insurance laws and regulations. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: Reviews applications and financial requirements for risks requiring moderate technical underwriting skills. Determines acceptability of risk in accordance with company guidelines and standards. Recommends appropriate pricing and coverage...

Job Summary The Senior Manager of Global Quality Management (GQM) supports the execution of clinical quality activities to ensure compliance with Good Clinical Practice (GCP), regulatory requirements, and internal standards across global clinical trials. This role provides hands-on quality oversight, supports audit and inspection readiness, and collaborates with internal teams and external partners to maintain high-quality standards throughout the clinical development lifecycle. Key Responsibilities Clinical Study Support Serve as a GCP quality resource to clinical teams during study planning, conduct, and close-out. Support the review of study documents (e.g., protocols, monitoring plans, vendor agreements) for quality and compliance. Assist in identifying and resolving quality issues, protocol deviations, and potential noncompliance. Collaborate with Clinical Operations, Regulatory Affairs, and Medical Affairs to embed quality practices...

Come make a difference and consider this unique opportunity to step into a rewarding career. Amazing Opportunity and Great Place to Work! Our story At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight." Our Values: Champion People - be empathetic and help create a place where everyone belongs. Grow with purpose - Be inspired by our higher calling of improving lives. Be Alight - act with integrity, be real and empower others. It's why we're so driven to connect passion with purpose. Alight helps clients gain a benefits advantage while building a healthy and financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, absence management and navigation. With a comprehensive total rewards package, continuing education and training, and tremendous potential with a growing global...

The Global Quality Audit Manager is responsible for planning, executing, and reporting on global audits to ensure Good Clinical Practice (GCP) compliance across Contract Research Organizations (CROs), clinical laboratories, and clinical investigator sites. This role plays a critical part in maintaining the integrity of clinical trial data and ensuring patient safety by verifying adherence to regulatory requirements and internal standards. As a key member of the Global Quality Management team, the Audit Manager will collaborate with cross-functional stakeholders to identify risks, drive continuous improvement, and support inspection readiness across the clinical research landscape. Key Responsibilities Audit Execution : Plan, conduct, and report GCP audits of CROs, clinical laboratories, and investigator sites globally, ensuring compliance with ICH-GCP, local regulations, and company policies. Provide oversight to contract and consultant resources in audit...

About Us SolomonEdwardsGroup, LLC ("SolomonEdwards") is a full-service professional services firm offering financial, operational, and technology consulting and operations support. We work with some of the world's most prominent companies to help them envision and achieve a better future. We know that our consulting services are only as meaningful as the people and talent behind them, and we are committed to recruiting incredibly talented, committed, and collaborative individuals who can help us deliver exceptional client service. For more information, visit SolomonEdwards Position Summary: We are seeking a Revenue Cycle Management (RCM) Business Analyst to join a growing, nationwide healthcare organization with a technology-forward model and strong telehealth presence. In this high-impact role, you will partner directly with Revenue Cycle leadership to uncover and communicate key performance insights. The ideal candidate brings both executive presence and hands-on data...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Network Management Consultant - Remote Job Description The Network Management Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This includes development of network contracts, participation requirements, analysis of pharmacies, and ensuring contract and regulatory compliance. This position is accountable for creation and management of specialty fee schedules to ensure competitiveness and serves as the liaison between Prime's Network Management and Specialty teams. Responsibilities Negotiate market competitive high-profile and/or complex...

Utilization Management Representative II Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Utilization Management Representative II is responsible for managing incoming calls, including triage, opening of cases and authorizing sessions. How you will make an impact: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior...

POLITICAL SCIENCE (BL-POLS-IUBLA) Our nationally ranked Political Science department is one of the oldest in the nation, established in 1914. We provide a world-class education in all aspects of political science. We teach courses in American politics, the politics of countries around the world, the politics between nations and international actors, political philosophy, and research methodology. Our students are engaged in political life in Indiana and around the world. We offer a B.A. in Political Science, as well as two dual degrees with Economics and Philosophy and several minors. Our undergraduate students are encouraged to build specializations in areas such as international relations, world political regions, and political theory. We also coordinate internships, service learning, and ¿on the job¿ learning experiences to help you develop skills to build your career. Training the next generation of political scientists is part of our mission, too. We offer a graduate degree...