Senior Network Contracting, Medicaid Job at CVS Health (Work at Home)

Payer Lead, Medicaid

The Payer Lead – Medicaid will own Babylist Health's end-to-end Medicaid contrac...

Location

United States

Salary:

104995.00 - 125952.00 USD / Year

Babylist

Expiration Date

Until further notice

Requirements

6–8+ years of experience in payer contracting, with deep Medicaid and MCO expertise
Prior experience at a DME, healthcare services company, or payer-adjacent organization
Proven track record of securing state licenses and MCO contracts
Strong existing relationships across Medicaid agencies, MCOs, and industry trade groups
Comfort operating in complex regulatory environments
Able to get hands-on and in the weeds to deliver iron clad contracts that can be turned on expeditiously
Experience at a health-tech, high growth, or similar start up environment a plus
You're comfortable and enthusiastic about working in an AI-forward environment where AI tools are part of daily operations
You embrace using technology to enhance your work while keeping people at the center

Job Responsibility

Own Babylist Health's end-to-end Medicaid contracting strategy and execution
Unlock one of the company's largest growth opportunities by securing state Medicaid licenses and Managed Care Organization (MCO) contracts
Expand Babylist Health's footprint across high-birth-volume states
Build durable payer relationships that enable long-term scale
Set the Medicaid market strategy in partnership with the GM
Prioritize state license applications
Drive direct contracting efforts
Build the external relationships (trade associations, payer stakeholders, regulators) required to win in competitive Medicaid markets
Own the Medicaid expansion roadmap, including state prioritization, sequencing of license acquisition, and MCO penetration targets
Partner with an outside consulting firm to submit Medicaid license applications in prioritized states

What we offer

Competitive salary with equity and bonus opportunities
Company-paid medical, dental, and vision insurance
Retirement savings plan with company matching and flexible spending accounts
Generous paid parental leave and PTO
Remote work stipend to set up your office
Perks for physical, mental, and emotional health, parenting, childcare, and financial planning

Fulltime

New

Senior Manager, Contract Negotiation Manager

This position supports Ancillary Provider Contracting and Relationship Managemen...

Location

United States , Work at Home

Salary:

75400.00 - 165954.00 USD / Year

CVS Health

Expiration Date

March 31, 2026

Requirements

5+ years of Provider Contract Network and Negotiation experience preferably within the ancillary space
Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
3+ years related experience Commercial HMO, PPO products knowledge
3+ years related experience Medicare and/or Medicaid products knowledge
Must reside in Ohio
Bachelor’s Degree or equivalent professional experience

Job Responsibility

Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with ancillary providers
Manages contract performance in support of network quality, availability, and financial goals and strategies
Recruit providers as needed to ensure attainment of network expansion and adequacy targets
Collaborates cross -functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities
Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities
Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities
Provides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unit
Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities
Optimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are met
Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic information

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Fulltime

Senior Community Management Professional

Become a part of our caring community and help us put health first. The Senior C...

Location

United States

Salary:

65000.00 - 88600.00 USD / Year

Humana

Expiration Date

Until further notice

Requirements

Must reside in Michigan or within 40 miles of the border in Indiana or Ohio and be able to support members in southeast Michigan
Bachelor’s degree
Two (2) or more years of previous experience in healthcare or health plan marketing, community engagement or member/patient outreach
One (1) or more years of formal leadership experience
Skilled in planning, project management, community engagement and development, and resource mobilization
Understands the fundamentals of effective community engagement specific to Medicaid members, including those with behavioral health needs and varied health literacy
Proven knowledge and understanding of how to remove barriers to care in the Medicaid population
Exercises professional judgment and demonstrates strong facilitation, conflict management and consensus building skills
Ability to prioritize, organize, and coordinate multiple projects simultaneously
This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB

Job Responsibility

Responsible for directing community engagement practices, facilitating and planning Member and Community Advisory Panels, collaborating with contracted medical and ancillary service providers, Federally Qualified Health Centers, Social Service Agencies, and care managers with the responsibility to link our membership to services and supports critical to the improvement of health outcomes
Responsible for representation of members’ interest, including input in policy development, planning and decision-making
Interviews, hires, mentors, evaluates, coaches and manage performance for team of Community Engagement Specialists
Responsible for engagement in community boards and committees such as the Community Health Worker Network
Works directly with the Equitable Population Health Leadership team to drive outcomes aligned with larger organizational goals and builds a robust member outreach program
Compare member’s demographic and social support and services data to identify opportunities to address and fill service gaps with strategic community partners and service providers
Cultivate need-based partnerships with social support and service providers, supporting evidence-based programs with positive health outcomes
Positively position Humana among local/community groups and coalitions, community health leaders, and public health service providers.

What we offer

medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance
bonus incentive plan
bi-weekly payment for internet expense for employees in California, Illinois, Montana, or South Dakota
telephone equipment provided.

Fulltime

New

Business Intelligence Associate

The next step of your career starts here, where you can bring your own unique mi...

Location

India , Bangalore

Salary:

Not provided

Metyis

Expiration Date

Until further notice

Requirements

3 – 8 years of professional work experience in Data Visualization and KPI dashboarding
Deep expertise in Power BI
Proficient in writing Complex SQL queries & Optimizing Queries
Good problem-solving skills and an analytical mindset
Ability to assess the performance of data pipelines for latency and query run times
Ability to work in the English language with strong written and oral communication skills

Job Responsibility

Take a leading role in building our center of excellence by delivering dashboarding and visualization requirements to various clients
Delivery of reports and dashboards in a timely and efficient manner
Liaise with the onsite team and client teams in scoping the requirements and convert to a suitable visualization (that is developed over multiple, agile sprints)
Be the single point of contact for all complex query resolution
Provide inputs for improving dashboard performance and suggest efficient data transformations for creating dashboards
Inculcate best practices
Oversee the maintenance of the dashboards that have already been built
Guide and mentor team members

What we offer

Interact with C-level at our clients on regular basis to drive their business towards impactful change
Lead your team in creating new business solutions
Seize opportunities at the client and at Metyis in our entrepreneurial environment
Become part of a fast growing international and diverse team

New

Pharmacy Manager

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Cumming

Salary:

65.00 - 85.00 USD / Hour

CVS Health

Expiration Date

April 13, 2026

Requirements

Active Pharmacist License in the state where the Store is located
Active National Provider Identifier (NPI)
Not on the DEA Excluded Parties list
1-2 years of experience as a Pharmacist
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus
Customer Service and Team Orientation
Communication Skills
Mathematical Reasoning

Job Responsibility

Lead and develop a pharmacy team that provides exceptional patient care
Promote best practices and lead through change
Identify and address performance opportunities
Support novel program awareness
Onboard newly hired pharmacy team members
Recognize colleagues for their success
Exhibit best practices when working the bench
Provide patients with meaningful counseling
Abide by all legal and regulatory guidelines
Direct and effective management of their pharmacy team

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Fulltime

New

Senior Technical Product Manager Marketing Technology

As Senior Technical Product Manager Marketing Technology, you will take ownershi...

Location

Portugal , Porto

Salary:

Not provided

Metyis

Expiration Date

Until further notice

Requirements

Degree in Business Informatics, IT, Applied Computer Sciences, Economics, or related fields
Proven experience (5+ years) in IT Product Management, stakeholder management, and software integration projects, ideally in a marketing, advertising, or CRM environment
Strong technical background with hands-on experience in MarTech solutions, marketing automation, and/or personalization platforms (e.g., Braze, SAP Marketing, Tealium, Dynamic Yield or relevant competitors as Adobe Experience Platform, Salesforce Marketing Cloud, Bloomreach, Oracle Marketing Cloud, etc.)
Ability to translate business requirements into technical concepts and drive implementation
Experience with integration architectures (Azure, API integration, streaming technology, ETL processes)
Analytical strength and excellent communication skills
able to act as a bridge between business and IT
Fluent in English

Job Responsibility

Act as Technical Product Manager for key tools in our MarTech Stack
Consult business owners on the effective use of our marketing solutions, identifying optimisation opportunities and new features
Translate business cases and functional requirements into technical specifications, challenging partners to find efficient solutions
Manage the technical implementation of new features, interfaces, templates, reporting suites, middleware, and automation
Serve as the interface between business users and technical stakeholders (internal/external developers, vendors)
Oversee daily operations of our solutions from a technical perspective
Set up and maintain monitoring to proactively identify and resolve issues before business impact occurs
Share responsibility with business teams for tenders and selection of new solutions

What we offer

Become part of a fast-growing international and diverse team

New

Technical Officer Health Biosciences

A leading Melbourne-based university is seeking a Technical Officer – Health Bio...

Location

Australia , Melbourne

Salary:

60.00 - 62.46 AUD / Hour

Randstad

Expiration Date

March 19, 2026

Requirements

Experience working in Medical Imaging, Nuclear Medicine, Radiation Therapy or Medical Radiation laboratories
Strong laboratory operations and equipment maintenance experience (ideally within tertiary education)
Sound knowledge of OH&S legislation and industry standards
Highly organised with strong communication and stakeholder engagement skills
Relevant degree qualification in Medical Imaging, Nuclear Medicine, Radiation Therapy or related discipline
Valid Working with Children Check

Job Responsibility

Manage daily operations of Health Biosciences laboratories
Maintain SOPs, risk assessments, chemical registers and related documentation
Provide technical advice, inductions and training to staff and students
Oversee laboratory equipment, maintenance schedules and servicing
Monitor consumables and coordinate purchasing
Ensure compliance with OH&S legislation, industry standards and university policies
Assist with installation and commissioning of specialised equipment

What we offer

Plus Super

New

Support Worker

Do you want to help young people and adults with complex needs make life happen ...

Location

United Kingdom , Guildford

Salary:

23455.00 - 25000.00 GBP / Year

Randstad

Expiration Date

March 10, 2026

Requirements

Relevant care/education or support worker experience (desirable)
SEN experience
Eligibility to work in the UK

Job Responsibility

Support young people and adults with complex needs with life skills, education, and social interaction
Work in a day education centre supporting vulnerable young people and adults from 18 years upwards

What we offer

Onsite parking
Brilliant and modern setting with outdoor spaces
Shuttle bus available from certain locations
Brilliant rates of pay
Access to Free CPD course and Safeguarding Training/courses
Supportive and available senior leadership team
Career progression opportunities
On-site training

Senior Network Contracting, Medicaid

CVS Health

Location:
United States , Work at Home

Category:
-

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
February 22, 2026

Expiration:
March 28, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

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Senior Network Contracting, Medicaid

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Location:United States , Work at Home

Category:-

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:February 22, 2026

Expiration:March 28, 2026

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Category:
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Job Posted:
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Expiration:
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