- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health . As a Manager for Medicare Advantage Utilization Management , you'll provide direct management to a team of UM ... coordinators and nurses. You'll work closely with Medicare Advantage leadership to plan , execute, and manage..., and concurrent review ACM/CCM preferred + Knowledge of Health Plan , DMHC, CMS, HIPPA and NCQA… more
- Henry Ford Health System (Rochester Hills, MI)
- …Shift Eligible for Full-Time Benefits Under general supervision of the Pharmacy Advantage Management team, the Customer Service Representative (CSR) responds to ... emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans… more
- The Cigna Group (Bloomfield, CT)
- …in provider, client and customer relations, contracting or national ancillary account management environment. + Experience with Medicare Advantage - Supplemental ... This is a **Medicare Advantage position** WORK LOCATION: REMOTE position The **National...Contracting Service & Operations team to create Corrective Action Plan (CAPs) and mitigation plans when needed. + Leads… more
- Highmark Health (Camp Hill, PA)
- …Six Sigma, TQI, TQC or other quality management certification + Experience in health plan provider network performance management , population health ... Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant...of user interfaces, predicative analytic tools, and other population health management tools endorsed by Highmark. +… more
- Henry Ford Health System (Rochester Hills, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... REQUIRED: + BS/BA degree in marketing, communications, public relations, advertising, health care management or a related field; Master's Degree… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- …Partner with client delivery teams with the implementation of the Human Resource Management (HRM) components of CGI Advantage ERP solution within the public ... ** Advantage ERP - HRM Consultant** **Category:** Business Consulting,...limited to Position Control, Payroll, Time & Leave, Personnel Management , and Benefits/Deductions Collaborate closely with clients and co-workers… more
- Henry Ford Health System (Rochester Hills, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... + Evaluates any pharmacy related inquiries (ie, financial barriers, therapy management related outcomes, non-adherence to therapy) and communicates with nursing,… more
- The Cigna Group (Bloomfield, CT)
- …The **Project Manager** is a key role that supports **Cigna's Medicare Advantage ** line of business, directly addressing customer and client demands for higher ... program value. This is a high functioning role with project management , service delivery, and strategic planning responsibilities. The **Project Manager** will… more
- Advantage SCI (Washington, DC)
- …will assist our government customer in the implementation of a comprehensive Occupational Health and Safety program, responsible to plan , and evaluate the safety ... Federal Occupation of Health , etc.). concerning environmental health and safety issues and advise management ...to 15 pounds occasionally. Noise level: Low to moderate Keyword: Health and Safety Specialist From: Advantage … more
- The Cigna Group (Bloomfield, CT)
- …training, etc.). **RESPONSIBILITIES:** + Educating providers and office staff on health plan initiatives, contracts, policies, and procedures. + Managing ... Maintain contracted provider demographic records by validating and submitting all data management requests for completion. + Prepare for and participate in meetings… more
- Skyline Products (Colorado Springs, CO)
- …in the position + Attain quarterly and annual objectives assigned by management + Respond effectively to RFPs Preferred Skills: + Price negotiation experience ... Business Analysis, ability to determine the project goals from stakeholder interests + Plan , schedule and track project timelines and milestones + Ability to travel… more
- Advantage Solutions (Boston, MA)
- …sales and marketing agencies specializing in outsourced sales, merchandising, category management and marketing services to manufacturers, suppliers and producers of ... materials for presentation. Communicate and engage cross-functionally to ensure comprehensive plan and budget tied to strategy including strategic initiatives. +… more
- UCLA Health (Los Angeles, CA)
- …at New Century Health Plan and coordinate the care for our Medicare Advantage members. As a Care Management Nurse, you will focus on improving health ... coordination, or a related field. + Experience with Medicare Advantage plans and knowledge of CMS regulations is highly...as part of a team. + Proficiency in electronic health records (EHR) and care management software,… more
- UCLA Health (Los Angeles, CA)
- …of clinical practice experience + 2 years or more years of Medicare Advantage management experience + Experience in a health plan or large healthcare ... can do all this and more at New Century Health Plan . Reporting to the Chief Medical...leaders to enhance the overall performance of the Medicare Advantage Plan Salary Range: $142,100- $348,100/annuallyQualifications We're… more
- Henry Ford Health System (Troy, MI)
- …and pharmacy member appeals and grievances for Health Alliance Plan 's (HAP's): Commercial, Medicare Advantage , Medicare-Medicaid Program (MMP), and Medicaid ... National Committee for Quality Assurance (NCQA), Office of Personnel Management (OPM), MI Health Link, and Better...financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven … more
- Henry Ford Health System (Troy, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... and, appeals for all product lines (HMO, AHL, Medicare Advantage (MA) and Prescription Drug Plan (PDP)...understanding of accounting principles. Additional Information + Organization: HAP ( Health Alliance Plan ) + Department: Appeals and… more
- UCLA Health (Los Angeles, CA)
- … health organization. Help drive clinical excellence and innovation across a growing health plan . Take your professional expertise to new heights. You can do ... all this and more at UCLA Health New Century Health Plan ....multiple clinical programs + Drive the execution of population health management initiatives + Ensure alignment of… more
- PNC (Dallas, TX)
- …have an opportunity to contribute to the company's success. As a Retirement Plan Advisor within PNC's Institutional Asset Management organization, you will be ... and service benchmarking. Responsibilities include working closely with clients on: plan design, investments, vendor management , participant education, and… more
- UCLA Health (Los Angeles, CA)
- …in a healthcare environment + Two or more years of managed care or health plan experience preferred + Experience processing ambulatory commercial, Medicare Fee ... Health . As a key leader within our Medicare Advantage team, you will be responsible for assisting with...Knowledge of the HMO referral process, eligibility verification, and health plan benefit interpretation a plus +… more
- CVS Health (Oklahoma City, OK)
- …direct patient care experience. **Preferred Qualifications** 1. Demonstrated experience in population health management and managed Care. 2. Passion and ability ... other executive team members in Medicaid driving clinical excellence, achieving measurable health outcomes, and supporting quality and medical management in a… more