- Molina Healthcare (Columbus, OH)
- …application of Lean/Six-Sigma. + Project management. + Process design & engineering. + Medicare . + Proven track record with results. + Process mapping tools - Visio, ... apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
- Guidehouse (Hanover, MD)
- …technical competency, business development, client service and people development. As a Consultant , you will work with an experienced team to support the development ... comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …audit results. Monitors new regulatory and/or billing requirement changes from Medicare Administrative Carriers and CMS websites and published guidance. Performs ... Large Healthcare Environment, hospital, physician practice, third party payer, Medicare intermediary, health insurer, or accounting/consulting firm. (Required) 10… more
- Humana (Nashville, TN)
- …and help us put health first** The RN Senior Stars Improvement, Clinical Consultant / Professional executes the overall Medicare Stars Improvement Program within ... working relationship with the health plan. The RN Senior Stars Improvement Consultant / Professional: + Builds and maintains strong relationships with assigned… more
- Elevance Health (Atlanta, GA)
- ** Medicare Medical Director** Location: This position will work a hybrid model (remote and office). The ideal candidate will **must live** within 50 miles of one of ... our Elevance Health PulsePoint locations. The ** Medicare Medical Director** is responsible for the administration of...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- Trinity Health (Muskegon, MI)
- …reside in the West Michigan region. **What the Clinical Financial Consultant will need:** **Minimum: Bachelor's degree in finance, business, counseling, social ... medical field working with the financial needs of patients. Experience with Medicare health plans, COBRA regulations, Affordable Care Act Marketplace Plans, Medicaid… more
- Humana (Columbus, OH)
- …on Medicare Advantage strategy development. As a Insurance Strategy Consultant , you will deconstruct issues and challenges, perform targeted research and ... hospital corporation in the 80's, to a leading health benefits company beginning in the 90's. Today, Humana is...in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's… more
- Robert Half (Boston, MA)
- …variety of rewards we offer at Protiviti at https://www.protiviti.com/sites/default/files/2023-12/2024- benefit -highlights.pdf . Any benefits outlined are part ... JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB… more
- Guidehouse (Mclean, VA)
- …Obtain Public Trust **What You Will Do** **:** Guidehouse is looking for a Senior Consultant to work on a Centers for Medicare and Medicaid Services (CMS) ... programs, specific to the Affordable Care Act. The Senior Consultant will work with a team of reviewers to...Insurance Exchanges preferred, but not required + Knowledge of Medicare , Medicaid, Medicare Advantage preferred, but not… more
- Elevance Health (Norfolk, VA)
- **Be Part of an Extraordinary Team** **Title** : Business Information Developer Consultant - HEDIS Analytics **Location:** Candidates must reside within 50 miles or ... the Possibilities. Make an Extraordinary Impact.** The **Business Information Developer Consultant ** is responsible for developing and executing more complex data… more
- Elevance Health (St. Louis, MO)
- **Business Information Developer Consultant - HEDIS Analytics** **Location:** This position will work a hybrid model (remote and in office one to two days per week). ... Louis, MO, Wallingford, CT or Louisville, KY. The **Business Information Developer Consultant - HEDIS Analytics** is responsible for developing and executing more… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. We are seeking an ... shopping with our customers. + Business casual attire, including jeans. Excellent Benefits and Compensation: + Employee bonus program. + 401(k) with company match… more
- WellSense (Boston, MA)
- Sr. Provider Relations Consultant - (MA residents)-$5,000 sign on bonus WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide… more
- Elevance Health (Independence, OH)
- **Medical Policy Consultant ** National Government Services is a proud member of Elevance Health Companies, Inc. family of brands. We administer government contracts ... for Medicare and partner with the Centers for ...8 am - 4:30 pm EST.** The **Medical Policy Consultant ** is responsible for researching and drafting NGS Medical… more
- CareFirst (Baltimore, MD)
- …into the local offices on occasion.** **PURPOSE:** The Sr. Pharmacy Business Consultant provides expertise in tailored, strategic, and critical work to help design, ... pharmacy programs that support initiatives related to Government Programs (Medicaid and Medicare ) with a focus in Quality and Cost of Care. **ESSENTIAL FUNCTIONS:**… more
- Signature Healthcare (Louisville, KY)
- …Modern Healthcare's "Best Places to Work!" Overview The ideal Signature Clinical Care Consultant Candidate would have working knowledge of Medicare , Medicaid and ... facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great… more
- MyFlorida (Tallahassee, FL)
- 68065014 - SYSTEMS PROGRAMMING CONSULTANT / FX TCOE TRAINING & COMMS. COORDINATOR Date: Nov 6, 2024 The State Personnel System is an E-Verify employer. For more ... Agency for Health Care Administration Working Title: 68065014 - SYSTEMS PROGRAMMING CONSULTANT / FX TCOE TRAINING & COMMS. COORDINATOR Pay Plan: Career Service… more
- MyFlorida (Tallahassee, FL)
- OPS GOVERNMENT OPERATIONS CONSULTANT I - 64855062 Date: Nov 18, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Agency: Department of Health Working Title: OPS GOVERNMENT OPERATIONS CONSULTANT I - 64855062 Pay Plan: Temp Position Number:...to the Department of Children and Families. Prepares annual Medicare Part B Fee Schedules for regional sites. Assists… more
- Humana (Arlington, VA)
- …community and help us put health first** The Senior Acquisition Integration Consultant performs project-oriented duties related to the integration of an acquired ... an in-depth evaluation of variable factors. The Senior Acquisition Integration Consultant implements activities and projects associated with the assimilation of… more
- CVS Health (Phoenix, AZ)
- …and affordable. **Position Summary** This is a fulltime Quality Management Nurse Consultant opportunity within Arizona. The working schedule is Monday- Friday 7:00am ... miles) about 25-50% of the time. The QM Nurse Consultant is a work at home role. Experienced HEDIS...knowledge of NCQA HEDIS and STARS Measures for both Medicare and Medicaid, with recent experience in the annual… more