- Healthfirst (NY)
- …Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. ** Compliance & Regulatory Responsibilities:** Noted ... on all aspects related to one or more specific Medicare performance areas such as Risk Score Accuracy, ...key member cohorts and opportunities for achieving short- and long -term profitable growth and retention strategies. + Works collaboratively… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Product Solutions Manager III Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... safety net required to achieve that purpose. Job Summary The Product Solutions Manager III is responsible for assisting the product leadership team within the… more
- The Cigna Group (Austin, TX)
- …- Dallas, East Texas (must live in/or near area)** **Excited to grow your Medicare career?** We value our talented employees, and whenever possible strive to help ... about the role: **SUMMARY:** Responsible for the execution of the Cigna Medicare strategy for local topline sales agencies, directly contracted agents, and broker… more
- CVS Health (Salt Lake City, UT)
- …care more personal, convenient and affordable. **Position Summary** Aetna is looking for a Medicare Sales Broker Manager to join the Utah sales team who will ... achieve sales results through an assigned Utah hierarchy of independent Medicare brokers. Responsibilities include: - Develop and execute market strategy impacting… more
- Healthfirst (NY)
- …agency + Knowledgeable of Department of Health (DOH) and Center for Medicare & Medicaid Services (CMS) regulations ** Compliance & Regulatory Responsibilities:** ... the enabling tools and technology (software and hardware) that support the Medicare Sales Operations team Works with internal and external constituents as applicable… more
- UCLA Health (Los Angeles, CA)
- Description As the Manager of Medicare Advantage Sales, you will be driving our sales strategies and functions. You will be responsible for: * Serving as the key ... * Manage the sales-assisted enrollment and commission processes * Monitor compliance targets for Field Marketing Organizations and sales agents * Communicate… more
- The Cigna Group (St. Louis, MO)
- …lines of businesses, stakeholders, and matrix partners (ex. Clinical, Compliance , Operations, Growth, Finance, etc.), providing proactive identification of ... analysis and serve as initial point of contact for compliance on CMS notices possibly impacting Stars and RA....gather materials for Stars and RA team meetings and Medicare leadership meetings: + Seniors Business Operating Review Monthly… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …designed for Full Medicaid and Medicare recipients that need in home care and Long -term care services, + Care Managers who will manage day to day needs, + Care ... Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island,...performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling… more
- MarketSource (Alpharetta, GA)
- 121666BRTitle: Compliance ManagerJob Description: Compliance Manager (Insurance) MarketSource Inc., an Allegis Group Company, develops and delivers innovative ... efforts. Essential Job Functions: * Design, implement, and lead the insurance compliance management strategy for the organization's Medicare Advantage sales… more
- The Mount Sinai Health System (New York, NY)
- …data science. We enable nearly $200 million/year in NIH-funded biomedical research. The Compliance Manager is an individual contributor reporting to the Dean for ... applications and computation is consistent with all regulatory guidelines. **RESPONSIBILITIES** The Compliance Manager will be responsible for all facets of… more
- Boehringer Ingelheim (Ridgefield, CT)
- …and tactical goals of Boehringer-Ingelheim or BIPI in the retail, wholesale, long term care, hospital, specialty, and other relevant markets through the optimization ... and to provide support to the Associate Director, Contract Compliance by: developing a comprehensive discount accrual forecasts and...forecasts and by providing support for Managed Care / Medicare Part D group efforts as required in order… more
- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance , Medical/BH Reimbursement Policy Manager will have overall responsibility for ... and Behavioral Health reimbursement policies for statewide impact. The Policy Manager is responsible for managing cross-departmental implementation of changes to… more
- InnovaCare (San Juan, PR)
- …to bringing passion and customer focus to the business. The Care Manager is responsible to assess all referred cases, plan, implement, perform interventions, ... to ensure the continuity of care for short and long term. Assumes leadership across the continuum of care...health assessment.o Notifies supervisor of any processes not in compliance with the SNP's policies and MOC requirements.o If… more
- MetroLink (Los Angeles, CA)
- Senior Contract & Compliance Administrator Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4642379) Apply Senior Contract & Compliance ... Metrolink is seeking a highly skilled Senior Contract and Compliance Administrator to join our Contracts and Procurement team....EXERCISED AND RECEIVED + Receives supervision from Director, Senior Manager , and Manager II roles. + The… more
- Highmark Health (Dover, DE)
- …care across the continuum of services and assisting members physical, behavioral, long term services and supports (LTSS), social, and psychosocial needs in the ... needs, available benefits, resources and services including available options for long term care community or facility-based service delivery. + Provide education,… more
- Banner Health (AZ)
- …work, we invite you to bring your experience and skills to BPN. As an Arizona Long Term Care (ALTCS) Case Manager , you will be required to visit members in ... Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an...does require Pima County, Arizona residency for territory and compliance .** If this role sounds like the one for… more
- MetroLink (Los Angeles, CA)
- Manager I, Human Resources Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4578046) Apply Manager I, Human Resources Salary $89,909.00 - ... of the Metrolink commuter rail system, is seeking a Manager I to work in the Human Resources Department....recruitment process for a wide variety of positions in compliance with State and Federal laws and Metrolink practices.… more
- MyFlorida (Largo, FL)
- …+ Three (3) years of experience in third party billing in a long -term healthcare environment including Medicare , Medicaid, and Commercial Insurers and related ... HEALTH OPERATIONS MANAGER - SES - 50000237 Date: Sep 19,...third party billing in a clinical related environment including Medicare , Medicaid, and Commercial Insurers + Three (3) years… more
- MetroLink (Los Angeles, CA)
- Senior Manager , Project Management (Limited Term) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4663705) Apply Senior Manager , Project ... operator of the METROLINK Commuter Rail System, is seeking a Senior Manager , Project Management who will provide leadership and oversight for day-to-day management… more
- Robert Half Finance & Accounting (Windsor, CT)
- Description Business Office Manager - Long Term Care/Skilled Nursing Location: Windsor, CT area- FULLY ONSITE, no exceptions Position: Full-Time, Permanent ... - $90,000 (commensurate with overall experience) Our client is a reputable Long -Term Care (LTC) organization, dedicated to providing exceptional care and services to… more