- 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. Facilitates and ... has the option to work remote; Ohio residents preferred._** **Responsibilities** ** Medicare Advantage Customer Experience Strategist** + **Facilitates projects… more
- Highmark Health (Harrisburg, PA)
- …are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Advantage Product Solutions Manager II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, ... on product agnostic initiatives as well as strategic partnerships. Medicare : Required Medicare Advantage , with experience serving duals population. Direct… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Senior Contact Center Representative, you will be addressing and resolving complex member inquiries, providing detailed ... + Two or more years working contact center environment or experience with Medicare Advantage health plan, highly desired + Working knowledge of Medicare … more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... and CPT (II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications, required + Knowledge of … more
- UCLA Health (Los Angeles, CA)
- …level. You 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 various initiatives related to UM administrative,… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert (SME) ... management experience * Knowledge of HIPAA regulations * Knowledge of Medicare Advantage , STARS/HEDIS program, and NCQA technical specifications, a plus *… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running ... required * Five or more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5 years of experience with Encounter… more
- CareFirst (Washington, DC)
- …The incumbent will have primary responsibility for issues related to Medicare / Medicare Advantage , prescription drugs, utilization management, and ... behavioral health. **ESSENTIAL FUNCTIONS:** The incumbents essential functions may include, but are not limited to, the following: + Serving as an internal resource to Public Policy, Government Affairs, Government Programs, Mandates and all other areas of… more
- UCLA Health (Los Angeles, CA)
- …to manage engagement within a 100% virtual work environment + Understanding of Medicare Advantage program rules and regulations + In-depth knowledge of health ... plan processes + Strong communication, interpersonal, and organizational skills + College degree preferred + Experience leading teams of more than 100 employees is highly desirable + Computer proficiency with Microsoft Office + Ability to meet deadlines with… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. The ... Medicare Advantage Products Analyst plays an integral role in the product development of the Medicare Advantage . This role supports Medicare product… more
- AdventHealth (Altamonte Springs, FL)
- …work well with diverse teams, excellent analytical skills, a deep understanding of the Medicare Advantage program and data, and a high degree of creativity and ... and Excel to create custom reports and analyses for operators + Reviewing Medicare Advantage and ACO REACH data sets from payors for accuracy and validating… more
- Providence (WA)
- …data, and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare ... and providing critical insights to enhance the performance of our Medicare Advantage plans **_Please note the following important detail regarding this role:_**… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process + Ensures prospective members are… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Working under ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- …submission per Medicare , Commercial, and Medicaid billing guidelines + Submission of Medicare Advantage Copy claims + As Medicare payment occurs, ... Medicare Biller The CommuniCare Family of Companies currently...living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in Cincinnati,… more
- Dignity Health (Phoenix, AZ)
- …**Responsibilities** Develops operates and administers the regulatory compliance program for both Medicare Advantage (Part C) and Medicare Part-D plan ... of SCHN. + Develops and monitors the implementation of and compliance with Medicare policies and procedures through the creation and implementation of a work plan.… more
- Medical Mutual of Ohio (OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans ... remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** **Responsibilities** ** Medicare… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Under limited ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace… more
- Humana (Leesburg, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... exceed $113K depending on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the… more