- UCLA Health (Los Angeles, CA)
- …preferred * 3-5 years of experience in healthcare program management, ideally within a Medicare Advantage plan or health insurance setting, preferred * ... role in driving the success of key initiatives for the UCLA Health Medicare Advantage Health Plan. In this role, you will: * Oversee the planning, execution,… more
- Trinity Health (Columbus, OH)
- …auditing, billing and/or coding. **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and ... billing and/or coding. + Must possess an in-depth knowledge of current Medicare coding and billing requirements + Advanced knowledge of current medical terminology,… more
- Baylor Scott & White Health (Columbus, OH)
- …plan design. **KEY SUCCESS FACTORS** Sales experience in HMO or PPO individual health insurance , Medicare Advantage insurance , group health insurance ... FUNCTIONS OF THE ROLE** Coordinates and conducts sales activities for Individual and Medicare Advantage plans to enroll prospective members into the health plan… more
- Trinity Health (Columbus, OH)
- …be able to work remotely. **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... and quality + Working knowledge of protocols and procedures of Centers For Medicare and Medicaid Services + Proven ability to work effectively with internal and… more
- Ochsner Health (New Orleans, LA)
- …managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Proficiency in using ... public programs such as those funded by Medicare , Medicaid, Medicare Advantage and commercial insurance plans. + Excellent psychotherapeutic skills. +… more
- Molina Healthcare (Columbus, OH)
- **Job Summary** As the leader for Molina's Medicare Advantage product (Non-Dual), this position has P&L, business strategy, sales distribution and provider ... with senior leadership, determines the annual implementation of Molina's Medicare Advantage product strategic plan. + Has...The ideal candidate will have deep experience in the Insurance industry, with a proven track record of hitting… 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, ... strategic planning on product agnostic initiatives as well as strategic partnerships. Medicare : Required Medicare Advantage , with experience serving duals… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** Are you an experienced actuarial professional with a passion for Medicare Advantage ? Join our dynamic team as a Senior Actuarial Analyst, ... premiums, risk scores, and reserves for new and existing insurance plans. + Support senior analysts and actuaries as...required). + Minimum of 4 years of experience in Medicare Advantage . + Completion of at least… more
- Providence (Beaverton, OR)
- …we know that to inspire and retain the best people, we must empower them.** ** Medicare Advantage is a strategic growth strategy for PH&S and Providence Health ... emerging markets. It will be managing and leading various enterprise-wide Medicare compliance-related initiatives and projects in relation to our delegated entities.… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …RoleThe Clinical Utilization Reviewer is responsible for facilitating care for our Medicare Advantage members who may have complex healthcare needs, authorizing ... and escalate quality of care issues. + Understand member insurance products and benefits, as well as regulatory and...care). + Utilization Management experience, preferred + Experience with Medicare Advantage , preferred + Active licensure in… more
- Ochsner Health (New Orleans, LA)
- …systems and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Strong interpersonal skills ... necessary to deal effectively and courteously with patients, families, multidisciplinary team members, departmental peers, and community agency personnel. **Job Duties** + Conducts patient assessment interviews, provides referrals and coordinates discharge… more
- Ochsner Health (Mandeville, LA)
- …managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Proficiency in using ... computers, software, and web-based applications. + Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. **Job Duties** + Interviews… more
- Ochsner Health (Lafayette, LA)
- …managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Proficiency in using ... computers, software, and web-based applications. + Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. + Ability to travel… more
- Ochsner Health (New Orleans, LA)
- …care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. **Job Duties** * Interviews ... and assesses patients and assists throughout patient care plan. * Identifies and provides helpful resources to patients and families. * Maintains patient records and documents and communicates critical information to the medical team. * Participates in on-call… more
- Ochsner Health (Gretna, LA)
- …systems and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Strong interpersonal skills ... necessary to deal effectively and courteously with patients, families, multidisciplinary team members, departmental peers, and community agency personnel. **Job Duties** + Conducts patient assessment interviews, provides referrals and coordinates discharge… more
- Ochsner Health (New Orleans, LA)
- …systems and public programs such as those funded by Medicare , Medicaid, Medicare Advantage and commercial insurance plans. + Excellent psychotherapeutic ... skills. + Superior interpersonal skills necessary to deal effectively and courteously with patients, families, multi-disciplinary team members, departmental peers, and community agency personnel. **Job Duties** + Conducts complex assessment, independent… more
- Ochsner Health (Morgan City, LA)
- …systems and public programs such as those funded by Medicare , Medicaid, Medicare Advantage and commercial insurance plans. + Excellent psychotherapeutic ... skills. + Superior interpersonal skills necessary to deal effectively and courteously with patients, families, multi-disciplinary team members, departmental peers, and community agency personnel. **Job Duties** + Conducts complex assessment, independent… more
- Ochsner Health (New Orleans, LA)
- …care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. **Job Duties** * Interviews ... and assesses patients and assists throughout patient care plan. * Identifies and provides helpful resources to patients and families. * Maintains patient records and documents and communicates critical information to the medical team. * Participates in on-call… 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 ... is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of...Medicare Advantage Products Analyst plays an integral role in the… more