- Highmark Health (Harrisburg, PA)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Humana (Columbus, OH)
- …highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Insurance Strategy Consultant , you will ... initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development...need it. These efforts are leading to a better quality of life for people with Medicare ,… 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. We are ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Elevance Health (Columbus, OH)
- … Sr.** for **Provider Success** is responsible for consulting with providers (Commercial, Medicare Advantage and Medicaid Lines of Business) to assess and deploy ... Care Consultant Sr. (Provider Success) - JR135703 **Location** :...action plans around population health management, patient satisfaction and quality and cost performance. + Facilitation of collaborative meetings… more
- Highmark Health (Columbus, OH)
- …gain share and risk share models and will be implemented for the Organization's Medicare Advantage , Medicaid, ACA, and commercial populations with the goal of ... maximizing quality while reducing healthcare costs. + Work with reimbursement,...+ Collaborate with and support the senior Strategic Partners Consultant role as needed + Other duties as assigned… more
- Adecco US, Inc. (Independence, MO)
- …with **2+ years preferred** . + **Healthcare Background** : Experience with ** Medicare Advantage !** + **Senior Community** : Familiarity with or experience ... Exciting opportunity for an **Outside Medical Sales Membership Consultant in St. Louis, MO.** + Your focus...positive impact on seniors' lives by connecting them with quality medical care. Want to learn more? Apply now… more
- TEKsystems (Carmel, IN)
- …growth mindset. * Strong critical-thinking and organizational skills to achieve high- quality outcomes. * Comfortable evaluating risk and exercising discretion in ... * Excellent written and interpersonal communication skills. * Understanding Medicare About TEKsystems: We're partners in transformation. We help...We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… 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. Medical Mutual' ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- CenterWell (Dallas, TX)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- The County of Los Angeles (Los Angeles, CA)
- …Facilities Inspection Division and are responsible for either survey services, consultant services, or licensing, enforcement and training services. These positions ... hospitals and other health care facilities to evaluate the quality of care provided with respect to State, Federal...and the coordination of work with other Sections. + Consultant Services: Directs a staff of consultants who provide… more
- Humana (Columbus, OH)
- …insights, BI dashboards, research and evidence. + Work experience with a payer with Medicare Advantage and Medicaid lines of business. + Experience with Medicaid ... they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service… more
- ChenMed (Philadelphia, PA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... demonstrates 1) success in developing providers to deliver high quality , cost-effective care; 2) effective dyad partnership with the...Act as a health coach, rather than just a consultant for sickness, by helping patients set short and… more
- ChenMed (Columbus, OH)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Cincinnati, OH)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- Cedars-Sinai (Los Angeles, CA)
- …MH services, including maintaining the network of providers for the CSMN Medicare Advantage plan(s). + Assists Contracting with identification, engagement, and ... executive leadership within the CSMN, including but not limited to Quality , Population Health, Clinical Transformation, Network Management, Clinical Operations and… more
- Provider Solutions & Development (Walla Walla, WA)
- …Mary is one of seven hospitals in the state to earn a five-star rating for quality from the Centers for Medicare and Medicaid Services, while also having an ... a large research network, and opportunities for investigator-initiated trials. Take advantage of all these professional growth opportunities while enjoying life in… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive ... efficient transition of care across the continuum. + Responsible for monitoring quality metrics specific to the department & ensuring complete & accurate… more