- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Senior Contact Center Representative, you will be addressing and resolving complex member inquiries, providing ... clear and empathetic communication + Manage escalated calls from Contact Center Agents related procedural inquiries + Assist members,...Center environment + Two or more years in a Medicare Advantage role, highly desired + Exceptional… more
- Point32Health (Canton, MA)
- …a team environment. + Strong understanding of the managed care industry, preferably Medicare Advantage plans. + Experience in Product Development. + Experience ... are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have two main… more
- Banner Health (AR)
- …8:00 AM - 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight ... is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. +...regulations through personal initiative, seminars, training programs and peer contact . 5. This position interacts with a multitude of… more
- Point32Health (Canton, MA)
- …strategies, ensuring adherence to Federal Medicare and State requires related to Medicare Advantage and Prescription Drug Plans and Dual Programs (SCO and ... Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Compliance Senior Manager will report to the Government Programs Compliance Officer.… more
- Martin's Point Health Care (Portland, ME)
- …programs. + Strong project management experience required. + Experience in Medicare Advantage and TRICARE preferred. Required License(s) and/or Certification(s): ... (Behaviors): + Broad knowledge of managed care and health plan functions; Medicare Advantage required; USFHP and/or TRICARE knowledge is a plus… more
- Guidehouse (Mclean, VA)
- …+ Knowledge of Health Insurance Exchanges preferred, but not required + Knowledge of Medicare , Medicaid, Medicare Advantage preferred, but not required + ... Senior Consultant to work on a Centers for Medicare and Medicaid Services (CMS) project with the Office...for a position, and you require an accommodation, please contact Guidehouse Recruiting at ### or via email at… more
- Robert Half (Boston, MA)
- …services or industry. + Knowledge of healthcare payer regulatory requirements, including Medicare Advantage . + Proficiency in Microsoft Office suite applications ... JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW...healthcare payer regulations and guidance with emphasis on the Medicare Managed Care Manual. + Expertise of core business… more
- Robert Half (Boston, MA)
- …services or industry. + Knowledge of healthcare payer regulatory requirements, including Medicare Advantage . + Proficiency in Microsoft Office suite applications ... JOB REQUISITION Risk and Compliance - Healthcare - Senior Manager LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK...healthcare payer regulations and guidance with emphasis on the Medicare Managed Care Manual. + Expertise of core business… more
- Molina Healthcare (Olive Branch, MS)
- …and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for ... of customer service. **Job Duties** This role serves as the primary point of contact between Molina Health plan and the Plan's highest priority, high volume and… more
- Point32Health (Boston, MA)
- …Pricing work. The key responsibilities for this role are pricing, rate filing ( Medicare Advantage Bid) development, strategic analysis, and other ad hoc ... you will be doing** + Support the preparation, analysis, and submission of Medicare Advantage bids, ensuring compliance with CMS regulations. + Maintain current… more
- CenterWell (Arlington, TX)
- …+ Develop and nurture relationships with brokers and intermediaries specializing in senior healthcare, Medicare Advantage , and value-based care models. ... revenue growth. + Serve as the primary point of contact for brokers, providing them with the necessary tools,...models. + Deep understanding of Original Medicare , Medicare Advantage , and other senior … more
- BrightSpring Health Services (Louisville, KY)
- Our Company Abode Care Partners Overview Seeking an Account Representative for our Signature Advantage Plan who will work with senior care partners to assist in ... enrolling new residents and members. Actively market plan to new senior care partners within plan service area. Responsibilities + Working with senior care… more
- BrightSpring Health Services (Louisville, KY)
- …a Medical Services company, Population Health Management services company, and a Medicare Advantage Institutional Special Needs Plan (I-SNP).Under the direction ... focus of this position will be to support the Medicare Advantage Institutional Special Needs Plan (I-SNP),...validate and communicate impact of strategic operational changes to senior management and Company operations on a consistent basis.… more
- Conviva (Port Saint Lucie, FL)
- …+ Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating multiple centers across… more
- New York State Civil Service (Tupper Lake, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... from your employment.If appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a National Provider Identifier… more
- The Cigna Group (Houston, TX)
- …coverage area.** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment & Stars program for assigned populations ... within an assigned market. Lead Analyst will be primary contact for provider groups on Risk Adjustment at joint...5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan experience preferred. +… more
- CenterWell (Houston, TX)
- …administrators. + Nearly 250,000 total patients served in 2022, including those in Medicare Advantage , value-based arrangements or other Medicare programs. ... help us put health first** The Medical Assistant is the first point of contact for patient care. Responsible for administrative duties in addition to patient care.… more
- Conviva (Boca Raton, FL)
- …of two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating multiple centers across… more
- Conviva (Pompano Beach, FL)
- …of two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Medicine, Internal Medicine or Geriatric Medicine preferred + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- Conviva (Tampa, FL)
- …of three to five years directly applicable experience preferred. + Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... be required to be screened for TB. **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more