- 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
- Vanderbilt University Medical Center (Nashville, TN)
- …the analysis and interpretation of data from internal/external sources to provide information to all levels of leadership. Participates in the assembly of ... documentation and data to support analytical reporting to senior business operational leaders and physician leadership regarding: + Audit results to outside… more
- Guidehouse (Hanover, MD)
- …or MS-BA in the following degree concentrations are preferred: Accounting, Business , Economics, Finance, Health Policy, Management/ Information System, Public ... helping CMS advance their vision of strengthening healthcare as well as the information available to beneficiaries and providers who serve them. Our Consultants help… more
- Elevance Health (St. Louis, MO)
- ** Business Information Developer Consultant - HEDIS Analytics** **Location:** This position will work a hybrid model (remote and in office one to two days ... St. Louis, MO, Wallingford, CT or Louisville, KY. The ** Business Information Developer Consultant -...+ Manages all measures and population reports for all Medicare projects. + Maintains HEDIS timelines used to support… more
- Elevance Health (Atlanta, GA)
- ** Medicare Medical Director** Location: This position will work a hybrid model (remote and office). The ideal candidate will **must live** within 50 miles of one of ... our Elevance Health PulsePoint locations. The ** Medicare Medical Director** is responsible for the administration of...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- Elevance Health (Seven Fields, PA)
- **JR127301 Business Consultant Sr (Operational)** The Sr. Business Consultant will support the Advanced Primary Care risk adjustment team through vendor ... operating systems; minimum of 3 years experience as a Business Consultant with project management skills; or...risk adjustment and/or health insurance industry. + Experience in Medicare Advantage and Medicaid in a provider based or… more
- CareFirst (Baltimore, MD)
- …to travel into the local offices on occasion.** **PURPOSE:** The Sr. Pharmacy Business Consultant provides expertise in tailored, strategic, and critical work to ... effective accomplishment of initiatives tasks and goals. + Collaborate on Medicaid and Medicare Quality and Cost of Care business strategy, thesis, programs and… more
- Humana (Columbus, OH)
- …health benefits organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, ... on Medicare Advantage strategy development. As a Insurance Strategy Consultant , you will deconstruct issues and challenges, perform targeted research and… more
- Humana (Nashville, TN)
- …and help us put health first** The RN Senior Stars Improvement, Clinical Consultant / Professional executes the overall Medicare Stars Improvement Program within ... working relationship with the health plan. The RN Senior Stars Improvement Consultant / Professional: + Builds and maintains strong relationships with assigned… more
- HCA Healthcare (Nashville, TN)
- …**Job Summary and Qualifications** The Coding Operations Education and Appeals Consultant is responsible for assisting in the efficient and effective design, ... The education program components and the appeals process include coding and Health Information Management (HIM) initiatives. This person serves as a key promoter of… more
- Elevance Health (Independence, OH)
- **Medical Policy Consultant ** National Government Services is a proud member of Elevance Health Companies, Inc. family of brands. We administer government contracts ... for Medicare and partner with the Centers for ...8 am - 4:30 pm EST.** The **Medical Policy Consultant ** is responsible for researching and drafting NGS Medical… 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. We are seeking an ... other duties as assigned. **Qualifications** Education and Experience: + Bachelor's degree business administration, finance, human resources, or a related field. + 5… more
- WellSense (Boston, MA)
- Sr. Provider Relations Consultant - (MA residents)-$5,000 sign on bonus WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide… more
- Deloitte (Fort Lauderdale, FL)
- …Are you interested in helping clients drive alignment with their business , improve organizational and human resource performance and establish a culture ... focused on adding business value? That is what the new generation of...Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions… more
- Deloitte (Minneapolis, MN)
- …Are you interested in helping clients drive alignment with their business , improve organizational and human resource performance and establish a culture ... focused on adding business value? That is what the new generation of...Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions… more
- MyFlorida (Tallahassee, FL)
- …Office (EPMO) program managers, agency executives and sponsors, internal and external business partners, and the Centers for Medicare and Medicaid Services ... 68065014 - SYSTEMS PROGRAMMING CONSULTANT / FX TCOE TRAINING & COMMS. COORDINATOR Date: Nov 6, 2024 The State Personnel System is an E-Verify employer. For more … 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** :...They are how we achieve our strategy, power our business outcomes and drive our shared success - for… more
- ChenMed (Winter Park, FL)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... + Begins to nurture, build and cultivate direct-to-seniors and business -to- business partnerships to generate new patient opportunities year-round.… more
- Public Consulting Group (Columbus, OH)
- …of their user base. Services: + Strategy, Architecture, Planning, and Procurement + Business Enablement + Business Solutions + Project Assurance The Medicaid ... the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our...as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined… more
- Humana (Tallahassee, FL)
- …health first** The Humana Florida Team is seeking a Senior STARS Improvement Consultant / Professional who will work directly with the Stars Improvement Lead to ... Pharmacy development strategies. Additionally, the associate will engage with various business partners and be responsible for managing critical features of large… more