- 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
- 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 ... is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. + Identifying and...a timely fashion. + Working in start-up environment + Medicare Advantage Compliance training, audits, regulations, and manuals. +… more
- Molina Healthcare (Long Beach, CA)
- …application of Lean/Six-Sigma. + Project management. + Process design & engineering. + Medicare . + Proven track record with results. + Process mapping tools - Visio, ... MS Project. + Power BI or Tableau. **Preferred License, Certification, Association** Lean Six Sigma Master Black Belt or Lean Sensei To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job… 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) ... offered by the health plan + Act as a consultant and partner to the contracted IPAs + Traveling...experience * Knowledge of HIPAA regulations * Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications, a… more
- Humana (Spring Hill, FL)
- …put health first** The Nurse Senior Stars Improvement, Clinical Professional/ Consultant contributes to the development, implementation, and management of the ... company's Medicare /Medicaid Five-Star Quality Rating System. The Senior Stars Improvement,...Experience. The Nurse Senior Stars Improvement, Clinical Professional / Consultant focuses on areas of clinical emphasis related to… more
- Plante Moran (Traverse City, MI)
- Healthcare Reimbursement Consultant - Acute Care + Location: United States, Michigan, Traverse City + Location: United States, Michigan, Southfield + Location: United ... a wide array of services including the filing of their Medicare and Medicaid Cost Reports, Medicare DSH optimization, Medicare Wage Index related services,… more
- Humana (Montgomery, AL)
- …caring community and help us put health first** The Senior Stars Improvement Consultant / Professional executes the overall Medicare Stars Improvement Program ... with physician groups and internal partners.. The Senior Stars Improvement Consultant / Professional works via virtual and in-person collaboration with providers… more
- Nuvance Health (Fishkill, NY)
- *Description* *Per Diem Lactation Consultant - Southern O/B* We are seeking an experienced and compassionate lactation consultant to provide breastfeeding ... and their babies throughout the prenatal and postpartum period. The lactation consultant will see patients in our obstetric offices for prenatal and postpartum… 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 per week). ... Louis, MO, Wallingford, CT or Louisville, KY. The **Business Information Developer Consultant - HEDIS Analytics** is responsible for developing and executing more… more
- Guidehouse (Philadelphia, PA)
- …Obtain Public Trust **What You Will Do** **:** Guidehouse is looking for a Senior Consultant to work on a Centers for Medicare and Medicaid Services (CMS) ... programs, specific to the Affordable Care Act. The Senior Consultant will work with a team of reviewers to...Insurance Exchanges preferred, but not required + Knowledge of Medicare , Medicaid, Medicare Advantage preferred, but not… more
- Elevance Health (Tampa, FL)
- **Be Part of an Extraordinary Team** **Title** : Business Information Developer Consultant - HEDIS Analytics **Location:** Candidates must reside within 50 miles or ... the Possibilities. Make an Extraordinary Impact.** The **Business Information Developer Consultant ** is responsible for developing and executing more complex data… more
- Robert Half (Boston, MA)
- JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB ... Protiviti is looking for a Risk and Compliance Senior Consultant to join our growing Healthcare team. What You...healthcare payer regulations and guidance with emphasis on the Medicare Managed Care Manual. + Expertise of core business… 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
- Stantec (Denver, CO)
- Benefits Consultant - ( 240003FF ) **Description** Grow with the best. Join a smart, creative, and inspired team that works to support operational excellence. The ... vital to making our Company stronger. **Your Opportunity** We are looking for a Benefits Consultant to join our team! As part of the HR Talent Services team, the… more
- MyFlorida (Tallahassee, FL)
- OPERATIONS & MGMT CONSULTANT MGR - SES - 65000081 Date: Oct 25, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... 840128 Agency: Elder Affairs Working Title: OPERATIONS & MGMT CONSULTANT MGR - SES - 65000081 Pay Plan: SES...(Serving Health Insurance Needs of Elders) program, SMP (Senior Medicare Patrol) Program, MIPPA ( Medicare Improvement for… more
- Signature Healthcare (Indianapolis, IN)
- …Modern Healthcare's "Best Places to Work!" Overview The ideal Signature Clinical Care Consultant Candidate would have working knowledge of Medicare , Medicaid and ... facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great… more
- Deloitte (Minneapolis, MN)
- …Human Capital practice. Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions Practice, you will ... the individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or Medicare Supplement products for various… more
- Deloitte (New York, NY)
- …Human Capital practice. Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions Practice, you will ... the individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or Medicare Supplement products for various… more
- Public Consulting Group (Columbus, OH)
- …www.publicconsultinggroup.com . PCG is seeking candidates for a Project Manager (Fire & EMS Consultant ) position who will work as an integral part of a dynamic team ... along with peers and senior staff. The Fire/EMS Consultant will be responsible for carrying out the day-to-day...public safety consulting business line, and other Medicaid and Medicare related projects. This role will use knowledge of… more
- Elevance Health (Manchester, NH)
- **Care Consultant Sr.** **Location** : Must reside in the state of **Maine** or **New Hampshire, and be within** 50 miles (1 hour commute) of our South Portland, ME ... working in the local office 1- 2 days per week. The **Care Consultant Sr.** for **Provider Success** is responsible for consulting with providers ( Medicare… more