• Medicare Advantage Quality…

    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
    Highmark Health (10/24/24)
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  • Medicare Advantage Risk Adjustment…

    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...in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience *… more
    UCLA Health (10/25/24)
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  • Senior Medicare Compliance…

    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 ... ensuring appropriate oversight is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. + Identifying and documenting all noncompliance… more
    Banner Health (10/11/24)
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  • Sr. Process Consultant ( Medicare

    Molina Healthcare (Long Beach, CA)
    **JOB DESCRIPTION** **Job Summary** Leads business process improvement initiatives that result in operational efficiencies and/or an increase in customer ... satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of...+ Project management. + Process design & engineering. + Medicare . + Proven track record with results. + Process… more
    Molina Healthcare (10/25/24)
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  • Business Information Developer…

    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 ... St. Louis, MO, Wallingford, CT or Louisville, KY. The ** Business Information Developer Consultant - HEDIS Analytics**...+ Manages all measures and population reports for all Medicare projects. + Maintains HEDIS timelines used to support… more
    Elevance Health (10/29/24)
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  • Business Information Developer…

    Elevance Health (Tampa, FL)
    **Be Part of an Extraordinary Team** **Title** : Business Information Developer Consultant - HEDIS Analytics **Location:** Candidates must reside within 50 miles ... WFH 3-4 days/week **Build the Possibilities. Make an Extraordinary Impact.** The ** Business Information Developer Consultant ** is responsible for developing and… more
    Elevance Health (10/17/24)
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  • Nurse Senior Stars Improvement Consultant

    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
    Humana (10/29/24)
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  • Healthcare Reimbursement Consultant - Acute…

    Plante Moran (Traverse City, MI)
    Healthcare Reimbursement Consultant - Acute Care + Location: United States, Michigan, Traverse City + Location: United States, Michigan, Southfield + Location: United ... care healthcare consulting team focuses on our clients' critical business needs. Our team works with acute providers including...wide array of services including the filing of their Medicare and Medicaid Cost Reports, Medicare DSH… more
    Plante Moran (09/26/24)
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  • Senior STARS Improvement Consultant

    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
    Humana (10/31/24)
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  • Per Diem Lactation Consultant

    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
    Nuvance Health (10/04/24)
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  • Risk and Compliance - Healthcare Industry, Senior…

    Robert Half (Boston, MA)
    …emphasis on the Medicare Managed Care Manual. + Expertise of core business processes related to payer practices. + Expert understanding of commonly used internal ... JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY,...preparation of client proposals and strategies to win new business . + You have interest in working with a… more
    Robert Half (10/22/24)
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  • Healthcare Review/Audit Senior Consultant

    Guidehouse (Mclean, VA)
    …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
    Guidehouse (10/06/24)
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  • Sr. Provider Relations Consultant - (MA…

    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
    WellSense (09/12/24)
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  • Government Health Actuary Consultant

    Deloitte (New York, NY)
    …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 (08/09/24)
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  • Government Health Actuary Consultant

    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
    Deloitte (10/16/24)
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  • Project Manager/Fire & EMS Consultant

    Public Consulting Group (Columbus, OH)
    …(FSS) Center of Excellence. This individual will support the public safety consulting business line, and other Medicaid and Medicare related projects. This role ... 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… more
    Public Consulting Group (10/11/24)
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  • Care Consultant Sr, - Provider Success

    Elevance Health (Costa Mesa, CA)
    … 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. (California Provider Success) - JR133276 **Location**...vary depending on the above factors as well as market/ business considerations. No amount is considered to be wages… more
    Elevance Health (10/27/24)
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  • CMS Consultant -LSCS

    The Joint Commission (Oakbrook Terrace, IL)
    …and comply with federal regulations and processes regarding the Medicare certification program and Federal survey methodology. Creatively approaches client ... or client educational updates when requested. Responsible for new CMS business development (to a defined expectation) inclusive of client relationship management,… more
    The Joint Commission (10/12/24)
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  • Care Consultant Sr.

    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
    Elevance Health (11/02/24)
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  • Provider Contract/Cost of Care Consultant

    Elevance Health (OH)
    …background. **Preferred Skills, Capabilities and Experiences:** * Must have experience with Medicare & Commercial Lines of Business . * Experience with relational ... **Provider Contract/Cost of Care Consultant ** **Location:** This position will work a hybrid...an impact:** * Creates and maintains databases to track business performance. * Analyzes data and summarizes performance using… more
    Elevance Health (09/19/24)
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