- Daiichi Sankyo, Inc. (Bernards, NJ)
- …but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and ... Lead drafting and negotiating contracts for commercial, Medicaid and Medicare coverage, as well as other government contracts, trade/distribution agreements,… more
- 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
- 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
- Banner Health (TX)
- …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
- Molina Healthcare (Columbus, OH)
- **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
- Guidehouse (Hanover, MD)
- …who serve them. Our Consultants help our clients improve their business processes, internal controls, operating efficiency, transparency and performance management, ... enhance their skills in the areas of technical competency, business development, client service and people development. As a... development, client service and people development. As a Consultant , you will work with an experienced team to… more
- Molina Healthcare (Columbus, OH)
- …analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for ... design, or related experience. **PREFERRED EDUCATION:** Master's Degree in Business Administration, Finance, Mathematics, Statistics, or Economics **PREFERRED EXPERIENCE:**… more
- Elevance Health (Columbus, OH)
- ** 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 ... be able to work Eastern Time Zone hours. 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
- HealthEdge Software Inc (Columbus, OH)
- **Overview** **Overview:** The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting ... Source products (from basic to advanced features/functionality), payment methodologies/policies ( Medicare , Medicaid, and commercial), payment integrity, and healthcare plan… more
- MyFlorida (Tallahassee, FL)
- 68065017 - SENIOR INFO TECH BUSINESS CONSULTANT /FX CERTIFICATION LEAD Date: Dec 16, 2024 The State Personnel System is an E-Verify employer. For more information ... for Health Care Administration Working Title: 68065017 - SENIOR INFO TECH BUSINESS CONSULTANT /FX CERTIFICATION LEAD Pay Plan: Career Service Position Number:… 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
- CVS Health (Austin, TX)
- …Training hours may differ from the shift you are hired for. The WorkLife Consultant (WLC) is part of the WorkLife Team and provides consultation, assessment, and ... needs, elder/adult care, basic/everyday needs, and mental health. Due to expanded business , elder care is the top requested need. Additional Responsibilities: + The… more
- CVS Health (Austin, TX)
- …schedule is Monday through Friday, 11:45am to 8:15pm Eastern Time.** The WorkLife Consultant (WLC) is part of the WorkLife Team and provides education about ... or customer service oriented. + Additional responsibilities assigned based on business need, including staffing an online chat platform. **Required Qualifications**… more
- 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
- 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
- Adecco US, Inc. (Bradenton, FL)
- …passionate professional to join our client's team! Position Name: **Membership Consultant ** Location: **Bradenton, FL** - 34209 Employment Type: Direct-Hire & ... - Monday-Friday: 8am-5pm - No: weekends **Requirements** - Several years of Medicare Sales and Community Relations experience. - Experience with Medicare … 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
- Stantec (Chandler, AZ)
- Benefits Consultant - ( 240004CC ) **Description** Grow with the best. Join a smart, creative, and inspired team that works to support operational excellence. The ... making our Company stronger. **Your Opportunity** We are looking for a Benefits Consultant specializing in compliance to join our HR Talent Services team! The… more
- Elevance Health (Roanoke, VA)
- … 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)** **Location** : Must reside...vary depending on the above factors as well as market/ business considerations. No amount is considered to be wages… more
- Elevance Health (Louisville, KY)
- … 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) - JR135927 **Location** :...They are how we achieve our strategy, power our business outcomes and drive our shared success - for… more
