- The Joint Commission (Oakbrook Terrace, IL)
- …Provides on-site consultation, education and technical assistance in the provision of CMS content area (including all types of Federal surveys), federal ... organizations or other clients, emphasizing practical approaches in the provision of CMS content area (including all types of Federal surveys), federal… more
- General Dynamics Information Technology (Fairfax, VA)
- …to make a personal impact as a **Program Director** supporting the Center for Medicare & Medicaid Services ( CMS ) A large federal healthcare payer. GDIT is ... years of experience leading technical and business requirements and system implementations + 10+ years of project management...continuous improvement + Health Care Industry or Centers for Medicare and Medicaid Services ( CMS ) experience (5-7… more
- General Dynamics Information Technology (Fairfax, VA)
- …to make a personal impact as a **Data Engineer Advisor** supporting the Center for Medicare & Medicaid Services ( CMS ) A large federal healthcare payer. GDIT is ... Engineer Advisor** performs integration of complex large-scale hardware, software, and system architecture components to ensure reliable and sustainable operation of… more
- Medical Mutual of Ohio (OH)
- …reply report review and validating manufacturer labeler code updates in the PBM system . . Supports Medicare Plan Finder processes for validating DestinationRx ... a health plan, pharmacy, or PBM operations, which includes exposure to Centers for Medicare & Medicaid Services ( CMS ) guidelines, preferably Part D. . Certified… more
- General Dynamics Information Technology (Fairfax, VA)
- …make a personal impact as a **Principal Solutions Architect** supporting the Center for Medicare & Medicaid Services ( CMS ) A large federal healthcare payer. GDIT ... of the project, help with complex security requirements capture, solutions architecture, system design, and technical project management In this role, you… more
- Carle (Urbana, IL)
- …and answering questions on statutory requirements, regulatory requirements, and Centers for Medicare and Medicaid Services ( CMS ) related to the Medicare ... Advantage, or Part D experience. SKILLS AND KNOWLEDGE Knowledge of Medicare regulations and CMS guidelines. Ability to research specific internet web sites to… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services ( CMS ) and company policies and regulations. The ... + AHIP certified + Computer/technology literacy + Compliant with CMS and CPHL policies. + Follow CPHL, CMS...CPHL sites located throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare … more
- Centene Corporation (Austin, TX)
- …million members. **Position Purpose:** This position will be a member of Medicare & Compliance Senior Leadership, chairs Centene's Medicare Compliance Committee, ... with a commitment to service leadership. + Leading the Medicare Compliance team with a collaborative mindset and demonstrated...that data and other information and materials submitted to CMS are accurate and in compliance with CMS… more
- CVS Health (Boston, MA)
- …The Coordinator will assist in ensuring CVS compliance to Centers for Medicare and Medicaid ( CMS ) requirements, resulting in successful claim processing ... convenient and affordable. **Job Description Summary** The primary responsibility of the Medicare Part B Operations Coordinator is to support activities related to … more
- Medical Mutual of Ohio (Brooklyn, OH)
- …the product development of the Medicare Advantage. This role supports Medicare product management by evaluating data trend experience, creating data ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....work on product and benefit design during the annual CMS Bid cycle and act as a key member… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Medicare Quality Specialist, Pharmacy will assist the Medicare Adherence Pharmacists Team to improve Medicare Star Ratings and CAHPS by ... internal and external partners, assisting with the administration of Medicare programs, and other projects assigned to support the...health benefits and refer to appropriate teams (eg, Care Management , mail order) when necessary + Assist with the… more
- Wider Circle (CA)
- …Scope of Appointment, the presentation of the product, sales conversion and relationship management of a Medicare beneficiary * Daily tasks include completing a ... a fast-growing boutique insurance agency focused on helping people understand their Medicare Benefits. We work with underserved populations to help them navigate … more
- Centene Corporation (Cheyenne, WY)
- …Master's degree preferred. + 5+ years project implementation, product or program management experience. + Medicare Supplement Benefits (Dental, Vision, Hearing) ... levels, and value by leading the dental, vision and hearing Medicare Product development through strategy development, identify opportunities, plan, organize,… more
- CVS Health (Southfield, MI)
- …limited to: * Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals and applicable Medicaid rules including risk ... business, analytical and communication skills to support, manage and develop Medicare and Medicaid compliance programs and processes that promote compliant and… more
- CVS Health (Nashville, TN)
- …+ Ensuring that the relevant information is captured in Customer Relationship Management system (CRM) + Other duties as assigned. **Accountabilities** : ... an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part...and standards with a robust knowledge with respect to CMS and states regulations. + Ability to multitask, and… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …ProAct. Responsibility for the understanding and compliance of benefit designs, system management of formularies, eligibility, claims and payment, ... and/or EGWP programs.** **Scope of Responsibilities:** Provides oversight and management of Medicare Part D/EGWP program. **Job...Medicare Part D/EGWP programs + Ensure compliance with CMS rules and regulations surrounding Medicare Part… more
- The Cigna Group (Morris Plains, NJ)
- …requires the following core skills to be successful: + Executive Presence + Medicare Expertise + Communication + Relationship Management + Strong strategic ... **POSITION SUMMARY** The Medicare Client Strategy Senior Manager is accountable for...as work cross functionally with research, sales and account management , client and patient services and other functional areas… more
- USAA (Tampa, FL)
- …implementation of business processes. This role will involve execution of any Issue Management matters for Medicare Supplement claim issues. As business process ... settlements + Knowledge of process, procedures and requirements related to Centers for Medicare & Medicare Services ( CMS ) + Extensive experience working… more
- The Cigna Group (Bloomfield, CT)
- …provider, client and customer relations, contracting or national ancillary account management environment. + Experience with Medicare Advantage, Cigna ... The **National Ancillary & Non-par Management (NANPM) Senior Advisor** role is a critical...40% of Cigna's total medical cost savings. The **NANPM Medicare Senior Advisor** is responsible for negotiating Medicare… more
- The Cigna Group (Bloomfield, CT)
- …Enablement team is responsible for developing solution changes for the ongoing needs of CMS Medicare Risk Adjustment processes and systems. The ** Medicare ... all Risk Adjustment overpayments including: identification, actuarial valuation, submission to CMS , processing by CMS , and reconciliation. + Answering questions… more