• Medical Director - Regulated Medicare

    CVS Health (Hartford, CT)
    …Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan ... Bring your heart to CVS Health . Every one of us at CVS ...care resources. **This is a remote based (work at home ) based anywhere in the US.** Responsibilities of this… more
    CVS Health (01/22/25)
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  • Medicare Specialist (HHS)

    Walworth County (Elkhorn, WI)
    …and assistance with set-up/planning as needed. Perform home visits to home bound consumers regarding SeniorCare or Medicare Part D issues, including ... Medicare Specialist (HHS) Print (https://www.governmentjobs.com/careers/walworthco/jobs/newprint/3201106) Apply  ...Elkhorn, WI Job Type Casual Job Number 2021-00139 Department Health & Human Services Division Aging & Disability Resource… more
    Walworth County (01/11/25)
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  • Sr Vice President, Medicare

    CareOregon (Portland, OR)
    …Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Sr Vice President, Medicare Department Medicare Administration Exemption Status Exempt Requisition # ... 24745 Direct Reports Medicare Leadership Team Manager Title Chief Financial Officer Pay...OHA, contractual and other requirements. + Promotes innovation, process review and continual improvement. + Maintains a deep understanding… more
    CareOregon (12/17/24)
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  • Medicare Sales Field Agent - CarePlus…

    Humana (Fort Lauderdale, FL)
    … Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... consumers. **_Face to face interactions in a prospective members' home are a requirement for this position._** **Use your...help people with Medicare , or both Medicare and Medicaid, achieve their best possible health more
    Humana (12/13/24)
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  • Senior Manager, Medicare Sales

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** Are you passionate about the Medicare population, looking for a role in management with ... Medicare Sales motivates and drives a team of Medicare Sales Field Agents who sell individual health...provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work… more
    Humana (01/17/25)
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  • Medicare Advantage Provider Operations…

    The Cigna Group (Bloomfield, CT)
    …team meets all deliverables and milestones supporting the Annual Readiness process for Medicare and Medicaid. + Review MA Provider Operations systems and ... Nashville, TN, Chicago, IL, Richardson, TX** Willing to consider Remote/Work from Home for the right candidate.** Ability to travel up to 25%.** **OVERVIEW:**… more
    The Cigna Group (01/23/25)
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  • Proposal Development Professional - Group…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Group Medicare Proposal Development Professional reviews solicitations and prepares ... to effectively manage multiple activities + Experience with public sector contract review + Project Management experience + Group Medicare experience is… more
    Humana (01/03/25)
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  • Chief Medical Officer, Medicare

    VNS Health (Manhattan, NY)
    …and advancement opportunities What You Will Do * Provides oversight of VNS Health Plans clinical components for utilization review and decision making.* Leads ... on issues related to Fraud, Waste, and Abuse of Medicare /Medicaid services.* Collaborates with pharmacy services to review...of care begins with you. Together, we will revolutionize health care in the home and community.… more
    VNS Health (11/20/24)
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  • Quantitative Research Associate ( Medicare

    Abt Global Inc. (Rockville, MD)
    …desire to grow their career and their experience conducting research on post-acute care, nursing home health care policy, and health care claims data to play ... systems for nursing homes or other post-acute care settings, health care policy. + Use Medicare claims...Demonstrated expertise and desire to further develop expertise in health care research, particularly related to nursing home more
    Abt Global Inc. (01/23/25)
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  • Medicare Sales Field Agent - Eastern Texas…

    Humana (Tyler, TX)
    …field sales community events, as well as, visiting prospects in their homes. Our ** Medicare Sales Field Agents** sell individual health plan products and educate ... part of our caring community and help us put health first** Total compensation package (base pay +commission with...on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in… more
    Humana (10/29/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Columbus, OH)
    …leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab + Must be passionate about contributing ... **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The… more
    Humana (01/07/25)
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  • Medical Director- Medicare (Licensed in CA)

    Molina Healthcare (San Bernardino, CA)
    Medicare . **PREFERRED EDUCATION:** Master's in Business Administration, Public Health , Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… more
    Molina Healthcare (12/07/24)
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  • Patient Account Representative - Medicare

    Guidehouse (Lewisville, TX)
    …Chris Rivera (Manager, Talent Acquisition) at ###_** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + ... Leave + 401(k) Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term &… more
    Guidehouse (11/03/24)
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  • Home Health Liaison

    BAYADA Home Health Care (Honolulu, HI)
    …allow you to make a difference in people's lives while you grow your career? We're **BAYADA Home Health Care** , a leading home health care company-and ... we believe that our clients and their families deserve home health care delivered with compassion, excellence,...of BAYADA. + Demonstrate mastery of clinical and regulatory home care eligibility criteria. + Review all… more
    BAYADA Home Health Care (01/15/25)
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  • Home Health Sales Associate

    BAYADA Home Health Care (Colorado Springs, CO)
    …benefits of BAYADA. + Demonstrate mastery of clinical and regulatory home health care eligibility criteria. + Review all medical documentation and work with ... people's lives while you grow your career? We're **BAYADA Home Health Care** , a leading ...of strong interpersonal skills. + Demonstrated knowledge of the Medicare COPs and other program requirements, as applicable. +… more
    BAYADA Home Health Care (12/24/24)
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  • Transitional Care Manager, Home

    BAYADA Home Health Care (Philadelphia, PA)
    BAYADA Home Health Care, in partnership with...of BAYADA. + Demonstrate mastery of clinical and regulatory home care eligibility criteria. + Review all ... families at designated facilities to coordinate the initiation of home health care services. Are you looking...of strong interpersonal skills. + Demonstrated knowledge of the Medicare COPs and other program requirements, as applicable. +… more
    BAYADA Home Health Care (11/08/24)
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  • Home Health RN Nurse Manager

    BAYADA Home Health Care (Canton, MA)
    … Care is seeking a Registered Nurse (RN) to fill the position of ** Home Health Nurse Manager** for our **Canton, MA** Medicare Certified home health ... program + To learn more about BAYADA Benefits, click here (https://www.bayada.com/benefits/) **As a Home Health Nurse Manager your day may look like this!** +… more
    BAYADA Home Health Care (01/17/25)
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  • RN Home Health Nurse Manager

    BAYADA Home Health Care (Wilmington, MA)
    …Care is seeking a Registered Nurse (RN) to fill the position of ** Home Health Nurse Manager** for our **Wilmington, MA** Medicare Certified home ... employee assistance program. + Field mileage reimbursement. **As a Home Health Nurse Manager your day may...cohesive and consistent management of all field staff. + Review all clinical documentation to ensure consistent, accurate, high-quality… more
    BAYADA Home Health Care (11/12/24)
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  • RN Home Health Associate

    BAYADA Home Health Care (Nashua, NH)
    …the position of **Clinical Associate** for our **Nashua, NH (relocating to Derry, NH)** Medicare Certified home health office. **Why choose BAYADA?** + ... BAYADA Home Health Care is seeking a...BAYADA Home Health Care is seeking a Registered Nurse (RN)...cohesive and consistent management of all field staff. + Review all clinical documentation to ensure consistent, accurate, high-quality… more
    BAYADA Home Health Care (11/29/24)
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  • Home Health Nurse Staff Educator

    Acute Home Healthcare (Orlando, FL)
    …+ All Elements of Oasis Documentation + Medicare Programs ( Home Health Value Based Purchasing, Pre-Claim Review ) + CMS and Other Regulatory Resources + ... Home Healthcare Clinical and Business Operations + Medicare and Insurance Billing Processing + Reviewing Patient Charts...+ Licensed RN + Minimum 5 years Experience in Home Health + Minimum 2 years Experience… more
    Acute Home Healthcare (01/09/25)
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