- Highmark Health (Harrisburg, PA)
- …in the use of user interfaces, predicative analytic tools, and other population health management tools endorsed by Highmark. + Independently and autonomously ... STARS, Medicaid HEDIS, risk revenue value streams, and population health management **Preferred** + 7 years in...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996… more
- Elevance Health (Columbus, OH)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit ... **Audit & Reimbursement III - Medicare Cost Report Audit** **_Locations:_** _This is a...is a proud member of Elevance Health 's family of brands. We administer… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- …for the development and management of adult living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central ... Pennsylvania, Indiana, West Virginia, Virginia, and Maryland. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services… more
- CVS Health (Hartford, CT)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...more personal, convenient and affordable. **Position Summary** As the Medicare Reporting Lead Director, you will be responsible for… more
- CVS Health (Salt Lake City, UT)
- …+ Responsibility for the management and organization of plan activities at the health plan as it relates to the Medicare business. + Monitoring the budget ... in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health 's unrivaled… more
- Medical Mutual of Ohio (OH)
- …and experience. + 3 years of experience with government health insurance programs which includes exposure to Medicare Advantage, MA compliance protocols, ... experience in Medicare sales compliance or equivalent experience with government health insurance programs which includes exposure to Medicare Advantage,… more
- UCLA Health (Los Angeles, CA)
- …* 3-5 years of experience in healthcare program management , ideally within a Medicare Advantage plan or health insurance setting, preferred * In-depth ... that will play a pivotal role in driving the success of key initiatives for the UCLA Health Medicare Advantage Health Plan. In this role, you will: * Oversee… more
- CVS Health (Lansing, MI)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...analytical and communication skills to support, manage and develop Medicare and Medicaid compliance programs and processes that promote… more
- RWJBarnabas Health (Oceanport, NJ)
- Quality Officer III ( Medicare )Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding ... integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical thinking and a higher...& Long Term Disability + Life & Accidental Death Insurance + Tuition Reimbursement + Health Care/Dependent… more
- Corewell Health (Grand Rapids, MI)
- …professional with a passion for accuracy and collaboration? Join our team as a Medicare Premium Management Coordinator Associate and play a vital role in ... 1 year of relevant experience in a billing, account management , or finance related field Preferred + Associate's Degree...Business/Finance + 1 year of relevant experience in the health care or heath plan industry About Corewell … more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health . As a Manager for Medicare Advantage Utilization Management , you'll provide direct management to a team of UM ... coordinators and nurses. You'll work closely with Medicare Advantage leadership to plan, execute, and manage various...experience in an HMO environment + Thorough knowledge of health care industry, utilization review, utilization management ,… more
- Medical Mutual of Ohio (Brooklyn, OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million ... of the Medicare Advantage. This role supports Medicare product management by evaluating data trend...million Ohioans. We're not just one of the largest health insurance companies based in Ohio, we're… more
- CVS Health (Columbus, OH)
- …**Position Summary** The Federal Employee Program (FEP) is one of the largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr. Manager ... Bring your heart to CVS Health . Every one of us at CVS ...new programs, benefits, processes, and technology are deployed, the Medicare Business Analytics - FEP - Sr. Manager incorporates… more
- Walworth County (Elkhorn, WI)
- …PAYMENT: Hourly. VACATION: Not eligible. SICK LEAVE: Not eligible. HOLIDAYS: Not eligible. INSURANCE : Health Insurance : Not eligible. Dental Insurance : ... 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
- Medical Mutual of Ohio (Brooklyn, OH)
- …Ohio._** Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....million Ohioans. We're not just one of the largest health insurance companies based in Ohio, we're… more
- Medical Mutual of Ohio (OH)
- …of mind to more than 1.2 million Ohioans. We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in ... remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** **Responsibilities** ** Medicare… more
- CVS Health (Salem, OR)
- …in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience ... Bring your heart to CVS Health . Every one of us at CVS ...of this Medical Director role are related to Regulated Medicare Appeals: * Direct daily work on part C… more
- AdventHealth (Altamonte Springs, FL)
- …+ Experience in analytics with emphasis in healthcare and/or clinical application and health insurance finances + Experience in risk adjustment **_EDUCATION AND ... **Senior Medicare Data & Finance Analyst** **Location:** Virtual **All...ventures. This role will include leveraging data from electronic health records, claims, and payer reports by means of… more
- Centene Corporation (Jefferson City, MO)
- …government contract law, health law and managed care preferred Knowledge of Medicare and/or Medicaid insurance , state insurance and HMO regulations ... lead Corporate Counsel on projects and certain matters. **For Health Plan Operations and Medicare :** + Serves...Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans,… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Advantage Product Solutions Manager II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, ... (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by...of product and enterprise goals. The position works with management , business owners and other key stakeholders to develop… more
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