- CVS Health (Southfield, MI)
- …working schedule of three days onsite per week in Southfield, MI The Sr. Compliance Manager is an experienced/career level compliance position that applies ... individual will work independently, as well as collaboratively, with internal senior level Medicare compliance and business teams that operate MMP and DSNP… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …and business partners. **Responsibilities** + Provide oversight of operational activities of Medicare Part D/EGWP programs + Ensure compliance with CMS rules ... minimum wage requirements. Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/12697/ manager -of- medicare -part-d-and-egwp-programs/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-NY-East… more
- The Cigna Group (Bluffton, SC)
- …across the business units. + Reports to the Part C Legal Compliance Manager ;*Monitors transactions and business processes associated with reconciling ... Responsible for Part C audit activities for the Cigna Compliance Department, with particular emphasis on Coding, Risk Adjustment and Coding Decisions. Collaborates… more
- Banner Health (AZ)
- …innovation to employment settings by including remote and hybrid opportunities. As a Senior Manager Sales Medicare , you will manage a small sales team and ... Sales Department and meet sales targets. The Sales Senior Manager works within the Banner Medicare program...results to appropriate management and leadership staff. 6. Ensure compliance with State and Federal laws, rules, regulations and… more
- Lowe's (Charlotte, NC)
- **Your Impact** The Care Manager is a telephonic medical case management position with emphasis on early intervention, return to work planning, coordination of ... treatment to an appropriate resolution. Apply medical treatment guidelines for future Medicare -covered expenses. The candidate will work directly for a Fortune 100… more
- Healthfirst (NY)
- **Duties and Responsibilities:** + Monitor experience under Healthfirst's Medicare line of business. + Provide support for annual Medicare bids for all ... analysis and other ad hoc analyses. + Research, evaluate and analyze Medicare market landscape. + Analyze product and segment performance, incorporating both… more
- The Cigna Group (Bloomfield, CT)
- This job posting encompasses two **Regional Medicare ** **Provider Contracting Senior Managers** serves as an integral member of the Network Development and Solutions ... Team, supporting the Northeast Region. This role reports to the Medicare Provider Contracting Regional Vice President. This role is a key contributor to the… more
- The Cigna Group (Nashville, TN)
- …about the role:** **SUMMARY:** Responsible for the execution of the Cigna Medicare strategy for local topline sales agencies, directly contracted agents, and broker ... excel. . Carry out appropriate sales activity standards as directed by their manager . Responsible for reporting their daily & weekly activities to ensure alignment… more
- Medical Mutual of Ohio (OH)
- …under general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare ... under general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare… more
- CareFirst (Owings Mills, MD)
- …**Experience:** 3 years' experience in project related field **Preferred Qualifications:** + Medicare Pharmacy experience + CMS Compliance experience + ... Medicare Prescription Payment Program standards and process knowledge + Project Management Professional Certification (PMP)Knowledge of Agile/Scrum methodology. **Knowledge, Skills and Abilities (KSAs)** + Proficient in Microsoft Office applications. +… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #266 Monday, October 7, 2024 Centers Plan for Healthy Living's goal is to create the ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and...performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling… more
- Corewell Health (Grand Rapids, MI)
- …Ensure compliance to CMS requirements and standards + Other projects assigned by Medicare Quality Manager and/or Director How Corewell Health cares for you + ... Job Summary The Medicare Quality Specialist, Pharmacy will assist the ...numbers, and performing data analysis to ensure accuracy and compliance + Assist members in understanding and navigating their… more
- The Cigna Group (Bloomfield, CT)
- …Proactively communicates with appellants, leadership team, providers and the original case manager to resolve investigation issues and to ensure the appeal is ... due date based on various regulations which dictate the compliance timeframes. This is a key step as incorrect...matrix partners to ensure accurate and timely processing of Medicare Appeals. + Support the implementation of new process… more
- The Cigna Group (Sunrise, FL)
- …conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst's responsibilities include: + ... provider group improvement plans autonomously, with expert-level technical support from manager . + Knowledge of quality and affordability metrics and tools;… more
- The Cigna Group (Denver, CO)
- …conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance External Representative's responsibilities include: + ... creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on strategic plans on growth, development, and vision… more
- The Cigna Group (Seattle, WA)
- …creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on strategic plans on growth, development, and vision ... for assigned territory. Participating with the Senior Manager / Manager in monthly financial review. + Assisting in initiatives and performing special projects and… more
- The Cigna Group (Atlanta, GA)
- …and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director, this individual ensures the effective performance management of ... leader for the local market. + Responsible for maintaining compliance to CMS and company policies and guidelines. +...members contribute to the growth and profitability of the Medicare Advantage business in their market in the following… more
- Point32Health (Canton, MA)
- …with healthcare program requirements. + **Collaboration:** At the direction of the Medicare Compliance Officer, collaborate with leadership and department heads ... who we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Compliance Senior Manager will report to the Government Programs … more
- CVS Health (Irving, TX)
- …(Scottsdale, AZ, Woonsocket, RI, Hartford, CT, Northbrook, IL, or Irving, TX) The Compliance Manager , FDR Oversight Program is an individual contributor career ... level position within Medicare Compliance who will execute operational and compliance program effectiveness reviews to support our FDR Oversight program. In… more
- MarketSource (Alpharetta, GA)
- 121666BRTitle: Compliance ManagerJob Description: Compliance Manager (Insurance) MarketSource Inc., an Allegis Group Company, develops and delivers innovative ... efforts. Essential Job Functions: * Design, implement, and lead the insurance compliance management strategy for the organization's Medicare Advantage sales… more
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