- Lundbeck (Atlanta, GA)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/ Compliance ... transform lives. Join us on our journey of growth!As a Psychiatry Account Manager , you lead the promotion of our psychiatry portfolio, executing sales and marketing… more
- Lundbeck (Chicago, IL)
- …the way in creating positive customer experiences! As a BioPharmaceuticals Account Manager , you lead the promotion of our infusion product, driving demand creation ... internal and external partners and effectively addresses payer access issues ( Medicare , Medicaid, Commercial) using Lundbeck resources. Local Market & Therapeutic… more
- Lundbeck (Nyack, NY)
- …and transform lives. Join us on our journey of growth!As a Neuroscience Account Manager , this is an incredible opportunity to join the growing promotion of our CNS ... to promoted portfolio using Lundbeck resources. Utilize deep understanding of Medicare payer landscape in addition to other payer channels including Medicaid… more
- Merck & Co. (Sacramento, CA)
- …with the in-scope customer team: Customer Team Leader, Key Account Manager , Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, ... consider qualified applicants with arrest and conviction records for employment in compliance with the San Francisco Fair Chance Ordinance Los Angeles Residents… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Medicare Risk Adjustment Program Manager will be accountable for the ... role will facilitate appropriate communications and interface among the Medicare Product, Compliance , and Coding Integrity areas...and ensure program deliverables are achieved on time. The Medicare Risk Adjustment Program Manager will be… more
- CVS Health (Trenton, NJ)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... market performance, cost structure and local execution of medical costs management, compliance , and revenue integrity efforts for all Medicare Advantage products… more
- UCLA Health (Los Angeles, CA)
- Description As a key leader within Medicare Advantage Operations, the Senior Manager will be responsible for overseeing the strategic management and operational ... you will ensure the efficient and compliant operation of all Medicare Advantage activities, aligning with CMS regulations and internal organizational standards.… more
- CVS Health (Columbus, OH)
- …emphasizing whole-person wellness, and driving down costs. Aetna is hiring a local Broker Manager to support the growth of our industry leading Medicare business ... market strategy impacting the recruitment, onboarding, engagement, production, and compliance adherence of assigned independent broker base. Travel expectations… 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
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... direction from the Director of Quality, the Senior Program Manager ensures that the health plan is compliant with...all quality related obligations required by the Centers of Medicare and Medicaid Services (CMS), the Massachusetts Division of… 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
- AmeriHealth Caritas (Newtown Square, PA)
- …**Responsibilities:** Under the supervision of the Director of Care Management, the Manager of Care Management is responsible for the direct performance of Case ... Management Responsible for compliance with State and Federal laws and business plan...Directs the case management activities to comply with the Medicare Model for case management. 6. Develop and recommend… more
- Molina Healthcare (FL)
- …of clinical guidelines. + Facilitates integrated, proactive HCS management, ensuring compliance with state and federal regulatory and accrediting standards and ... collaboration to enhance the continuity of care + Functions as hands-on manager responsible for supervision and coordination of enterprise clinical policy to drive… more
- CVS Health (Des Moines, IA)
- …**This position must sit in Iowa.** CVS Health/Aetna is hiring a Broker Manager to support our growing Sales Organization. CVS Health/Aetna is working to transform ... whole-person wellness, and driving down costs. Aetna is hiring a local Broker Manager to support the growth of our industry leading eastern Iowa business. This… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...leve ls , quality of work output , in compliance with established CRH ' s policy and standards… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #266 Monday, December 2, 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
- Healthfirst (NY)
- **Duties & Responsibilities:** Support Medicare Retention Manager in overseeing and measuring a broad range of existing Medicare customer retention ... Activities including assignment, monitoring and measurement of both Core Product, Medicare Cost Savings and Age-In outreach programs Manage current Involuntary… more
- Corewell Health (Grand Rapids, MI)
- …administer all steps of the Pharmacy appeal and review processes for all Medicare products in a pleasant and expedient manner to ensure quality customer service ... and compliance with all legislative, regulatory and accreditation requirements. Assist...the member appeal and ALJ hearing processes for all Medicare products to thoroughly investigate appeal requests, leveraging critical… more
- Elevance Health (Costa Mesa, CA)
- ** Medicare Quality Management Health Planning Director Sr.** **Location:** This position will work in a hybrid model (remote and office). The ideal candidate will ... miles of one of our California Elevance Health PulsePoint locations. The ** Medicare Quality Management Health Planning Director Sr.** will be responsible for driving… more
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