• Corporate Compliance ( Medicare Duals)…

    CVS Health (Southfield, 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...located in the state of Michigan The Sr. Compliance Manager is an experienced/career level compliance position that applies… more
    CVS Health (12/05/24)
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  • Medicare Advantage Product Solutions…

    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, ... (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by...to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product… more
    LA Care Health Plan (10/30/24)
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  • Senior Manager , Medicare Product…

    Point32Health (Canton, MA)
    …years of related business experience with three to five years of experience with Medicare insurance products required. At least two years of CMS bid development ... are reviewed and ready for bid filing in CMS' Health Plan Management System (HPMS). The Senior Manager...of each market. All responsibilities extend to any new Medicare markets should Point32Health choose to expand its footprint… more
    Point32Health (01/03/25)
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  • Medicare Broker Manager - Las Vegas,…

    CVS Health (Carson City, NV)
    Bring your heart to CVS Health . Every one of us at CVS ...Las Vegas Nevada area** Aetna is looking for a Medicare Sales Broker Manager to join the ... 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 more
    CVS Health (11/05/24)
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  • Utilization Management Manager

    UCLA Health (Los Angeles, CA)
    …your career to the next level. You can do all this and more at UCLA Health . As a Manager for Medicare Advantage Utilization Management, you'll provide direct ... Description Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take… more
    UCLA Health (11/22/24)
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  • Medicare Quality Specialist Pharmacy

    Corewell Health (Grand Rapids, MI)
    …CMS requirements and standards + Other projects assigned by Medicare Quality Manager and/or Director How Corewell Health cares for you + Comprehensive ... Job Summary The Medicare Quality Specialist, Pharmacy will assist the ...member outreach calls, scheduling appointments, and assisting members with health benefit questions. Additionally, this role will require collaboration… more
    Corewell Health (12/10/24)
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  • Sr Mgr, Medicare Business Analytics - FEP

    CVS Health (Columbus, OH)
    …Program (FEP) is one of the largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr. Manager provides technical, analytical and business ... 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 more
    CVS Health (12/21/24)
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  • Medicare Pharmacy Coordinator

    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
    Medical Mutual of Ohio (12/20/24)
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  • Senior Medicare Compliance Analyst

    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 (11/27/24)
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  • Medicare Products Analyst

    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 ... 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 (11/12/24)
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  • Senior Director Medicare Ops

    Banner Health (AZ)
    …of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work ... for ensuring cross-organizational collaboration of operational teams within the Banner Insurance Division, specifically with Banner Population Health Service… more
    Banner Health (12/15/24)
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  • Patient Account Representative - Medicare

    Guidehouse (Lewisville, TX)
    …at ###_** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative** is an extension of a...Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending… more
    Guidehouse (11/03/24)
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  • Medicare D Billing Representative

    BrightSpring Health Services (Arlington, TX)
    …+ Benefitsstart on the 1st day of the month following 30 days of employment ( Health , dental, vision, and life insurance ). + Mileage Reimbursement- We cover your ... Competitive Pay- Your skills are rewarded. + Company-Paid Disability Insurance - Both short-term and long-term. + 401k Plan- Secure...hour as determined by the Director and Clinical Hub Manager + Provide clinical support to members of the… more
    BrightSpring Health Services (12/24/24)
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  • Manager , Actuary

    VNS Health (Manhattan, NY)
    …for Medicare and Medicaid Services (CMS), National Association of Insurance Commissioners (NAIC), Department of Health (DOH), rate reviewers, auditors, ... OverviewVNS Health Medicare Advantage experiences accelerated year-over-year...of paid time off and 9 company holidays + Health insurance plan for you and your… more
    VNS Health (12/13/24)
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  • Contract Negotiation Manager - Behavioral…

    CVS Health (Olympia, WA)
    …handles dispute resolution and settlement negotiations with solo and group Behavioral Health providers for all lines of business ( Medicare , commercial etc.). ... quality, availability, and financial goals and strategies for all lines of business ( Medicare , commercial etc.). + Recruits Behavioral Health providers as needed… more
    CVS Health (12/03/24)
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  • Clinical Manager - Home Health

    VNA Health (Santa Barbara, CA)
    …managed appropriately as well as the supervision of the clinical team. The Clinical Manager ensures that all home health services to newly admitted and active ... accordance with state regulations and as required by the Medicare Conditions of Participation. The Clinical Manager ...ensure optimal coordination of care for all active Home Health cases. The Clinical Manager assists in… more
    VNA Health (11/26/24)
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  • RN- Home Health Clinical Manager

    BAYADA Home Health Care (Morristown, NJ)
    **BAYADA Home Health Care** is currently seeking a full-time **Registered Nurse, RN,** to fill the position of **_Clinical Nurse Manager_** in our office located in ... Morristown, NJ **.** As Nurse Manager you will lead the field staff in client...the care provided by a multi-disciplinary team of home health care professionals + Management and mentoring of Clinical… more
    BAYADA Home Health Care (12/18/24)
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  • Case Manager , D-SNP, Health Plan

    Sanford Health (Bismarck, ND)
    …full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance , dental insurance , vision insurance , life ... care and services across the continuum of care. Case Manager , D-SNP will conduct a timely Health ... and/or discharge planning preferred. Experience working with the Medicare and Medicaid populations is preferred. Currently licensed with… more
    Sanford Health (12/16/24)
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  • Supervisory Health Insurance

    Centers for Medicare & Medicaid Services (Woodlawn, MD)
    …(FSG), Division of Medicare Secondary Payer Operations (DMPO). As a Supervisory Health Insurance Specialist, GS-0107-15, you serve as the Director of DMPO ... and procedures for coordinating Medicare benefits with primary and secondary health insurance benefits; and 3) Providing technical expertise in advising CMS… more
    Centers for Medicare & Medicaid Services (12/20/24)
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  • Case Manager RN, Home Health

    Sutter Health (Alameda, CA)
    …+ Thorough understanding of home care and/or hospice services, Title XXII, Medicare Conditions of Participation, CHAP home health and/or hospice accreditation ... are so glad you are interested in joining Sutter Health ! **Organization:** SCAH-Sutter Care at Home - Bay **Position...The Primary Care Clinician reports directly to the Clinical Manager as do the other members of the interdisciplinary… more
    Sutter Health (12/11/24)
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