- Highmark Health (Buffalo, NY)
- …are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... CPT and CPT (II), and HCPCS coding systems + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications + Knowledge of HIPAA… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Specialist, you will be responsible for: + Serving as a Subject Matter Expert (SME) ... or more years of health plan experience, highly desired + Knowledge of Medicare Advantage , STARS/HEDIS program, and NCQA technical specifications + Knowledge and… more
- UCLA Health (Los Angeles, CA)
- …level. 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 initiatives related to UM administrative,… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. This position ... of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and Medicare Supplement products. Reporting directly to the Chief… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process + Ensures prospective members are… more
- UCLA Health (Los Angeles, CA)
- …Senior Product Manager to lead the design, development, and implementation of our Medicare Advantage products. In this role, you'll partner with the Director ... and compliance throughout the member lifecycle. Key Responsibilities: + Lead end-to-end Medicare Advantage product development. + Support and help manage the… more
- Humana (South Miami, FL)
- …Based Role:** + **Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and ... Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help… more
- BrightSpring Health Services (Bowling Green, KY)
- …of Business Abilis Health Plan, an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare ... Abilis Health Plan Overview * Abilis Health Plan was formerly Signature Advantage * We are seeking a Sales Account Representative/Executive for our Abilis Health… more
- CVS Health (Concord, NH)
- …of medical costs management, compliance, and revenue integrity efforts for all Medicare Advantage products (inclusive of collaborating with the Employer Group ... every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in their market, supporting… more
- Erickson Living (Tinton Falls, NJ)
- …benefits. + Be knowledgeable of all applicable CMS regulations and guidelines of specific Medicare Advantage Plans. + Create sales events intended to allow new ... Village by Erickson Senior Living We are hiring a Medicare Sales Agent, also known as our Health Insurance...and their families on matters pertaining to the Erickson Advantage Health Plan and insurance matters in general. Erickson… more
- Dignity Health (Phoenix, AZ)
- …(MCO) is responsible for developing, implementing, and overseeing the compliance program for Medicare Advantage (Part C) and Medicare Part D activities ... This position will maintain day-to-day operational alignment with the Mercy Care Medicare team while holding direct reporting accountability to the Chief Executive… more
- Henry Ford Health System (Traverse City, MI)
- …and planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for ... SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting...years of successful health insurance sales experience in the Medicare market. + Minimum of three (3) years of… more
- Centene Corporation (Cheyenne, WY)
- …role in shaping the annual budget and quarterly financial forecasts across all 32 Medicare Advantage markets. + **Collaborative Team Culture** : Join a group ... and are looking to continue growing their actuarial career in ** Medicare financial forecasting, actuarial analyses, and bid support.** **Location:** Applicants for… more
- CVS Health (Chicago, IL)
- …priorities and deadlines **Preferred Qualifications** + Prior Pharmacy, Part D, or Medicare Advantage experience + ASA **Education** + Bachelor's Degree ... is primarily responsible for modeling pharmacy network contracting arrangements for Aetna's Medicare Part D business and providing actuarial support to key business… more
- Fallon Health (Worcester, MA)
- …external SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage , Medicare Supplement, NaviCare, Summit Elder Care, ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
- Centene Corporation (Harrisburg, PA)
- …+ Identify prospective enrollees and determine eligibility for participation in the Advantage Medicare product + Understand and apply all policies and ... procedures pertaining to: Disclosures and provisions of the Advantage Medicare product, enrollment and disenrollment + Develop a presence in the local community… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does ... offices and/or conferences and exhibits. + Staff dedicated to supporting Medicare Advantage must have working knowledge of Medicare enrollment guidelines… more
- Lifespan (Rochester, NY)
- …knowledge of Medicare and Medicare related insurance such as Medicare Advantage plans and Medigap Supplementals. . Working knowledge of community ... implement strategies. . Public Education:Schedule presentations and outreach on Medicare , Part D, Advantage plans, and ...presentations and outreach on Medicare , Part D, Advantage plans, and Medicare assistance Programs. .… more
- Humana (Lincoln, NE)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will ... Utilization management experience in a medical management review organization such as Medicare Advantage , managed Medicaid, or Commercial health insurance +… more
Related Job Searches:
Advantage,
Assistant Director Medicare Advantage,
Manager Medicare Advantage Sales,
Medicare,
Medicare Advantage Actuarial Analyst,
Medicare Advantage Plan Sales,
Medicare Advantage Product Manager,
Medicare Advantage Provider Performance,
Medicare Advantage Quality Consultant,
Medicare Advantage Risk Adjustment