• Medicare Advantage Product

    LA Care Health Plan (Los Angeles, CA)
    Medicare Advantage Product Solutions Manager II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: ... net required to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for...product agnostic initiatives as well as strategic partnerships. Medicare : Required Medicare Advantage , with… more
    LA Care Health Plan (10/30/24)
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  • Senior Manager , Medicare

    Point32Health (Canton, MA)
    …+ Strong understanding of the managed care industry, preferably Medicare Advantage plans. + Experience in Product Development. + Experience with applicable ... are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have two… more
    Point32Health (11/08/24)
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  • Medicare Products Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …with Product team colleagues to support the development and execution of Medicare Advantage product strategy and corresponding benefits. The Analyst will ... Products Analyst plays an integral role in the product development of the Medicare Advantage...building of plan benefit packages (PBPs), working with the Product Manager and market leadership to balance… more
    Medical Mutual of Ohio (08/13/24)
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  • Medicare Program Manager III

    Centene Corporation (Cheyenne, WY)
    … Supplemental benefits including dental, vision and hearing + Support Medicare Advantage bid development to determine product and benefit changes in response ... service levels, and value by leading the dental, vision and hearing Medicare Product development through strategy development, identify opportunities, plan,… more
    Centene Corporation (09/20/24)
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  • Medicare MAP Advisor

    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 ... Advisor Primary Responsibilities: + Educate prospects on CPHL MAP product designed for Full Medicaid and Medicare ...issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application… more
    Centers Plan for Healthy Living (11/06/24)
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  • Medicare Regional Provider Contracting…

    The Cigna Group (Bloomfield, CT)
    …and sophisticated value-based reimbursements with hospitals and other providers for Cigna's Medicare product lines (eg, Hospital systems, ancillaries, and large ... and negotiating experience involving complex delivery systems and organizations required. Medicare Advantage experience required. + Experience with Physician,… more
    The Cigna Group (10/25/24)
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  • Actuarial Manager - Medicare Part C

    The Cigna Group (Austin, TX)
    …with cross functional teams and business partners. Performs actuarial analyses for Medicare Advantage business, including, but not limited to: medical expense ... analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) bid submissions,...on specific topics. + Provide guidance to stakeholders including product , finance and other groups in the organization. +… more
    The Cigna Group (10/25/24)
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  • Medicare Broker Manager - Las Vegas,…

    CVS Health (Carson City, NV)
    …- Travel as needed (majority within local area) **Preferred Qualifications** Experience with Medicare Advantage , SSI or Medicaid product sales or operations. ... will sit in the Las Vegas Nevada area** Aetna is looking for a Medicare Sales Broker Manager to join the Nevada sales team that drives and achieves sales results… more
    CVS Health (11/05/24)
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  • IT Project Manager (Core Systems)

    Medical Mutual of Ohio (Brooklyn, OH)
    …group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. IT Project Manager I Assists in leading ... status and track and report major issues. IT Project Manager II - III Manages enterprise projects and teams...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
    Medical Mutual of Ohio (09/04/24)
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  • Senior Manager , Compliance

    Point32Health (Canton, MA)
    …strategies, ensuring adherence to Federal Medicare and State requires related to Medicare Advantage and Prescription Drug Plans and Dual Programs (SCO and ... click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Compliance Senior Manager will report to the Government Programs Compliance Officer. This… more
    Point32Health (10/29/24)
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  • Actuarial Manager , Accountable Care

    CVS Health (Overland Park, KS)
    …key root-cause analyses, and manage the risk position of various value-based products ( Medicare Advantage , MSSP, ACO REACH).** **What will you do?** + Evaluate ... of relevant work experience -ASA or close to ASA required -Strong knowledge of Medicare Advantage products, ACO, MSSP, ACO REACH -High expertise in SQL,SAS,… more
    CVS Health (11/02/24)
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  • Manager , Acquisition Marketing - Group…

    Medical Mutual of Ohio (Brooklyn, OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Defines and ... multiple channels. . Maintains understanding of the brand and product strength in each region. . Analyzes the comprehensive...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
    Medical Mutual of Ohio (09/13/24)
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  • Manager , Grievance and Appeals, RN

    VNS Health (Manhattan, NY)
    …grievances and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health product lines. * Ensure Compliance: Stay ahead ... of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the daily operations...product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D, or Select… more
    VNS Health (09/04/24)
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  • Market Manager - Provider Relations…

    Trinity Health (Columbus, OH)
    …Day Shift **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... in Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** Market Manager - Provider Relations and Network Development is responsible for the… more
    Trinity Health (09/18/24)
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  • Senior Project Manager (Temporary…

    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. Depending on ... **Sr. Project Manager (temporary assignment)** **Location: Remote** Founded in 1934,...of project communications and work with project sponsors or product owners to resolve issues, address changes and identify… more
    Medical Mutual of Ohio (10/16/24)
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  • Manager , Medical Economics

    CVS Health (Overland Park, KS)
    …all four of Aetna's major lines of business (Commercial Group, Commercial Individual, Medicare Advantage , and Medicaid). This position will support a wide range ... across all four major lines of business (Commercial Group, Commercial Individual, Medicare Advantage , and Medicaid); this suite of reporting includes Executive… more
    CVS Health (11/07/24)
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  • Risk and Compliance - Healthcare - Senior…

    Robert Half (Boston, MA)
    …services or industry. + Knowledge of healthcare payer regulatory requirements, including Medicare Advantage . + Proficiency in Microsoft Office suite applications ... JOB REQUISITION Risk and Compliance - Healthcare - Senior Manager LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB DESCRIPTION You… more
    Robert Half (10/22/24)
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  • Manager Actuarial Analytics Commercial…

    Providence (CA)
    …designation + 7+ years of healthcare actuarial analytics experience working with Medicare Advantage pricing and bid development + Experience writing queries ... people, we must empower them._** **Providence Health Plan is calling a Manager Actuarial Analytics, Commercial who will:** + Be responsible for producing pricing,… more
    Providence (10/26/24)
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  • IS EDW Development Manager

    CareOregon (Portland, OR)
    …Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title IS Development Manager - EDW Job Code A1119 Exemption Status Exempt Management Level Manager ... + Participates in long-term systems architecture planning specifically to take advantage of new cloud technologies, to resolve challenges encountered today and… more
    CareOregon (11/08/24)
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  • Compliance Manager HMSA

    Magellan Health Services (Honolulu, HI)
    …Requirements Responsibilities Knowledge of HIPAA, federal and state regulatory processes. Medicare Advantage and/or Medicaid managed care experience preferred ... Serves as the compliance and privacy manager for assigned areas of the company or...from diverse operational groups and organizations into a written product . Excellent verbal and written communication skills. 5-8 years… more
    Magellan Health Services (10/16/24)
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