- LA Care Health Plan (Los Angeles, CA)
- Medicare Advantage Product Solutions Manager II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los ... strategic planning on product agnostic initiatives as well as strategic partnerships. Medicare : Required Medicare Advantage , with experience serving duals… more
- UCLA Health (Los Angeles, CA)
- …Ability to manage engagement within a 100% virtual work environment + Understanding of Medicare Advantage program rules and regulations + In-depth knowledge ... unit + Accountable for managing and leading the Care Concierge program Salary Range: $76,200 - $158,800/annually Qualifications We're seeking a self-motivated,… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. The ... Medicare Advantage Products Analyst plays an integral role in the...of plan benefit packages (PBPs), working with the Product Manager and market leadership to balance market competitiveness and… more
- Point32Health (Canton, MA)
- …a team environment. + Strong understanding of the managed care industry, preferably Medicare Advantage plans. + Experience in Product Development. + Experience ... at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have two main… 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 ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application… 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. Working under ... so claims can be processed. Works with lead or manager to implement changes.** + **Orients, trains, assists and...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Medical Mutual of Ohio (OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans ... remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** **Responsibilities** ** Medicare… more
- The Cigna Group (Sunrise, FL)
- …primary conduit to the providers and the individual that represents Cigna Medicare Advantage . The Provider Performance Enablement Lead Analyst's responsibilities ... Components** All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: +… 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. Facilitates and ... to work fully remote; Ohio residents preferred._** **Responsibilities** **Health Plan Quality Program Manager ** + Facilitates projects to increase Star Ratings… 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. Medical Mutual' ... their best possible health and quality of life. **Account Manager - Individual Market** Responsible for brokers sales results and...of the individual and senior markets including ACA, short-term, Medicare Supplement, Medicare Advantage and… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a VBC Program Manager WFH? At HCA Healthcare, you come first. HCA Healthcare has committed ... a difference. We are looking for a dedicated VBC Program Manager WFH like you to be...projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models; Medicare Advantage including HEDIS; and commercial payer… more
- LA Care Health Plan (Los Angeles, CA)
- …improvement programs. Analytics experience with Medicare Advantage , Medicare Fee-For-Service (FFS), Multipurpose Senior Services Program (MSSP) and ... Manager , Analytics Job Category: Accounting/Finance Department: Risk Adjustment...care claims Knowledge of Risk Adjustment models (eg CMS Medicare Advantage , HHS-HCC, Medicaid DxCG) Extensive knowledge… more
- 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
- 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 (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Under limited ... supervision, the RN Case Manager evaluates and provides support to members, their families,...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Atlantic Health System (Morristown, NJ)
- …of Medicare Risk Adjustment Files associated with Medicare Advantage plans. + Coordination and communication of program updates and opportunities ... payer lines of business + Engage in assessments of MSSP - Medicare Shared Savings Program participation as required by the ACOs. + Communicate and educate on… more
- The County of Los Angeles (Los Angeles, CA)
- MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS...program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum… more
- Medical Mutual of Ohio (Toledo, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Medical Mutual' ... **_The Case Manager II position allows you the flexibility to...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Elevance Health (Richmond, VA)
- …Impact:** + Manages the day-to-day operations of our 'Other' revenue programs in Medicare Advantage and Medicaid + Develops metrics, policies and procedures in ... **Title: Manager Government Business other revenue programs ( Manager...Overview:** Responsible for ensuring the overall success of our Medicare and Medicaid 'Other' Revenue programs with the intent… more
- TEKsystems (Loma Linda, CA)
- …plan, which is essential for the organization's operational integrity. The Compliance Program Manager will develop and implement ongoing compliance training ... procedures across the organization. In this role, the Compliance Program Manager will also be tasked with...hospital billing and coding requirements, particularly those related to Medicare and Medi-Cal, as well as knowledge of relevant… more
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