- UCLA Health (Los Angeles, CA)
- …relationship-building skills with clinical and non-clinical personnel + Knowledge of the Medicare Advantage STARS program and NCQA technical specifications ... all this and more at UCLA Health. As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects while… more
- The Cigna Group (Birmingham, AL)
- …group contracting and negotiations** + **Experience with Healthcare - Commercial and Medicare Advantage ** + Experience in developing and managing key provider ... Alabama/Mississippi Market. Must live in either Alabama or Mississippi._** The ** Manager , Provider Contract Network Management** serves as an integral member of… 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
- Martin's Point Health Care (Portland, ME)
- …(LIS). + Coordinates Part D benefit training for plan staff with regard to annual Medicare program pharmacy benefit changes and on an as needed basis as Part ... most major insurance plans. Martin's Point also administers two health plans: Generations Advantage ( Medicare Advantage plans available throughout Maine and… more
- State of Indiana (Indianapolis, IN)
- …is fully engaged with this mission. Role Overview: In this role, Medicaid/ Medicare Coordination Manager , you will establish priorities, targets, and deadlines ... the subject matter expert on dually-eligible individuals, staying breast of Medicare /Medicaid policy and program innovations, current research and opportunities… more
- The Cigna Group (Baltimore, MD)
- …Components** All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: + ... with STARS, HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage required + Required - Microsoft Outlook, Excel, PowerPoint,… more
- The Cigna Group (Tampa, FL)
- A member of the Cigna Medicare Business Operational Excellence Process Engineering team. This role will lead, facilitate, and drive business process engineering ... goals that will lead to providing Cigna a competitive advantage + Provide constant, ongoing communication to ensure barriers/obstacles...leading a team of professionals, either as a direct manager or as a cross organizational team leader +… more
- InnovaCare (San Juan, PR)
- …provider of healthcare management in North America. Through two it's main ways, Medicare Advantage and the provider network, we are committed to healthcare, ... passion and customer focus to the business. The Care Manager is responsible to assess all referred cases, plan,...that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries, through Medicare … 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' ... **_The Specialty Account Manager is a Hybrid position (3-days in office)...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 ... for AMG specific programs + Monitor cross- program performance of quality results within value-based programs and...and identify trends and opportunities for improvement. + Monitor program renewal and reconciliation schedules + Track overall … more
- Point32Health (Canton, MA)
- …click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Lead Compliance Program Manager will be responsible for development, implementation ... as external stakeholders including government regulators and auditors. The Lead Compliance Program Manager will be responsible for collaborating with leadership,… more
- Trinity Health (Columbus, OH)
- …**Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... health insurance industry specific to sales and marketing roles (related to Medicare Advantage or another government-related insurance line) + Experience… more
- Centers Plan for Healthy Living (Bronx, NY)
- …working weekends and requires frequent travel to various Centers Plans or Healthy Living Advantage Care Medicare HMO Plan sites located throughout the five (5) ... and performing all required tasks assigned by the Sales Manager . Incumbent will be responsible for educating and enrolling...Territory Management + Maintain Centers Plans for Healthy Living Advantage Care Medicare HMO Plan visibility in… 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 ... manage people + This role reports to this job: MANAGER , PROVIDER REIMBURSEMENT + Necessary Contacts: In order to...and/or conferences and exhibits. + Staff dedicated to supporting Medicare Advantage must have working knowledge of… more
- CareFirst (Baltimore, MD)
- …analytics needs of the business and market with a focus in commercial and Medicare Advantage markets. Provides thought leadership and acts as a subject matter ... adequacy and utilization of CareFirsts Sales Enablement tools across commercial and Medicare Advantage lines of business. Ensure network and medical management… more
- LA Care Health Plan (Los Angeles, CA)
- …well as strategic partnerships inclusive of entry onto the Covered CA market. Medicare : Required Medicare Advantage , with experience serving duals ... Product Solutions Manager II Job Category: Administrative, HR, Business Professionals...population. Direct experience in Medicare and Duals program administration including stars,… more
- MarketSource (Alpharetta, GA)
- …implement, and lead the insurance compliance management strategy for the organization's Medicare Advantage sales program including carrier compliance, and ... 121666BRTitle:Compliance ManagerJob Description: Compliance Manager (Insurance) MarketSource Inc., an Allegis Group Company, develops and delivers innovative managed… more
- New York State Civil Service (Tupper Lake, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Property Manager 1 Occupational Category Administrative or General Management Salary Grade 18 ... State NY Zip Code 12986 Minimum Qualifications NON-COMPETITIVE MINIMUM QUALIFICATIONS: Property Manager Trainee 1: a bachelor's or higher degree. Property Manager… more
- Ciena Healthcare (Columbus, OH)
- …billing of all payer classes for claims generated by facility. + Review the Medicare , Managed Care, Medicare Advantage and Medicaid UB, CHAMPS, WebDenis ... Are you a business office manager with experience in skilled nursing accounts receivable?...+ Legacy,our new virtual community and rewards & recognitions program When you work with Laurel Health Care Company,… more
- Ciena Healthcare (Ovid, MI)
- …billing of all payer classes for claims generated by the facility. + Review the Medicare , Managed Care, Medicare Advantage and Medicaid UB, CHAMPS, WebDenis ... Are you a business office manager with experience in skilled nursing accounts receivable?...+ SPOTLIGHT, our virtual community and rewards and recognitions program , exclusively for Ciena staff members In addition, we… more
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