- The Cigna Group (Sunrise, FL)
- …to the providers and the individual that represents Cigna Medicare Advantage . The Provider Performance Enablement Lead Analyst's responsibilities ... **Role Summary** The Provider Performance Enablement Lead Analyst is...members contribute to the growth and profitability of the Medicare Advantage business in their market in… more
- Providence (WA)
- …ensuring compliance with regulatory guidelines, and providing critical insights to enhance the performance of our Medicare Advantage plans **_Please note the ... and speed for assessing product design impacts on financial performance for Medicare Advantage plans...career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace… more
- Highmark Health (Harrisburg, PA)
- …and provides strategic, hands-on, office based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies ... are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with… more
- 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, ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....on product agnostic initiatives as well as strategic partnerships. Medicare : Required Medicare Advantage , with… more
- The Cigna Group (Chattanooga, TN)
- …the total medical cost analytics for the Government Business Segment (Primarily Medicare Advantage business). This role will be responsible for developing ... but not limited to: Finance, Risk Management, Operations, Contracting, Provider Relations, Health Services, Product, and local market leadership.… more
- The Cigna Group (Seattle, WA)
- **Role Summary:** The Provider Performance Lead Analyst is a key member of the market that assists in the growth and development of the provider network. The ... providers and the individual that represents Cigna MA. The Provider Performance Lead Analyst's responsibilities include: +...members contribute to the growth and profitability of the Medicare Advantage business in their market in… more
- The Cigna Group (Atlanta, GA)
- …market, incumbent candidate will work from local office 3 days per week.** The Provider Performance Enablement Advisor is an integral part of a cross-functional, ... collaborative organization (which includes Market Provider Performance , Sales, Clinical Operations, Stars &...members contribute to the growth and profitability of the Medicare Advantage business in their market in… more
- BlueCross BlueShield of North Carolina (NC)
- …experience in related field. **What We'd Like** + Must have relevant experience in Medicare Advantage , Medicare Supplement and PDP. Preference for experience ... through product, program, market engagement and/or marketing communications strategies across all Medicare lines of business with a specific focus on Medicare … more
- Amazon (Seattle, WA)
- …Regulatory counsel to join our Legal team. This role primarily involves supporting Medicare , Medicare Advantage , and other value based care business ... tech organization, health plan or healthcare related government agency. - Familiarity with Medicare and Medicare Advantage , federal and state Fraud, Waste… more
- Humana (Columbus, OH)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance. +… more
- Somatus (Mclean, VA)
- …of leadership/management experience required. + Proven experience with commercial and/ or Medicare Advantage risk adjustment functions. + Proven track record of ... well-being + Community engagement opportunities + And more! The Sr. Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of… more
- Point32Health (Canton, MA)
- …a team environment. + Strong understanding of the managed care industry, preferably Medicare Advantage plans. + Experience in Product Development. + Experience ... in product strategy/bid planning meetings led by Product Strategy team to provide subject matter expertise, as needed, on matters related to product design,… more
- Humana (Leesburg, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in...applicants selected for leader review may be asked to provide their social security number, if it is not… more
- Medical Mutual of Ohio (OH)
- …including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ** Provider Analyst II** Provides ... history. Measures accuracy of projections. . Analyzes effectiveness of provider network performance through financial modeling, network...as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide… more
- The Cigna Group (Houston, TX)
- Role Summary The Provider Performance Manager is a key member of a cross-functional, collaborative organization (which includes Market Provider ... and Network Development & Solutions). Reporting directly to the Provider Performance Senior Manager, the Provider...members contribute to the growth and profitability of the Medicare Advantage business in their market in… more
- Medical Mutual of Ohio (OH)
- …stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans.** **Responsibilities** ** Provider Reimbursement Analyst II** ... complex financial analysis. Maintains market intelligence and analyzes network performance to provide Provider Engagement...as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide… more
- Medical Mutual of Ohio (OH)
- …group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace of mind to more ... 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… more
- Medical Mutual of Ohio (OH)
- …group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace of mind to more ... self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and...+ Acts as a primary source to verify limited provider information to support performance guarantees. +… more
- The Cigna Group (Houston, TX)
- …coverage area.** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment & Stars program for assigned populations ... act on any assigned audit educational opportunities timely and provide primary care or specialty care provider ...5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan experience preferred. +… more
- UCLA Health (Los Angeles, CA)
- …leading clinical efforts to optimize care delivery and outcomes for Medicare Advantage members. You will: + Provide clinical leadership and oversight to ... + Collaborate with senior leaders to enhance the overall performance of the Medicare Advantage ...to enhance the overall performance of the Medicare Advantage Plan Salary Range: $142,100- $348,100/annuallyQualifications… more