- Sanford Health (Dickinson, ND)
- …to the work of health and healing across our broad footprint.** **Facility:** Remote ND (Dickinson) **Location:** Dickinson, ND **Address:** **Shift:** 8 Hours - Day ... Hours:** 40.00 **Salary Range:** $37.50 - $62.00 **Job Summary** The Product Manager will lead the ongoing analysis, planning, and management of their respective… more
- Medical Mutual of Ohio (OH)
- …office in Brooklyn, OH. However, the role is open to considering candidates who are remote as long as they live within the state of Ohio._** Founded in 1934, Medical ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
- Humana (Sanford, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Health Care Service Corporation (Nashville, TN)
- …quality deliverables on schedule + Healthcare acumen, Managed Care Organization, Pharmacy Benefit Manager , Medicare experience + Advanced analytical skills, ... driving delivery, contingency planning, business results, and strategic planning for Medicare Part D Pharmacy consisting of multiple programs, complex projects, and… more
- US Tech Solutions (May, OK)
- …determination in a specialty/skilled clinical setting ie, specialty medical office or Pharmacy Benefits Manager (PBM) **Skills:** + MUST HAVE MANAGED CARE exp ... **Location: Remote ** **Duration: 6+ months contract** **Shift: Monday-Friday 9:30am-6pm...experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit… more
- Mayo Clinic (Rochester, MN)
- …dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (https://jobs.mayoclinic.org/ benefits /) - to take care of you ... every turn, you can build a long, successful career with Mayo Clinic. ** Benefits Highlights** + Medical: Multiple plan options. + Dental: Delta Dental or… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... by connecting them with appropriate resources and support services. The Care Manager provides education and guidance to members and their families on managing… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN43595B **Job Title** Compliance Officer **Working Title** Regulatory Compliance Manager - Hybrid/ Remote **Career Progression Track** F **Track ... RHIA ); knowledge of medical auditing, Federal healthcare program policies and requirements (including Medicare Parts A and B), and ICD -10, CPT , HCPCS , DRG… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** We are looking for an experienced Care Manager to support our Maryland Medicare enrollees. Under minimal supervision, the ... member's medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinary care team to ensure… more
- VetsEZ (Washington, DC)
- We are currently seeking a goal-oriented and strategic Capture Manager for a 100% remote position to drive new business opportunities within the Department of ... Services (HHS) and its sub-agencies, including the Centers for Medicare & Medicaid Services (CMS), National Institutes of Health...a plus. + Ability to obtain a Government clearance. Benefits : + Medical/Dental/Vision. + 401k with Employer Match. +… more
- Molina Healthcare (ID)
- **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** **Required… more
- CVS Health (Jefferson City, MO)
- …business needs.** **Position Summary** Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits ... Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return… more
- CVS Health (Springfield, IL)
- …models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... the country. **Family** **Summary/Mission** Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Behavioral Health Care Manager will support the Maryland Dual Eligible Special Needs Plan (MD DSNP). Under minimal ... supervision, the Care Manager researches and analyzes a member's medical and behavioral...review and clarify treatment plans ensuring alignment with medical benefits and policies to facilitate care between settings. Monitors,… more
- Molina Healthcare (Coeur D'Alene, ID)
- …Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not ... various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to: Value Based… more
- Molina Healthcare (Sterling Heights, MI)
- …priorities. + Demonstrates thorough understanding of Molina's product lines, Medicaid, Medicare SNP, Marketplace, MMP, etc. + Develops strategy to evaluate the ... apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** SHP Pharmacy Benefits Specialist ( Remote in WI)) **Cost Center:** 682891381 SHP-Pharmacy **Scheduled ... works closely with the Pharmacy Director, Clinical Pharmacy Specialist, and Operations Manager to provide consistent and accurate pharmacy benefit administration… more
- Humana (Albany, NY)
- …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of Medicare ... coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager , Medicare Sales, must have a solid understanding of the market they… more
- CenterWell (Salt Lake City, UT)
- …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... Medicare policies, processes, and procedures **Additional information** + Remote Role + **Incumbent must be based in Salt...at a time that is best for your schedule. ** Benefits ** Humana offers a variety of benefits … more