- Highmark Health (Harrisburg, PA)
- …are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs… more
- Banner Health (TX)
- …8:00 AM - 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight is in ... ensuring appropriate oversight is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. + Identifying and documenting all noncompliance… more
- Guidehouse (Hanover, MD)
- …or MS-BA in the following degree concentrations are preferred: Accounting, Business , Economics, Finance, Health Policy, Management/ Information System, Public ... helping CMS advance their vision of strengthening healthcare as well as the information available to beneficiaries and providers who serve them. Our Consultants help… more
- Molina Healthcare (Columbus, OH)
- …analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for ... utilization and unit cost medical cost drivers + Turn data into usable information by tell the story through data visualization working with clinical, provider… more
- Elevance Health (Columbus, OH)
- ** Medicare Medical Director** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one of our ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director** is responsible for the administration of...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- MyFlorida (Tallahassee, FL)
- 68065017 - SENIOR INFO TECH BUSINESS CONSULTANT /FX CERTIFICATION LEAD Date: Dec 16, 2024 The State Personnel System is an E-Verify employer. For more ... for Health Care Administration Working Title: 68065017 - SENIOR INFO TECH BUSINESS CONSULTANT /FX CERTIFICATION LEAD Pay Plan: Career Service Position Number:… more
- Humana (Columbus, OH)
- …health benefits organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, ... on Medicare Advantage strategy development. As a Insurance Strategy Consultant , you will deconstruct issues and challenges, perform targeted research and… more
- CVS Health (Austin, TX)
- …Training hours may differ from the shift you are hired for. The WorkLife Consultant (WLC) is part of the WorkLife Team and provides consultation, assessment, and ... care, basic/everyday needs, and mental health. Due to expanded business , elder care is the top requested need. Additional...relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS… more
- CVS Health (Austin, TX)
- …schedule is Monday through Friday, 11:45am to 8:15pm Eastern Time.** The WorkLife Consultant (WLC) is part of the WorkLife Team and provides education about ... or customer service oriented. + Additional responsibilities assigned based on business need, including staffing an online chat platform. **Required Qualifications**… more
- Adecco US, Inc. (Bradenton, FL)
- …passionate professional to join our client's team! Position Name: **Membership Consultant ** Location: **Bradenton, FL** - 34209 Employment Type: Direct-Hire & ... - Monday-Friday: 8am-5pm - No: weekends **Requirements** - Several years of Medicare Sales and Community Relations experience. - Experience with Medicare … more
- 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. We are seeking an ... other duties as assigned. **Qualifications** Education and Experience: + Bachelor's degree business administration, finance, human resources, or a related field. + 5… more
- Stantec (Chandler, AZ)
- Benefits Consultant - ( 240004CC ) **Description** Grow with the best. Join a smart, creative, and inspired team that works to support operational excellence. The ... making our Company stronger. **Your Opportunity** We are looking for a Benefits Consultant specializing in compliance to join our HR Talent Services team! The… more
- Deloitte (Fort Lauderdale, FL)
- …Are you interested in helping clients drive alignment with their business , improve organizational and human resource performance and establish a culture ... focused on adding business value? That is what the new generation of...Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions… more
- Elevance Health (Roanoke, VA)
- … Sr.** for **Provider Success** is responsible for consulting with providers (Commercial, Medicare Advantage and Medicaid Lines of Business ) to assess and deploy ... **Care Consultant Sr. (Provider Success)** **Location** : Must reside...vary depending on the above factors as well as market/ business considerations. No amount is considered to be wages… more
- Elevance Health (Louisville, KY)
- … Sr.** for **Provider Success** is responsible for consulting with providers (Commercial, Medicare Advantage and Medicaid Lines of Business ) to assess and deploy ... Care Consultant Sr. (Provider Success) - JR135927 **Location** :...They are how we achieve our strategy, power our business outcomes and drive our shared success - for… more
- ChenMed (Miami, FL)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... + Begins to nurture, build and cultivate direct-to-seniors and business -to- business partnerships to generate new patient opportunities year-round.… more
- ChenMed (Cincinnati, OH)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... JOB DUTIES/RESPONSIBILITIES:** + Nurtures, builds and cultivates direct-to-seniors and business -to- business partnerships to generate new patient opportunities… more
- Public Consulting Group (Columbus, OH)
- …of their user base. Services: + Strategy, Architecture, Planning, and Procurement + Business Enablement + Business Solutions + Project Assurance The Medicaid ... the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our...as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined… more
- Humana (Tallahassee, FL)
- …health first** The Humana Florida Team is seeking a Senior STARS Improvement Consultant / Professional who will work directly with the Stars Improvement Lead to ... Pharmacy development strategies. Additionally, the associate will engage with various business partners and be responsible for managing critical features of large… more
- CVS Health (Hartford, CT)
- …affordable. This position will be working from home anywhere in the US. Standard business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse ... Consultant position is responsible for processing the medical necessity of Medicare appeals for both participating and non- participating providers. Primary… more
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