- Daiichi Sankyo, Inc. (Bernards, NJ)
- …but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and ... Lead drafting and negotiating contracts for commercial, Medicaid and Medicare coverage, as well as other government contracts, trade/distribution agreements,… more
- 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 (AR)
- …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 ... is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. + Identifying and...a timely fashion. + Working in start-up environment + Medicare Advantage Compliance training, audits, regulations, and manuals. +… more
- Vanderbilt University Medical Center (Nashville, TN)
- …audit results. Monitors new regulatory and/or billing requirement changes from Medicare Administrative Carriers and CMS websites and published guidance. Performs ... Large Healthcare Environment, hospital, physician practice, third party payer, Medicare intermediary, health insurer, or accounting/consulting firm. (Required) 10… more
- Molina Healthcare (Columbus, OH)
- …application of Lean/Six-Sigma. + Project management. + Process design & engineering. + Medicare . + Proven track record with results. + Process mapping tools - Visio, ... MS Project. + Power BI or Tableau. **Preferred License, Certification, Association** Lean Six Sigma Master Black Belt or Lean Sensei To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant , you will be responsible for: + Serving as a Subject Matter Expert (SME) ... offered by the health plan + Act as a consultant and partner to the contracted IPAs + Traveling...experience * Knowledge of HIPAA regulations * Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications, a… more
- AccentCare, Inc. (San Diego, CA)
- …patient care. Salary: Schedule: Offer Based on Years of Experience Hospice Care Consultant Hospice Care Consultant Hospice Care Consultant Hospice Care ... Consultant Hospice Care Consultant Hospice Care Consultant Hospice Care Consultant Hospice Care ...of referral patterns. Experience with, or willing to learn, Medicare regulations and related reimbursement practices related to hospice… more
- Humana (Columbus, OH)
- …on Medicare Advantage strategy development. As a Insurance Strategy Consultant , you will deconstruct issues and challenges, perform targeted research and ... organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises… more
- CVS Health (Austin, TX)
- …9- 5:30 EST or CST Normal work Hours 11:45 - 8:15 EST The WorkLife Consultant (WLC) is part of the WorkLife Team and provides education about community resources, ... resource needs assessment, and community and/or national referrals to a variety of customers for a variety of needs including childcare, elder/adult care, and basic/everyday needs. The WLC is responsible for providing Worklife consultation and informational… more
- CVS Health (Austin, TX)
- …or CST** **Work hours after training 10 - 6:30 pm EST** **The WorkLife Consultant (WLC) is part of the WorkLife Team and provides education about community ... resources, resource needs assessment, and community and/or national referrals to a variety of customers for a variety of needs including childcare, elder/adult care, and basic/everyday needs. The WLC is responsible for providing Worklife consultation and… more
- Humana (Montgomery, AL)
- …caring community and help us put health first** The Senior Stars Improvement Consultant / Professional executes the overall Medicare Stars Improvement Program ... with physician groups and internal partners.. The Senior Stars Improvement Consultant / Professional works via virtual and in-person collaboration with providers… more
- Nuvance Health (Fishkill, NY)
- *Description* *Per Diem Lactation Consultant - Southern O/B* We are seeking an experienced and compassionate lactation consultant to provide breastfeeding ... and their babies throughout the prenatal and postpartum period. The lactation consultant will see patients in our obstetric offices for prenatal and postpartum… more
- Elevance Health (Roanoke, VA)
- **Be Part of an Extraordinary Team** **Title** : Business Information Developer Consultant - HEDIS Analytics **Location:** Candidates must reside within 50 miles or ... the Possibilities. Make an Extraordinary Impact.** The **Business Information Developer Consultant ** is responsible for developing and executing more complex data… more
- Elevance Health (St. Louis, MO)
- **Business Information Developer Consultant - HEDIS Analytics** **Location:** This position will work a hybrid model (remote and in office one to two days per week). ... Louis, MO, Wallingford, CT or Louisville, KY. The **Business Information Developer Consultant - HEDIS Analytics** is responsible for developing and executing more… more
- Guidehouse (Mclean, VA)
- …Obtain Public Trust **What You Will Do** **:** Guidehouse is looking for a Senior Consultant to work on a Centers for Medicare and Medicaid Services (CMS) ... programs, specific to the Affordable Care Act. The Senior Consultant will work with a team of reviewers to...Insurance Exchanges preferred, but not required + Knowledge of Medicare , Medicaid, Medicare Advantage preferred, but not… more
- WellSense (Boston, MA)
- Sr. Provider Relations Consultant - (MA residents)-$5,000 sign on bonus WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide… more
- Elevance Health (Louisville, KY)
- **Medical Policy Consultant ** National Government Services is a proud member of Elevance Health Companies, Inc. family of brands. We administer government contracts ... for Medicare and partner with the Centers for ...8 am - 4:30 pm EST.** The **Medical Policy Consultant ** is responsible for researching and drafting NGS Medical… more
- Humana (Louisville, KY)
- …and help us put health first** The Long-term Growth Strategy Consultant (Distribution) provides data-based strategic direction to identify and address business ... support for the Enterprise Growth vertical. The Long-term Growth Strategy Consultant 's work involves moderately complex assignments performed with limited direction… more
- Robert Half (Boston, MA)
- JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB ... Protiviti is looking for a Risk and Compliance Senior Consultant to join our growing Healthcare team. What You...healthcare payer regulations and guidance with emphasis on the Medicare Managed Care Manual. + Expertise of core business… more
- Stantec (Denver, CO)
- Benefits Consultant - ( 240003FF ) **Description** Grow with the best. Join a smart, creative, and inspired team that works to support operational excellence. The ... vital to making our Company stronger. **Your Opportunity** We are looking for a Benefits Consultant to join our team! As part of the HR Talent Services team, the… more
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