- CVS Health (Carson City, NV)
- …**Qualified Candidates will sit in the Las Vegas Nevada area** Aetna is looking for a Medicare Sales Broker Manager to join the Nevada sales team that drives and ... achieves sales results through an assigned Nevada hierarchy of independent Medicare brokers. Responsibilities include: - Develop and execute market strategy… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... and education programs to support improved Star Ratings. Responsible for Medicare Star projects and programs involving enterprise, department, cross-functional and… more
- Bloom Healthcare (Lakewood, CO)
- Job Title: Manager , Medicare Value-Based Programs Location: Denver, Colorado Reports to : Vice President of Innovation About Bloom: Bloom Healthcare is a ... patients first. Position Overview: Bloom Healthcare is looking for a motivated Manager of Medicare Value-Based Programs to oversee the daily operations of our … more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team ... of UM coordinators and nurses. You'll work closely with Medicare Advantage leadership to plan, execute, and manage various...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… 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, ... safety net required to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product Strategy, Sales and Marketing… more
- Corewell Health (Grand Rapids, MI)
- …+ Ensure compliance to CMS requirements and standards + Other projects assigned by Medicare Quality Manager and/or Director How Corewell Health cares for you + ... Job Summary The Medicare Quality Specialist, Pharmacy will assist the Medicare Adherence Pharmacists Team to improve Medicare Star Ratings and CAHPS by… more
- CVS Health (Southfield, MI)
- …position is located in the state of Michigan The Sr. Compliance Manager is an experienced/career level compliance position that applies compliance, regulatory, ... business, analytical and communication skills to support, manage and develop Medicare and Medicaid compliance programs and processes that promote compliant and… more
- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have two main ... filings, new benefit implementation, and product/vendor management processes. The Senior Manager will support annual assessment of new product strategies by… more
- Lowe's (Charlotte, NC)
- **Your Impact** The Care Manager is a telephonic medical case management position with emphasis on early intervention, return to work planning, coordination of ... treatment to an appropriate resolution. Apply medical treatment guidelines for future Medicare -covered expenses. The candidate will work directly for a Fortune 100… more
- CareOregon (Portland, OR)
- … Medicare Administration Exemption Status Exempt Requisition # 24745 Direct Reports Medicare Leadership Team Manager Title Chief Financial Officer Pay & ... This position is responsible for strategy, growth, and oversight of the Medicare Advantage line of business. Time is focused on enterprise-wide engagement, as… more
- US Tech Solutions (Canton, MA)
- **JOB SUMMARY:** The Lead Corporate Project Manager is responsible, on behalf of the Executive Sponsor or Business Sponsor, for the successful delivery of new ... Corporate Program Management Office (CPMO). The Lead Corporate Program Manager supports and advocates project management principles and methodologies within… more
- Healthfirst (NY)
- **Duties and Responsibilities:** + Monitor experience under Healthfirst's Medicare line of business. + Provide support for annual Medicare bids for all ... analysis and other ad hoc analyses. + Research, evaluate and analyze Medicare market landscape. + Analyze product and segment performance, incorporating both… more
- CVS Health (Columbus, OH)
- …Employee Program (FEP) is one of the largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr. Manager provides technical, analytical and ... new programs, benefits, processes, and technology are deployed, the Medicare Business Analytics - FEP - Sr. Manager... Medicare Business Analytics - FEP - Sr. Manager incorporates these into all aspects of the claims… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …delivering innovative solutions to drive effective change. A subject matter expert in Medicare processes, the manager ensures services align with client goals ... OVERVIEW/GENERAL PURPOSE OF THE POSITION The Client Services Manager is instrumental in cultivating and sustaining long-term relationships between the company and… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Compliance Audit Manager , you will lead and oversee risk-based audits and compliance initiatives for our Medicare ... desired * Minimum of 5 years of experience in Medicare Advantage and Part D Managed Care compliance role,...conducted by CMS and/or DMHC * Working knowledge of Medicare Advantage and Prescription Drug product and the agencies… more
- Always Best Care Senior Services (San Diego, CA)
- …Clinical Manager Always Best Care Home Health is seeking a RN Clinical Manager with Medicare experience to guide, lead and build a fast growing, results ... oriented Home Health Agency. The Clinical Manager compliments the Administrator in planning, developing and supervising the activities of Licensed and non-licensed… more
- VNS Health (Manhattan, NY)
- …challenging projects that push boundaries and decision making that drives results. As the Manager , Actuary for Medicare Advantage (MA), you will play a pivotal ... OverviewVNS Health Medicare Advantage experiences accelerated year-over-year growth, doubling membership...the last 12 months. We continue to strengthen our Medicare presence in New York City while actively expanding… more
- Medical Mutual of Ohio (OH)
- …remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** **Responsibilities** ** Medicare ... to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part...focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members… more
- AdventHealth (Altamonte Springs, FL)
- …role you'll contribute:** The Reimbursement Analyst is responsible for assisting the Reimbursement Manager with the preparation of work papers for the filing of the ... annual Medicare , Medicaid, and Champus/Tricare cost reports, audit preparation and...assigned are performed under the oversight of the Reimbursement Manager . **The value that you bring to the team:**… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...with systems , payers , and processes to the manager in a timely manner . Education and Experience… more
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