- USAA (Tampa, FL)
- …makes us so special! **The Opportunity** We are currently seeking a dedicated ** Business Process Owner Senior** that will support Medicare Supplement Claims for ... end-to-end claims process. This role will work with our third-party supplier and key business partners supporting our Medicare Supplement Claims. As business … more
- The Cigna Group (Nashville, TN)
- …are table stakes. MTO is uniquely positioned to work directly with engineering and business operations and partner to solve tactical and strategic problems. As ... **Summary** The Head of Medicare Technology Operations (MTO) Support is...process and performance across our technical ecosystem and the business operations landscape. + Drive a high… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …the health care or financial services industry.** + **Experience in Medicare and/or Medicaid preferred.** **Professional Certification(s)** + Project Management ... + Ability to interpret data trends and patterns, applying them to business processes and member experience. **Senior Medicare Advantage Customer Experience… more
- US Tech Solutions (Canton, MA)
- …experience, including leading the most cross -functional high-level initiatives. + Significant business process and project management experience related to the ... implementation of healthcare insurance business applications and products using industry-standard project and program management tools and techniques with… more
- AmeriHealth Caritas (Newtown Square, PA)
- … Product Team oversees the Medicare product portfolio. It supports AmeriHealth's Medicare Business and its critical Medicare and Medicaid integration ... **Education & Experience:** + 3 to 5 years of experience in Medicare /Medicaid vendor account/contract management and operations . + Bachelor's Degree required.… more
- Point32Health (Canton, MA)
- …required deadlines, as well as overseeing implementation of the product across the business . The Senior Manager will be responsible for ensuring that Plan Benefit ... bid filing. Post-filing the Senior Manager will collaborate with cross functional business partners to lead and oversee key aspects of product implementation,… more
- Centene Corporation (Cheyenne, WY)
- …functional and technical knowledge regarding overall program requirements and operations **Education/Experience:** + Bachelor's degree in Business ... project implementation, product or program management experience. + Medicare Supplement Benefits (Dental, Vision, Hearing) experience strongly preferred. + 5+… more
- Elevance Health (Columbus, OH)
- …for IM function at the business unit level and ensures operations ' effective achievement of objectives. . Coordinates project management across department ... **Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** This...through training and effective organizational development practices. . Reports project status and progress to business unit… more
- Vanderbilt University Medical Center (Nashville, TN)
- …assembly of documentation and data to support analytical reporting to senior business operational leaders and physician leadership regarding: + Audit results to ... of Compliance; + Identification of best practices and control procedures over operations and/or patient care to promote regulatory compliance; + Assistance in… 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) for ... degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience * Project… more
- Molina Healthcare (Columbus, OH)
- …of Lean/Six-Sigma. + Project management. + Process design & engineering. + Medicare . + Proven track record with results. + Process mapping tools - Visio, MS ... **JOB DESCRIPTION** **Job Summary** Leads business process improvement initiatives that result in operational...improvement efforts. Will lead re-engineering team and act as project manager in some cases. + Develops training curriculum… more
- LA Care Health Plan (Los Angeles, CA)
- …of requirements, assignments, priorities, and deadlines. The Regulatory Operations Project Manager II closely collaborates with business owners, vendors, ... Regulatory Operations Project Manager II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017… more
- MetroLink (Los Angeles, CA)
- …timeliness, implementing standards and best practices. + Provide guidance to operations / project management teams to recognize emerging issues, identify lessons ... FUNCTIONS Education and Experience + Bachelor's Degree in Engineering, Business Administration, Project Management or a related...exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is… more
- Commonwealth Care Alliance (Boston, MA)
- …**Essential Duties & Responsibilities** + Support the development of proposed project business cases, scope, estimates, delivery schedules and interdependencies ... complex and cross functional efforts + Demonstrated experience as a Senior Project Manager leading multiple cross functional business and technology… more
- Elevance Health (Columbus, OH)
- …priorities; must be comfortable interfacing with senior leadership. + Partner with business operations to understand operational metrics and reporting; assist ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...quality and other operational issues. + Assists in managing project scope to ensure business needs are… more
- CenterLight Health System (NY)
- JOB PURPOSE: The Senior Project Manager, Claims Payment Integrity supports the Senior Vice President and the Director in the day-to-day operations of the Claims ... of pending claims, appeals, recoupments, pricing, auditing, and reporting. + Provide project management support in data collection and tracking in report building to… more
- Waystar (Louisville, KY)
- …position are expected to have or develop a specific knowledge of Waystar's business , industry, and operations , including an intimate understanding of healthcare ... **ABOUT THIS POSITION** The Strategic Project Manager is responsible for the successful implementation of Waystar solutions by leading the team and the client … more
- Medical Mutual of Ohio (Toledo, OH)
- **_The Operations Data Analyst II position allows you the_** **_flexibility to work a hybrid schedule (on-site and at home)_** **_as long as you reside within a ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… more
- The Cigna Group (Nashville, TN)
- …team on tools/platforms to enable UAT testing + Gain a deep working knowledge of Medicare business , IT landscape, and coordinate collaboration of the UAT team + ... success. **Role Details** As an enabler of Enterprise Strategic Priority for Medicare Advantage Growth, the DMOM program will drive a competitive administrative cost… more
- Molina Healthcare (Phoenix, AZ)
- …service level agreements * This position plans, organizes, staffs, and coordinates the operations of state Medicaid/CHIP, Medicare and Marketplace Health Plan ... **Job Description** **Job Summary** Molina Health Plan Operations jobs are responsible for the development and administration of State Health Plan's operational… more
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