• Medicare Advantage Product Solutions…

    LA Care Health Plan (Los Angeles, CA)
    Medicare Advantage Product Solutions Manager II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los ... to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within...Advantage, with experience serving duals population. Direct experience in Medicare and Duals program administration including stars,… more
    LA Care Health Plan (10/30/24)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …(medical drug) programs as needed. . Performs other duties as assigned. ** Medicare Pharmacy Coordinator II ** Working under general supervision, administers ... mail pharmacy. . Intermediate Microsoft Office skills (Excel, Word, Power Point). ** Medicare Pharmacy Coordinator II ** . Associate Degree in Business… more
    Medical Mutual of Ohio (09/20/24)
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  • Mental Health Program Manager

    The County of Los Angeles (Los Angeles, CA)
    MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply  ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY...program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum… more
    The County of Los Angeles (10/30/24)
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  • Enterprise Shared Services Program

    LA Care Health Plan (Los Angeles, CA)
    Enterprise Shared Services Program Manager II (ALD) Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support Services ... the safety net required to achieve that purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a… more
    LA Care Health Plan (10/25/24)
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  • PAR - Case Manager II

    Medical Mutual of Ohio (Toledo, OH)
    **_The Case Manager II position allows you the flexibility to work at home as long as you reside within a 50-mile radius of the Toledo, OH Medical Mutual ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… more
    Medical Mutual of Ohio (10/10/24)
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  • Provider Network Account Manager II

    LA Care Health Plan (Los Angeles, CA)
    …all product lines of business (Medicaid, Medicare , and Commercial). The Account Manager II is responsible for the initial on-board training of new managed ... Provider Network Account Manager II Job Category: Provider Relations...+ Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision + Wellness Program + Volunteer Time Off… more
    LA Care Health Plan (08/30/24)
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  • Regulatory Operations Project Manager

    LA Care Health Plan (Los Angeles, CA)
    Regulatory Operations Project Manager II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Regulatory Operations Project Manager II manages a portfolio of complex regulatory change management and… more
    LA Care Health Plan (08/29/24)
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  • Manager II Performance Enhancement…

    Elevance Health (Woodlawn, MD)
    ** Manager II Performance Enhancement - NGS** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...and Medicaid Services to transform federal health programs. The ** Manager II Performance Enhancement** is responsible for… more
    Elevance Health (11/02/24)
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  • Regional Client Services Manager II

    BAYADA Home Health Care (Pennsauken, NJ)
    BAYADA Home Health Care is in search of a Regional Client Services Manager ll to support both the Bonsai and American Elm Regions. This role will encompass all ... duties related to the CSM II with emphasis on training and development of client...(2) years of BAYADA Home Health Care client services manager experience, within the Home Health Visits or Senior… more
    BAYADA Home Health Care (10/17/24)
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  • Risk Adjustment Coder II

    Point32Health (MA)
    …makes recommendations for course of action. + Maintains productivity levels as defined by the Manager / Supervisor for a Coding Specialist II by project type and ... , performs accurate and timely review and validation of Medicare Advantage, Commercial and Medicaid HCCs through medical record...accuracy levels as defined by the Manager / Supervisor for a Coding Specialist … more
    Point32Health (10/09/24)
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  • Medical Assistant II -Float Decatur…

    Hospital Sisters Health System (HSHS) (Decatur, IL)
    Summary The Medical Assistant II -Float is designated to float to clinics/departments based on the MA's competency level. Provides clinical expertise and functional ... mentor within the service area. Works closely with the manager to plan, implement, and facilitate the work activity...area to accomplish goals and objectives. The Medical Assistant II -Float is required to complete appropriate competency and cross… more
    Hospital Sisters Health System (HSHS) (10/26/24)
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  • Case Manager II , Registered Nurse

    Sutter Health (San Francisco, CA)
    …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... delivery of inpatient stay denials. * Assures delivery of Medicare Important Message within 48 hours of discharge/transition and...pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify… more
    Sutter Health (10/24/24)
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  • Central Service Technician I or II

    Marshfield Clinic (Eau Claire, WI)
    …any time have been or be excluded from participation in any federally funded program , including Medicare and Medicaid. This is a condition of employment. ... in the world!** **Job Title:** Central Service Technician I or II **Cost Center:** 301191306 ECHos-Sterilization Process **Scheduled Weekly Hours:** 40 **Employee… more
    Marshfield Clinic (11/09/24)
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  • Case Manager II , Psychiatric Intake

    Sutter Health (Berkeley, CA)
    …with financial counselor for delivery of inpatient stay denials. * Assures delivery of Medicare Important Message within 48 hours of discharge and no less than 4 ... and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits… more
    Sutter Health (10/24/24)
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  • Case Manager /Social Worker II

    Tidelands Health (Myrtle Beach, SC)
    … guidelines, COBRA, FMLA, Financial Assistance, Medication Assistance Program , Medication and Pharmaceutical Indigent Programs, Transportation Resources, Short-term ... Housing Resources, Advance Directives, Power of Attorney for Health Care and Wills, and Provide emotional support, provider options and facilitate transition to Hospice and in some cases, Palliative Care, depending on where the person resides.… more
    Tidelands Health (09/08/24)
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  • Pharmacy Information Services Specialist II

    Medical Mutual of Ohio (OH)
    …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Collaborates with internal ... oversight. . Assures compliance with contractual requirements of Pharmacy Benefit Manager (PBM) vendor for processing of pharmacy claims, accumulator transfers,… more
    Medical Mutual of Ohio (10/19/24)
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  • Software Developer II -V - Hybrid

    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. Medical Mutual' s ... cross-functional Scrum team under the direction of the IT Manager . Translates user stories and customer acceptance criteria of...casual attire, including jeans. **Excellent Benefits** + Employee bonus program + 401(k) with company match up to 4%… more
    Medical Mutual of Ohio (09/10/24)
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  • Social Worker II - Framingham- Growing PACE…

    Fallon Health (Framingham, MA)
    …to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that ... by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. **About… more
    Fallon Health (09/18/24)
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  • Compliance Advisor II

    LA Care Health Plan (Los Angeles, CA)
    Compliance Advisor II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Compliance Advisor II ensures LA Care business units are compliant with...Compliance unit, the Advisor also advises and supports the Manager , Director, and Chief Compliance Officer on other duties… more
    LA Care Health Plan (11/09/24)
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  • Utilization Management Nurse Specialist RN…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet… more
    LA Care Health Plan (11/09/24)
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