- 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 ... Duties assigned are performed under the oversight of the Reimbursement Manager . **The value that you bring...Health System . Review the reasonableness of hospital interim reimbursement rates and special payments received from Medicare… more
- Elevance Health (Smithfield, RI)
- **Audit & Reimbursement Senior -** ** Medicare Cost Report Audit** **Locations:** _This is a United States based, virtual position._ **National Government ... Services to transform federal health programs. The **Audit and Reimbursement Senior** , will support our Medicare ...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- AdventHealth (Altamonte Springs, FL)
- …of proposed operational decisions. Duties assigned are performed under the oversight of the Reimbursement Manager . **The value that you bring to the team:** + ... third party balances of AdventHealth + Review the reasonableness of hospital interim reimbursement rates and special payments received from Medicare and Medicaid… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement III- Medicare Cost Report Audit** **_Locations:_** _This is a virtual United States based position._ **National Government Services** is ... and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** will support our Medicare Administrative Contract (MAC) with the… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement III- Medicare Cost Report Appeals** **Location** : This is a virtual position; US based **National Government Services** is a proud ... and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** will support our Medicare Administrative Contract (MAC) with the… more
- Humana (Chicago, IL)
- …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales motivates and drives a team of Medicare ... and discipline a team of sales individuals. The Senior Manager , Medicare Sales must have a solid...retirement savings plan with a competitive match + Tuition reimbursement and/or scholarships for qualifying dependent children + And… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Product Solutions Manager III Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... safety net required to achieve that purpose. Job Summary The Product Solutions Manager III is responsible for assisting the product leadership team within the… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Product Solutions Manager II Job...benefits including + Paid Time Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision ... Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position...to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product… more
- The Cigna Group (Springfield, IL)
- The **Regional Medicare ** **Provider Contracting Senior Manager - Midwest** serves as an integral member of the Network Development and Solutions Team and ... reports to the Medicare Provider Contracting Regional Vice President. This role is...provider relationships including senior executives. + Knowledge of complex reimbursement methodologies, including incentive based models required. + Demonstrated… more
- Centene Corporation (Cheyenne, WY)
- …levels, and value by leading the dental, vision and hearing Medicare Product development through strategy development, identify opportunities, plan, organize, ... and meet company strategic objectives. + Develop and lead strategies for Medicare Supplemental benefits including dental, vision and hearing + Support Medicare… more
- The Cigna Group (Bloomfield, CT)
- …The **Project Manager ** is a key role that supports **Cigna's Medicare Advantage** line of business, directly addressing customer and client demands for higher ... effectiveness, and service performance outcomes within their assigned segment(s). The **Project Manager ** will serve as a liaison between the National Ancillary team… more
- The Cigna Group (Nashville, TN)
- …transportation, valid driver's license, and insurance required - mileage reimbursement provided_** **_Bilingual preferred, but is not required_** **_Valid local ... about the role:** **SUMMARY:** Responsible for the execution of the Cigna Medicare strategy for local topline sales agencies, directly contracted agents, and broker… more
- The Cigna Group (Nashville, TN)
- **Summary** The Data Governance & Ownership (DG&O) Senior Manager will work with the Provider Data Quality & Accuracy (PDQA) Director to establish the framework and ... covering the following domains: + Credentialing + Directory + Reimbursement \Capitation + Configuration + Network **Essential Functions and Responsibilities** +… more
- The Cigna Group (Birmingham, AL)
- Cigna Supplemental Benefits (CSB) has been growing rapidly with Medicare Supplement (MedSupp) annual revenues now exceeding $1.2b. The Medicare Supplement ... new business pricing strategy to drive profitable growth in the Medicare Supplement marketplace. Effectively communicate pricing strategy, positions, and changes to… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As a key member of our Medicare Advantage Operations team, you will partner with business and technical teams as well as ... or equivalent work experience + Minimum of 5 years' experience in a Medicare or Managed Care environment managing enrollment, claims, premium billing or encounters… more
- Medical Mutual of Ohio (OH)
- …. **_Eastern & Central Time Zones preferred._** **Responsibilities** ** Medicare Pharmacy Coordinator I** Working under general supervision, administers ... 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
- 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. The Medicare ... an integral role in the product development of the Medicare Advantage. This role supports Medicare product...of plan benefit packages (PBPs), working with the Product Manager and market leadership to balance market competitiveness and… more
- The Cigna Group (Bloomfield, CT)
- …training in Case Management + 1-2 years of oncology nursing experience + Medicare and/or Medicaid experience with geriatric populations + Certified Case Manager ... health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement , a minimum of 18 days of paid time off per year and paid… more
- The Cigna Group (Bloomfield, CT)
- …reporting to the manager of CTMs. This role will support the Medicare Advantage line of business by directly supervising the CTM team. The primary ... a Band 3 Management Career Track Role. **Customer Service Senior Supervisor- Medicare ** The Government Business CTM (Complaint Tracking Module) Complaint Resolutions… more
- The Cigna Group (Denver, CO)
- …+ Reliable transportation and valid driver's license + Mileage reimbursement provided **Job** **Summary:** The Provider Performance External Representative is ... conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance External Representative's responsibilities include: +… more
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