- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Senior Contact Center Representative, you will be addressing and resolving complex member inquiries, providing detailed ... required + Two or more years working contact center environment or experience with Medicare Advantage health plan, highly desired + Working knowledge of Medicare … more
- AdventHealth (Altamonte Springs, FL)
- ** Senior Medicare Data & Finance Analyst** **Location:** Virtual **All the benefits and perks you need for you and your family:** + Benefits from Day One + ... **Schedule:** Full-Time, Monday - Friday **The role you'll contribute:** The Senior Medicare Data & Finance Analyst is responsible for serving analytics needs… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Senior Medicare ... education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/178464/ senior - medicare -medicaid-biller-collector/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management Inc… more
- CVS Health (Southfield, MI)
- …risks. The individual will work independently, as well as collaboratively, with internal senior level Medicare compliance and business teams that operate MMP and ... business, analytical and communication skills to support, manage and develop Medicare and Medicaid compliance programs and processes that promote compliant and… more
- The Cigna Group (Morris Plains, NJ)
- **POSITION SUMMARY** The Medicare Client Strategy Senior Manager is accountable for and provides leadership to a team of Medicare Strategists and is ... for all Medicare strategic initiatives and market development. The Medicare Client Strategy Senior Manager plays a critical role in the interpretation of all… more
- USAA (Tampa, FL)
- …special! **The Opportunity** We are currently seeking a dedicated **Business Process Owner Senior ** that will support Medicare Supplement Claims for USAA Life ... the Life Company Chief Claims & Fraud Officer and will work on Medicare Supplement Claims activities and ensure a flawless execution of business-related processes,… more
- Providence (WA)
- …the best people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst, Medicare Bid who will:** + Be responsible for ... and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare Advantage… more
- Centene Corporation (Austin, TX)
- …that Medicare Compliance reports are provided regularly to the CRECO, the Medicare Compliance Committee, the Medicare Senior Leadership team and the ... **Position Purpose:** This position will be a member of Medicare & Compliance Senior Leadership, chairs Centene's Medicare Compliance Committee, attends… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …for this position is full remote with occasional time onsite.** The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, ... which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies...are a Qualifying Clinical Trial as defined by the Medicare Clinical Trial Policy (NCD 310.1) and designates medical… more
- Centene Corporation (Raleigh, NC)
- …anywhere in the Continental United States.** **Position Purpose:** Supports the Medicare Communications Compliance team in the management of regulatory requirements ... associated with the Medicare materials and sales compliance. Participates in the ongoing...ongoing oversight, analysis, review, and approval of all beneficiary-facing Medicare materials. In addition, may also support the department… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …a culture of continuous improvement.** + **Performs other duties as assigned.** ** Senior Medicare Advantage Customer Experience Strategist** + **Plans and ... and patterns, applying them to business processes and member experience. ** Senior Medicare Advantage Customer Experience Strategist** **Education and… more
- Medical Mutual of Ohio (OH)
- …any oversight process questions. . Performs other duties as assigned. ** Senior Medicare Pharmacy Coordinator** Working under limited supervision, administers ... mail pharmacy. . Intermediate Microsoft Office skills (Excel, Word, Power Point). ** Senior Medicare Pharmacy Coordinator** . Associate Degree in Business… more
- Medical Mutual of Ohio (OH)
- …questions with payment recovery staff.** + **Performs other duties as assigned.** ** Senior Medicare Clinical Auditor** + **Audits outpatient, inpatient and ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Working under general… more
- Prime Healthcare (Redding, CA)
- …Responsibilities The Senior Medicare ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare -Medicaid. This includes maintaining the deficiency lists used to obtain… more
- Point32Health (Canton, MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have two main ... related filings, new benefit implementation, and product/vendor management processes. The Senior Manager will support annual assessment of new product strategies by… more
- Centene Corporation (Jefferson City, MO)
- …offering quality, competitive product solutions for growth and retention of our Medicare members. Support the development and execution of product changes within the ... performance. Support the development and execution of product changes within the Medicare product life cycle and be responsible for delivering fully compliant… more
- Elevance Health (Norfolk, VA)
- **Risk Adjustment Advanced Analyst Senior ** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of ... **Preferred Location: Norfolk, VA.** The **Risk Adjustment Advanced Analyst Senior ** is responsible for creating statistical models to predict, classify,… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Senior Public Policy Analyst monitors, evaluates, and provides recommendations on strategy and communications regarding ... The incumbent will have primary responsibility for issues related to Medicare / Medicare Advantage, prescription drugs, utilization management, and behavioral… more
- The Cigna Group (Bloomfield, CT)
- This position, the Nurse Case Manager Senior Analyst, through the case management process, will promote the improvement of health outcomes to members and assist ... clinical care to the consumer + Case Management exp strongly preferred + Medicare experience strongly preferred + CCM Certification preferred + Requires high speed… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …business relationships among Insurers, PBMs, and Specialty Pharmacies including Medicaid and Medicare . + Ability to work with senior leadership to define, ... Senior Manager Hub Operations Date: Nov 25, 2024...people to make a difference with. **The opportunity** The Senior Manager, Hub Operations seeks to optimize the process… more
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