- ConsultNet (North Kingstown, RI)
- …and absolute customer satisfaction in a complex, inbound Customer Care center. Customer Care Manager , Rx will focus on supporting our Medicare Part D and PBM ... The Customer Care Manager supervises daily operations and team members while...business by providing a complex level of service to Medicare Part D and Commercial PBM members and managing… more
- Cambia Health Solutions, Inc (Portland, OR)
- …including small, mid-size, and large-group employers, as well as Individual and Medicare plans. The manager must deliver results efficiently, communicate ... better. As a member of the marketing team, our Integrated Marketing Programs Manager will work with stakeholders and subject matter experts to create educational… more
- Healthfirst (NY)
- …representing all Medicare sales business end users and leadership Conducts project estimate sessions with project stakeholders to drive project ... Organizes and leads the project team through the entire project ...tools and technology (software and hardware) that support the Medicare Sales Operations team Works with internal and external… more
- The Cigna Group (Bloomfield, CT)
- **WORK LOCATION: Position is REMOTE** The ** Project Manager ** is a key role that supports **Cigna's Medicare Advantage** line of business, directly ... and service performance outcomes within their assigned segment(s). The ** Project Manager ** will serve as a liaison...Masters in relevant field also valued + **2+ years Medicare experience, required** + **2+ years Project … more
- UCLA Health (Los Angeles, CA)
- …required + Minimum of 5 years' experience with CMS processes in a Medicare or Managed Care environment required + Project Management Professional certification ... at UCLA Health. As a key member of our Medicare Advantage Operations team, you will partner with business...technical teams as well as product owners/managers/directors to achieve project objectives and deliverables that include project … more
- Geisinger (Danville, PA)
- …the job. Position Details Additionally, the successful candidate will: + Serve as assistant project manager for Medicare Annual Enrollment Period Data and ... Provides application support to the Retail Sales (Individual and Medicare ) lines of business, which includes Inside and Field...the initial point of contact for the Commercial and Medicare Sales end user community by providing first-level support… more
- Healthfirst (NY)
- …Responsibilities:** + Well-versed on all aspects related to one or more specific Medicare performance areas such as Risk Score Accuracy, Medicare Clinical ... Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member experience. + Active analysis of complex financial reports… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Product Solutions Manager II 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 II is responsible for working within the Product Strategy, Sales and Marketing… 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...the community through service, organizations, activities and volunteerism + Project management background or certification a plus + Bilingual… more
- Healthfirst (NY)
- …medical economics, risk adjustment, and population health strategy implement Medicare strategy for profitable performance and ensure seamless partnership and ... + Well versed on all aspects related to all Medicare products + Must be able to perform additional...develop plan of action, communicate effectively, and execute within project timelines + Strong public speaking and oral and… more
- CVS Health (Hartford, CT)
- …by working in a fast paced, complex, cross-functional environment. The Sr. Manager , Project Program Management will lead a cross-functional team focused ... care more personal, convenient and affordable. **Position Summary** The Medicare Strategic PMO is seeking a number of qualified...PMO is seeking a number of qualified program and project managers to drive and lead large, critical and… more
- Commonwealth Care Alliance (Boston, MA)
- …This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and oversight ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- Molina Healthcare (Louisville, KY)
- …**Job Summary** This role requires a strategic thinker with excellent project management skills, who can coordinate cross-functional teams and drive results ... to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception... management experience. + Managed Care experience (Medicaid and Medicare ) + Experience working in a cross functional highly… 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 a ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- The Cigna Group (Nashville, TN)
- …an opportunity to lead complex analytics projects and initiatives for Cigna's Medicare Advantage Risk Adjustment business. The Manager will work collaboratively ... through a team of business analytics professionals. Reporting to the Senior Manager of Risk Adjustment Analytics, this position will manage the prioritization,… more
- The Cigna Group (St. Louis, MO)
- …and or equivalent work experience, highly preferred. + **5 or more years of** ** Medicare project and team management** **experience** + Track record of managing ... draft agenda and gather materials for Stars and RA team meetings and Medicare leadership meetings: + Seniors Business Operating Review Monthly Meeting + Quarterly… 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 member of ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …responsible for completing the Medical Policy activities outlined in BCBSLA's Medicare Advantage Medical Policy Development Policies & Procedures locating, tracking ... information and working closely with the Medical Directors and Manager of Medical Policy and Medical Appeals to ensure...on an as needed basis support the Medical Policy Project Analyst position when medical policy volume is elevated… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... define Coding Standards and best practices. Accept assignment from the Manager . Maintain strong interdepartmental relationships. Light travel may be required.… more
- Medical Mutual of Ohio (Dublin, OH)
- …and help our members achieve their best possible health and quality of life. IT Project Manager I Assists in leading enterprise projects and teams in compliance ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.... status and track and report major issues. IT Project Manager II Leads enterprise projects and… more