- Cambia Health Solutions, Inc (Renton, WA)
- Medicare Stars Transformation Consultant SRWork from home (telecommute or tele-flex) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our ... system. Who We Are Looking For: Every day, Cambia's dedicated team of Medicare Stars Transformation Consultants are living our mission to make health care easier… more
- Option Care Health (Springfield, IL)
- …the needs of the Business Teams.Interface and collaborate across the business with functions including Operations , Market Access, Internal Audit, Legal, ... oversight and/or review and approval of programs and processes with our Business Teams other functions.Collaborates with Compliance Operations on healthcare… more
- Cambia Health Solutions, Inc (Portland, OR)
- …provider engagement initiatives.Experience with healthcare economics and/or risk adjustment; project management of large-scale business change, strategy ... fit. What You Bring to Cambia: Qualifications: Bachelor's degree in business administration, finance, healthcare administration or related field. Master's degree… more
- Option Care Health (Chicago, IL)
- …pharmacy and/or nursing compliance programs.Direct experience applying knowledge of Medicare , Medicaid, and Managed Care reimbursement guidelines.Formal project ... medical or religious accommodations will be required to be submitted within 5 business days of start date. If medical and/or religious accommodation requests are… more
- Cosumnes Community Services District (Pine Bluff, CA)
- …for operations and maintenance (O&M) activities, implementation of standardized business processes, and related reporting. * Maintains the integrity and accuracy ... Bachelor's degree or equivalent education in architecture, engineering, maintenance operations management/construction science, finance, economics, business administration,… more
- The Cigna Group (Tampa, FL)
- A member of the Cigna Medicare Business Operational Excellence Process Engineering team. This role will lead, facilitate, and drive business process ... coordinate business projects, including: + Define the business case, guide chartering, apply proper project ...changes into implementation plans (DFSS and DMAIC preferred) + Medicare Operations experience preferred. + Bachelors Degree… more
- UCLA Health (Los Angeles, CA)
- …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 product ... achieve project objectives and deliverables that include project schedule management, scope, IT and business ...of 5 years' experience with CMS processes in a Medicare or Managed Care environment required + Project… more
- USAA (Phoenix, AZ)
- …what makes us so special! **The Opportunity** We are currently seeking a talented ** Business Process Owner I** 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
- Independent Health (Buffalo, NY)
- …cross-functional groups to track and ensure compliance with regulatory requirements for the Medicare line of business . The Medicare Programs Implementation ... to ensure program deliverables are achieved and aligned with Medicare line of business objectives. The ...proven understanding of regulatory requirements as they relate to Medicaid/ Medicare Managed Care Operations . + Skill in… more
- Centene Corporation (East Syracuse, NY)
- …care operations , compliance, auditing, project management, or business analysis experience, preferably within the Medicare field. Previous experience ... assure vendor performance consistently meets regulatory requirements and internal business objectives + Monitor vendor performance, including subsidiaries and… more
- Guidehouse (Lewisville, TX)
- …**Team Lead - Medicare Specialist** will assist in overseeing the daily operations of assigned project (s). This position is responsible for providing support ... Lead will and may work closely with their team, project supervisors, operations managers, and the client...opportunities with new and emerging approaches to our clients' business processes. This position will follow and ensure that… more
- St. Luke's University Health Network (Allentown, PA)
- … is responsible for managing and directing key operations and business -related projects. Leads and oversee multiple project strategic network initiatives ... align with network strategy. JOB DUTIES AND RESPONSIBILITIES: + Create detailed project plans, gather and document business requirements with intended outcomes,… more
- LA Care Health Plan (Los Angeles, CA)
- Technical Project Analyst II Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support Services Location: Los Angeles, CA, US, ... Project Analyst (TPA) II will support projects with Project Managers and/or business partners to ensure...and meaningful business and functional requirements for business and technical partners. Analyze operations and… more
- LA Care Health Plan (Los Angeles, CA)
- …definitive project execution plans. Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions ... would improve business performance. Consults across business operations...business and technology communities to accomplish expected committed project outcomes. Proven ability to understand healthcare technology architecture… 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
- Humana (Columbus, OH)
- …leader ready to support projects and products in support of Humana Government Business (HGB). The Senior Project Manager will manage assignments that involve ... key associates to meet the goals of Humana Government Business . **KEY ACCOUNTABILITIES** 50% ** Project Execution** :...5 or more years' experience in the fields of operations , organizational development or customer service + Lean; Six… more
- Centene Corporation (Jefferson City, MO)
- …instructions from regulatory agencies (Department of Insurance (DOI) and Centers for Medicare & Medicaid Services (CMS)) and assists in the development of and ... Performs root cause analysis to inform continuous improvement and special project development activities. + Oversees and prepares Qualified Health Plan templates… 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
- STERIS (Brooklyn Park, MN)
- Project Quality Engineer Req ID: 44399 Job Category: Quality Brooklyn Park, MN, US, 55445 Description: At STERIS, we help our Customers create a healthier and safer ... Part 820. This role supports complaint/CAPA investigations, supplier quality improvement, operations production and process controls, and product and service quality… more
- AdventHealth (Altamonte Springs, FL)
- …enrollment and obtains necessary supportive documentation. . Actively participates in business acquisitions. . Prepares/updates project and facility data ... enrollment and obtains necessary supportive documentation. o Actively participates in business acquisitions. o Prepares/updates Project and Facility spreadsheets… more
