- The Cigna Group (Atlanta, GA)
- …market, incumbent candidate will work from local office 3 days per week.** The Provider Performance Enablement Senior Advisor is an integral part of a ... cross-functional, collaborative organization (which includes Market Provider Performance , Sales, Clinical Operations, Stars &...members contribute to the growth and profitability of the Medicare Advantage business in their market in… more
- Humana (Atlanta, GA)
- … and Medicaid's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Medicare Strategy Lead, ... performance of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual … more
- Humana (Atlanta, GA)
- … and Medicaid's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Medicare Strategy ... performance of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual … more
- Humana (Atlanta, GA)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid requirements, and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Atlanta, GA)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... general surgery preferable** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other Medical… more
- Highmark Health (Atlanta, GA)
- …locations and departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage across footprint. Designs, implements and executes strategies ... the Organization are met and to optimize outcomes. Collaborates with the company's Medicare Advantage matrixed teams to improve processes, procedures and best… more
- Humana (Atlanta, GA)
- …Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and Medicare Advantage value based programs. DVACO is a joint venture among ... grouping, with more than 2,000 physicians and approximately 70,000 Medicare fee-for-service beneficiaries. Additionally, DVACO currently holds performance -based… more
- Humana (Atlanta, GA)
- …Sales and Specialty Marketing will advance our approach to marketing for Group Medicare Advantage , Individual and Group Specialty health care plans. In addition, ... We believe our role goes beyond that of a provider of insurance to that of a well-being partner...Humana's broad range of insurance plans, including the robust Medicare Advantage portfolio. This incumbent will combine… more
- Humana (Atlanta, GA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Atlanta, GA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Atlanta, GA)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... Medical Coding Coordinator 2 + Maintains required standards of performance and productivity to meet turnaround times and service...+ Works with other departments such as Claims, Finance, Provider Services, and Provider Configuration and Load… more
- Humana (Atlanta, GA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid, or other Medical management organizations,… more
- Humana (Atlanta, GA)
- …in 4+ Star plans for six consecutive years. This quality measure of Humana's Medicare Advantage product offering directly impacts our members' health. **Use your ... to a broad range of audiences * Ensure solutions provide the highest quality of data * Contribute to...moving the team towards cloud-based analytical platforms Member and Provider Analytics, the department this role is a part… more
- CenterWell (Atlanta, GA)
- …Internal Medicine or Geriatric Medicine preferr + Active and unrestricted DEA license + Medicare Provider Number + Minimum of two to five years directly ... team-based care environment. We are a value based care provider focused on quality of care for the patients...applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding… more
- Humana (Atlanta, GA)
- …to identify and address business issues and opportunities related to the high-needs Medicare Advantage (MA) and Special Needs Plan (SNP) populations that benefit ... on opportunities to improve member health outcomes, member and provider experience, clinical quality, and savings to medical costs....to analyze complex problems and issues related to our Medicare Advantage population using data and insight… more
- CVS Health (Atlanta, GA)
- …will be to continue to build and maintain our existing PPO, Extend, DMO and Medicare Advantage networks in a specific geographic area + Explaining the value in ... **Preferred Qualifications** + Dental industry knowledge + Knowledge of PPO and Medicare advantage methodologies + Negotiation skills + Sales presentation skills… more
- CenterWell (Atlanta, GA)
- …business in business, healthcare administration, or related field. + Proven experience with Medicare Advantage risk adjustment functions + Proven track record of ... of people, processes, and technology enablement (including GenAI) + Responsible for performance management and strategy development for PCO risk adjustment at the… more
- MarketSource (Alpharetta, GA)
- …and lead the insurance compliance management strategy for the organization's Medicare Advantage sales program including carrier compliance, and multi-carrier ... Oversee the investigation and remediation of customer and CTM complaints, Medicare sales allegations, and grievances and lead deficiency identification and… more
- Conviva (Atlanta, GA)
- …PCO has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality ... being considered for an interview will be asked to provide a social security number, if it is not...internet expense. + A minimum standard speed for optimal performance of 25*10 (25mpbs download x 10mpbs upload) is… more
- Humana (Atlanta, GA)
- …to transform traditional financial and Actuarial work + Strong understanding of Medicare Advantage products and dynamics that impact capitated arrangements and ... Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions.… more