- Molina Healthcare (NM)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- Humana (Albuquerque, NM)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and… more
- Molina Healthcare (NM)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key… more
- CenterWell (Santa Fe, NM)
- …appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a ... services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. +… more
- CenterWell (Santa Fe, NM)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
- CenterWell (Santa Fe, NM)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CenterWell (Santa Fe, NM)
- …CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group will provide ... , a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group...the state. . Graduate of accredited MD or DO program of accredited university . Board certification or eligible… more
- CenterWell (Santa Fe, NM)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel:… more
- CVS Health (Santa Fe, NM)
- …improve outcomes, manage costs, and offer an unmatched experience for our patients. As a Senior Product Manager , you will be a key leader in our organization, ... have the needed support from specialist. You'll work with senior business and engineering leaders to lead a product...digital health solutions + 4+ years as a Product Manager + Experience with data analytics and core healthcare… more
- CenterWell (Santa Fe, NM)
- …+ Coordinate, review, and analyze documentation and data entry supporting Medicare , Medicaid, and commercial payer requirements to ensure accurate and timely ... requested. + Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures + Participate in special… more
- CenterWell (Santa Fe, NM)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more