- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Senior Contact Center Representative, you will be addressing and resolving complex member inquiries, providing ... clear and empathetic communication + Manage escalated calls from Contact Center Agents related procedural inquiries + Assist members,...Center environment + Two or more years in a Medicare Advantage role, highly desired + Exceptional… more
- The Cigna Group (St. Louis, MO)
- …and other day of choosing)** **Summary:** The Stars and Risk Adjustment Operations Senior Advisor will report to the Stars and Risk Adjustment Managing Director and ... actions into a synthesized set of business updates and strategies for a senior executive-level audience. Ideally this high-potential candidate uses this role as a… more
- The Cigna Group (Bloomfield, CT)
- …is REMOTE** The **Project Manager** is a key role that supports **Cigna's Medicare Advantage ** line of business, directly addressing customer and client demands ... higher quality of care and greater affordability for the senior population. The primary focus for this role includes...+ Demonstrated ability to influence decisions in support of Medicare Advantage vision & strategy + **Proficient… more
- CVS Health (Lansing, MI)
- …+ 10+ years' of FP&A experience within the healthcare industry + Strong knowledge of Medicare . Knowledge of Group Medicare Advantage will be highly valued. + ... leadership + Serve as the primary point of contact for the Medicare COE and other...Education (IME) Payment and their financial impacts to the Medicare Advantage program + Strong financial acumen… more
- PruittHealth (Athens, GA)
- …at which to conduct outreach activities and maintain calendar of such events. Market Medicare Advantage on-site at senior centers, food pantries, community ... plan benefits and to act as a point of contact if the potential member or their family needs...community dynamics. * Demonstrate compliance with CMS regulations regarding Medicare Advantage Plans and PruittHealth Code of… more
- Martin's Point Health Care (Portland, ME)
- …programs. + Strong project management experience required. + Experience in Medicare Advantage and TRICARE preferred. Required License(s) and/or Certification(s): ... (Behaviors): + Broad knowledge of managed care and health plan functions; Medicare Advantage required; USFHP and/or TRICARE knowledge is a plus… more
- Martin's Point Health Care (Portland, ME)
- …most major insurance plans. Martin's Point also administers two health plans: Generations Advantage ( Medicare Advantage plans available throughout Maine and ... as a "Great Place to Work" since 2015. Position Summary The position of Senior Director, Member and Provider Services is responsible for the success and oversight of… more
- The Cigna Group (Bloomfield, CT)
- …termination management process in assigned markets for Commercial, IFP and Medicare Advantage products. Works closely with Contracting, Network Solutions, ... position aligned to the Northeast and Central USA market._** The **Business Project Senior Analyst** serves as an integral member of the Network Development and… more
- Elevance Health (Columbus, OH)
- …+ 8-10 years of leadership and Managed Care experience, preferably in Medicare Advantage strongly preferred. + Experience working closely with offshore ... **Rating/Claims System Senior Advisor** **Location:** This position will work a...as related to claims processing. + Responsible for monitoring Medicare changes as they relate to claims payment and… more
- Conviva (Columbia, SC)
- …has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality ... teamwork and providing a positive and welcoming environment for all. The Senior Business Systems Analysis Professional performs analysis of business, process and… more
- New York State Civil Service (Thiells, NY)
- …HELP Yes Agency People With Developmental Disabilities, Office for Title Senior Physical Therapist (NY HELPS) Occupational Category Health Care, Human/Social ... Minimum Qualifications MINIMUM QUALIFICATIONS:* Currently permanent in the title of Senior Physical Therapist.OR* Active and reachable on the appropriate Civil… more
- Molina Healthcare (Escondido, CA)
- …and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for ... of customer service. **Job Duties** This role serves as the primary point of contact between Molina Health plan and the Plan's highest priority, high volume and… more
- New York State Civil Service (Brewster, NY)
- …HELP Yes Agency People With Developmental Disabilities, Office for Title Senior Physical Therapist (NY HELPS) Occupational Category Health Care, Human/Social ... must have one year of permanent service as a Senior Physical Therapist or in a title deemed appropriate...maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on… more
- Independent Health (Buffalo, NY)
- …and statistical analyses, specifically designed to support pricing and bidding for Medicare Advantage plans. Such projects will support both internal and ... perks, benefits and commitment to diversity and inclusion. **Overview** As a Risk Revenue Analyst- Senior the incumbent will provide a full scope of actuarial… more
- Highmark Health (Columbus, OH)
- …to support STARs performance, and provider incentive programs in partnership with senior leadership for the Medicare Advantage Quality Consultants. ... departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage across footprint. Designs, implements and...any and all users. If you would like to contact us regarding the accessibility of our website or… more
- Conviva (San Antonio, TX)
- …+ Develop and nurture relationships with brokers and intermediaries specializing in senior healthcare, Medicare Advantage , and value-based care models. ... revenue growth. + Serve as the primary point of contact for brokers, providing them with the necessary tools,...models. + Deep understanding of Original Medicare , Medicare Advantage , and other senior … more
- Blue Cross and Blue Shield of Louisiana (New Orleans, LA)
- …This role does not manage people. + This role reports to this job: Vice President, Medicare Advantage & Medicare Supplement Plan Sales + Necessary Contacts: ... Medicare Advantage customers and all levels of internal BCBSLA personnel...industry trends, competitor activities, and emerging opportunities within the senior healthcare market adjusting sales strategies and identify new… more
- CenterWell (Houston, TX)
- …+ Develop and nurture relationships with brokers and intermediaries specializing in senior healthcare, Medicare Advantage , and value-based care models. ... revenue growth. + Serve as the primary point of contact for brokers, providing them with the necessary tools,...models. + Deep understanding of Original Medicare , Medicare Advantage , and other senior … more
- BrightSpring Health Services (Louisville, KY)
- …a Medical Services company, Population Health Management services company, and a Medicare Advantage Institutional Special Needs Plan (I-SNP).Under the direction ... focus of this position will be to support the Medicare Advantage Institutional Special Needs Plan (I-SNP),...validate and communicate impact of strategic operational changes to senior management and Company operations on a consistent basis.… more
- Conviva (Lake Park, FL)
- …+ Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating multiple centers across… more