- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Senior Contact Center Representative, you will be addressing and resolving complex member inquiries, providing ... required + Two or more years working contact center environment or experience with Medicare Advantage health plan, highly desired + Working knowledge… more
- UCLA Health (Los Angeles, CA)
- …You will provide tactical execution and leadership for our Member and Provider Contact Center , ensuring new and existing members and providers receive ... responsible for managing, coaching, and developing the supervisor and contact center teams to deliver high-performance results...within a 100% virtual work environment + Understanding of Medicare Advantage program rules and regulations +… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS)...issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application… more
- Dignity Health (Phoenix, AZ)
- …**Responsibilities** Develops operates and administers the regulatory compliance program for both Medicare Advantage (Part C) and Medicare Part-D plan ... conveniently in the heart of Phoenix Arizona St. Josephs Hospital and Medical Center is a 571-bed not-for-profit hospital that provides a wide range of health… more
- Conviva (New Braunfels, TX)
- …of two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... $300K depending on experience and location** . **Responsibilities:** . Evaluates and treats center patients in accordance with standards of care. . Follows level of… more
- Georgetown Univerisity (Washington, DC)
- …offers rigorous academic programs, a global perspective, exciting ways to take advantage of Washington, DC, and a commitment to social justice. Our community ... in the world. Requirements As a top academic health and science center in the United States, Georgetown University Medical Center (http://gumc.georgetown.edu/)… more
- Centers Plan for Healthy Living (Bronx, NY)
- …beneficiaries by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and ... in the community and serve as a point of contact for our current members. PRIMARY RESPONSIBILITIES : Performance...frequent travel to various Centers Plans or Healthy Living Advantage Care Medicare HMO Plan sites located… more
- Fallon Health (Worcester, MA)
- …Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit ... **Overview** **Fantastic Call Center Opportunities with training, career path advancement, great...the face of the organization; the single point of contact for our valued providers and members. Think of… more
- Medical Mutual of Ohio (Toledo, OH)
- …for resolution on first contact ). . Builds and maintains commercial and Medicare Advantage knowledge and skills. Participates in refresher or other training ... self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and...identifies and documents complaints and appeals in accordance with Center for Medicare /Medicaid Services (CMS) regulations. .… more
- Kelsey-Seybold Clinic (Baytown, TX)
- …completion of Epic Front desk training OR 1+ years KSC CBO, Managed Care or Contact Center experience. Preferred: 2+ years of working in a physician, hospital, ... to identify, understand and communicate plan details to patients with HMO, PPO, EPO, Medicare Advantage and other plans. 1+ years of cash handling or collections… more
- Delta Dental of Iowa (Johnston, IA)
- …manage key contract deliverables and program oversight related to our Medicaid and Medicare Advantage business. You will compile data from multiple sources, ... insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we...monitor, and provide all ODAG reporting required for CMS Medicare Advantage data submission and Audits to… more
- New York State Civil Service (West Seneca, NY)
- …Credentials will be reviewed at the time of interview.Background Investigation/Justice Center Review: In some agencies, the names of all prospective employees ... the Staff Exclusion List (SEL), maintained by the Justice Center for the Protection of People with Special Needs.Prospective...are responsible for payment of all required fees.Medicaid and Medicare : In order to be eligible for appointment and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Medical Mutual' ... fundamental customer service philosophies and best practices in a contact center environment. . Intermediate computer navigation...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Kelsey-Seybold Clinic (Spring, TX)
- …value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage , a Medicare Advantage plan offered to Houston-area ... + Actively participate and serve as the primary point of contact for department EPIC Optimization requests and implementations Cardiology Clinic Responsibilities:… more
- Conviva (Tampa, FL)
- …+ Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a...environment in a value-based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality… more
- Conviva (Boca Raton, FL)
- …of two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a...in a value based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality… more
- Elevance Health (Richmond, VA)
- …Impact:** + Manages the day-to-day operations of our 'Other' revenue programs in Medicare Advantage and Medicaid + Develops metrics, policies and procedures in ... the intent of enhancing the revenue we receive from Center for Medicare and Medicaid Services (CMS)...or local laws. Applicants who require accommodation to participate in the job application process may contact ###@elevancehealth.com for… more
- Conviva (Orange City, FL)
- …+ Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... with them. **Patient Care** : + Evaluates and treats center patients in accordance with standards of care. +...in a value based relationship environment. + Knowledge of Medicare guidelines and coverage. + Bilingual is a plus… more
- Kelsey-Seybold Clinic (The Woodlands, TX)
- …value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage , a Medicare Advantage plan offered to Houston-area ... up of all labs using CITRIX as needed) + Contact Department Chief regarding follow-up of unresulted and unaddressed...by Dr. Mavis Kelsey in Houston's renowned Texas Medical Center . More than 850 physicians and allied health professionals… more
- CenterWell (Arlington, TX)
- …and nurture relationships with brokers and intermediaries specializing in senior healthcare, Medicare Advantage , and value-based care models. + Identify and ... revenue growth. + Serve as the primary point of contact for brokers, providing them with the necessary tools,...and value-based care models. + Deep understanding of Original Medicare , Medicare Advantage , and other… more