- Highmark Health (Camp Hill, PA)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Humana (Columbus, OH)
- …on Medicare Advantage strategy development. As a Senior Medicare Strategy Consultant , you will deconstruct issues and challenges, perform targeted ... initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Washington, DC)
- …the performance of strategic initiatives and business areas, refreshing the Medicare Advantage growth strategy, and identifying improvement opportunities for ... us put health first** The Growth Strategy Program Management Consultant provides data-based strategic direction to identify and address...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Elevance Health (Lexington, KY)
- … Sr.** for **Provider Success** is responsible for consulting with providers ( Medicare Advantage and Medicaid) to assess and deploy appropriate interventions ... Care Consultant Sr. (Provider Success) - JR126256 **Location** :...action plans around population health management, patient satisfaction and quality and cost performance. + Facilitation of collaborative meetings… more
- Highmark Health (Harrisburg, PA)
- …gain share and risk share models and will be implemented for the Organization's Medicare Advantage , Medicaid, ACA, and commercial populations with the goal of ... maximizing quality while reducing healthcare costs. + Work with reimbursement,...+ Collaborate with and support the senior Strategic Partners Consultant role as needed + Other duties as assigned… more
- CVS Health (Columbus, OH)
- …**Required Qualifications** - CPC certification - 3+ years risk adjustment experience in Medicare advantage or commercial - 3+ years of provider education ... overall risk adjustment scores and gaps. Identifies opportunities to promote quality . Shares best practices in risk adjustment across all sites/regions.… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- CenterWell (Dallas, TX)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- ChenMed (Philadelphia, PA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... demonstrates 1) success in developing providers to deliver high quality , cost-effective care; 2) effective dyad partnership with the...Act as a health coach, rather than just a consultant for sickness, by helping patients set short and… more
- ChenMed (Columbus, OH)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Detroit, MI)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- Mount Sinai Health System (NJ)
- …Develop standards of care in accordance with The Valley Medical Group's Quality Assurance/ Quality Improvement process **REPORTS TO** **: Chair, Primary ... immunize patients from communicable diseases. 10. Refers patients to specialist for consultant services when necessary for the patient's well being. 11. Physician… more
- ChenMed (Detroit, MI)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- ChenMed (Fort Myers, FL)
- …when leading their care teams towards their performance goals. "IntuneHealth is for Medicare Advantage seniors seeking PCP-led, high- quality care when and ... serves as a health coach, rather than just a consultant for sickness, by helping patients set short and...to ensure compliance with guidelines. Participates in risk and quality management programs, clinical meetings and other meetings that… more
- Cedars-Sinai (Los Angeles, CA)
- …MH services, including maintaining the network of providers for the CSMN Medicare Advantage plan(s). + Assists Contracting with identification, engagement, and ... executive leadership within the CSMN, including but not limited to Quality , Population Health, Clinical Transformation, Network Management, Clinical Operations and… more
- Provider Solutions & Development (Walla Walla, WA)
- …Mary is one of seven hospitals in the state to earn a five-star rating for quality from the Centers for Medicare and Medicaid Services, while also having an ... a large research network, and opportunities for investigator-initiated trials. Take advantage of all these professional growth opportunities while enjoying life in… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive ... efficient transition of care across the continuum. + Responsible for monitoring quality metrics specific to the department & ensuring complete & accurate… more