- The Cigna Group (Bloomfield, CT)
- …and Negotiating experience involving complex delivery systems and organizations required; Medicare contracting value based experience required and ... Travel Required: Up to 25% - local and some overnight regional travel. The Medicare Advantage Value - Based Contracting Regional Director serves as an integral… more
- The Cigna Group (Nashville, TN)
- …Lead will be an individual contributor responsible for providing analytics supporting value - based care capabilities for Accountable Care. This role will be ... matrix partners to provide analytical reporting for use in evaluation of our value - based care programs. **Responsibilities** + Create tools and reports to help… more
- Medical Mutual of Ohio (OH)
- …. **_Eastern & Central Time Zones preferred._** **Responsibilities** ** Medicare Pharmacy Coordinator I** Working under general supervision, administers ... to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part...refills, and switch members to lower cost therapeutic alternatives based on discussions with providers. Documents all attempts in… more
- CVS Health (Lansing, MI)
- …not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual ... Solutions** (GRS) is a core component of the Aetna Medicare Organization. Our vision is to develop an industry-leading...industry-leading group retiree health care business by delivering unrivaled value to our plan sponsors and members alike. We… more
- AdventHealth (Altamonte Springs, FL)
- …24029849 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, ... of work papers for the filing of the annual Medicare , Medicaid, and Champus/Tricare cost reports, audit preparation and...performed under the oversight of the Reimbursement Manager. **The value that you bring to the team:** . Assist… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....Mutual is looking to grow our team! We truly value and respect the talents and abilities of all… more
- AdventHealth (Altamonte Springs, FL)
- …23007379 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, ... Reimbursement Analyst is responsible for preparing and filing the annual Medicare , Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal… more
- The Cigna Group (Phoenix, AZ)
- **Competitive Intelligence Advisor - Medicare Portfolio** **Our Team** Cigna continues to make significant investments in enterprise resources to drive growth across ... insights agenda to support internal stakeholders and clients for Cigna Healthcare's Medicare portfolio with a focus on individually sold Medigap and Supplemental… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans....Mutual is looking to grow our team! We truly value and respect the talents and abilities of all… more
- Humana (Columbus, OH)
- …of Humana processes, as well as a focus on collaborative business relationships, value - based care, quality metrics, population health, and disease or care ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- General Dynamics Information Technology (Fairfax, VA)
- …None **Job Family:** Data Analysis **Skills:** Analytical Thinking,Data Science, Medicare ,R Programming,Statistical Analysis **Experience:** 3 + years of related ... Data Scientist to help us support the Centers for Medicare and Medicaid Services (CMS). At GDIT, our people...of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements… more
- The Cigna Group (Bloomfield, CT)
- …direction of assigned markets and is accountable for the management of value - based and fee-for-service contracting and network management activities for multiple ... Manages increasingly complex contracts and negotiations for fee-for-service and sophisticated value - based reimbursements with hospitals and other providers for… more
- Centene Corporation (Cheyenne, WY)
- …and value by leading the dental, vision and hearing Medicare Product development through strategy development, identify opportunities, plan, organize, monitor ... health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on… more
- The Cigna Group (Plano, TX)
- …system contracting and negotiations for fee for service and sophisticated value - based reimbursements with providers for Cigna's Medicare product lines (eg, ... Antonio, Dallas or Plano** The **Director, Provider Contracting - Medicare ** serves as an integral member of the Network...for the management of the fee for service and value based contracting and network management activities… more
- The Cigna Group (Nashville, TN)
- …contract arrangements inclusive of health systems, physician groups, independent providers and value - based programs. + Directs network analytics for the market - ... has both an affordable and marketable network. + Manages existing market value - based arrangements (VBA). Responsibilities include overseeing VBA monthly close… more
- Somatus (Mclean, VA)
- Overview As the largest and leading value - based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to ... well-being + Community engagement opportunities + And more! The Sr. Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of… more
- Humana (Albany, NY)
- … Medicare Advantage plan filings + Lead the expansion and support for value - based care and innovation with internal and external providers + Build ... and provider engagement activities for all lines of business + Medicare Advantage experience **Additional Information** This position will require approximately 30%… more
- The Cigna Group (Denver, CO)
- …plan. + Educating providers on the performance requirements associated with value - based contracts. + Conducting regular provider visits to educate ... conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance External Representative's responsibilities include: +… more
- CVS Health (Hartford, CT)
- …and financials + Tracking progress against key milestones, and creating and implementing value - based metrics and analysis to measure outcomes + Proven track ... care more personal, convenient and affordable. **Position Summary** The Medicare Strategic PMO is seeking a number of qualified...in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin,… more
- The Cigna Group (Franklin, TN)
- …operational and analytical support to our partners to improve clinical programs, customer value , growth, and retention for Cigna Medicare . This role will help ... **Summary** The Data Scientist Lead Analyst will contribute to the Medicare Clinical and Customer strategy, performing research and analysis within the Clinical,… more