- Cambia Health Solutions, Inc (Portland, OR)
- …Compliance Officer leads the company's Government Programs Compliance efforts, including Medicare Compliance efforts and Federal Employee Program compliance ... health care public policy issues.Health insurance, including state, federal and managed care program requirements, with an emphasis on Medicare health care laws… more
- Alternate Solutions Health Network LLC (North Kansas City, MO)
- …Health Network LLC is seeking a Registered Nurse (RN) Home Health Case Management for a nursing job in North Kansas City, Missouri.Job Description & ... for our patients like they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and… more
- ConsultNet (North Kingstown, RI)
- The Customer Care Manager supervises daily operations and team members while ensuring efficiency, cost-effectiveness, and absolute customer satisfaction in a ... Customer Care Manager, Rx will focus on supporting our Medicare Part D and PBM business by providing a...customers. Oversees and monitors daily workflow to ensure smooth operations , process efficiency, and quality Develops and motivates staff.… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …knowledge and compliance with OSHA regulations, organization's safety policies and risk management program . Physical DemandsWeight Lifted: Up to 50 lbs, ... of the Hospice aides. Provides on-call coverage for the hospice program . Minimum Job QualificationsLicensure or other certifications: Georgia RN licensure. Current… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …position reports to the Executive Director of Hospital Revenue Cycle Operations and is responsible for developing, implementing, coordinating, and managing the ... throughout the organization. Develop the alignment of the revenue integrity program with applicable policies and procedures and all applicable laws, standards,… more
- Community Hospital Corp (Odessa, TX)
- …at ContinueCARE Hospital at Medical Center, Odessa, TX is responsible for the day-to-day operations of the clinical services of the 25 bed Long Term Acute Care ... financial and clinical performance of the hospital. Works with Board, senior management team, physicians and staff to develop, implement, and update strategies and… more
- Signature HealthCARE (Portland, TN)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid ServicesAdditionally, we have been awarded as a certified Great Place ... care possible to residentsHow you Will make a difference Manage the overall operations of the Nursing Department in accordance with Company policies, standards of… more
- Signature HealthCARE (Portland, TN)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid ServicesAdditionally, we have been awarded as a certified Great Place ... Healthcare's "Best Places to Work!" How you Will make a difference Our Plant Operations Directors make a difference in the lives of our stakeholders and residents by… more
- Blanchard Valley Health System (Findlay, OH)
- …THIS POSITION The purpose of this position is to provide leadership and management of the accounting staff, assist with accounting related duties as necessary, while ... economic conditions and recommends modifications in the health system's operations to the Finance and HR leadership. Duty 4:...and taxing authorities. Including but not limited to: a. Medicare and Medicaid Cost Reports. b. Forms 990 and… more
- The Cigna Group (Bloomfield, CT)
- …effectiveness. **Qualifications and Competencies** + 5+ years' experience working with the Medicare market and operations environments + 5+ years' experience in ... Reporting to the Risk Adjustment Strategy and Operations Leader, this role serves as leading and managing all activities related to Cigna's Corporate Integrity… more
- Molina Healthcare (Bowling Green, KY)
- …bottlenecks and recommend improvements. **Stakeholder Collaboration:** + Work closely with Medicare program managers, compliance officers, and other relevant ... Operations plays a critical role in managing and optimizing call center operations , with a focus on supporting Medicare -related services. As an AVP, you'll… more
- The Cigna Group (St. Louis, MO)
- …and or equivalent work experience, highly preferred. + **5 or more years of** ** Medicare project and team management ** **experience** + Track record of managing ... Wednesday and other day of choosing)** **Summary:** The Stars and Risk Adjustment Operations Senior Advisor will report to the Stars and Risk Adjustment Managing… more
- The Cigna Group (Bloomfield, CT)
- …Care/Managed Care Programs and/or Operations , required + 2+ years Relation Management experience, required + Medicare experience, highly preferred + Clinical ... **This is a Medicare Advantage position.** **Work Location: This is a...includes driving and/or supporting the vendor service strategy, relationship management , business process improvements, operational efficiencies and effectiveness, and… more
- The Cigna Group (Bloomfield, CT)
- …+ Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for ... regular trainings and other collaborative meetings as appropriate. + Works with management team to achieve operational objectives and financial goals. + Supports… more
- The Cigna Group (Bloomfield, CT)
- …required; MBA and/or Masters in relevant field also valued + **2+ years Medicare experience, required** + **2+ years Project Management experience, required** + ... Leadership mentality + Experience in health care/managed care programs and/or operations preferred + Result-oriented with demonstrated project management skills… 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' s ... health and quality of life. Directs the Individual and Medicare Sales team policies and objectives to achieve sales...Directs the day-to-day brokered and captive agent resources and operations to meet set sales targets. . Collaborate with… more
- USAA (San Antonio, TX)
- …that will support Medicare Supplement Claims for USAA Life Company Claims Operations . This employee will report to the Life Company Chief Claims & Fraud Officer ... processes. This role will involve execution of any Issue Management matters for Medicare Supplement claim issues.... claim settlements + Experience working with quality assurance program /process for Medicare Supplement claims + Working… more
- The Cigna Group (Bloomfield, CT)
- …are being delivered and effectively disseminated by accountable teams (Business Management , Business Development, Operations , etc.). + Lead other projects, ... a member of the clinical senior leadership team, the Chief of Staff for the Medicare Clinical Strategy team will report directly to the Vice President (VP) and Chief… more
- CVS Health (Lansing, MI)
- …+ Develop annual operating plans and work across the Aetna and Medicare organizations to assess performance, define clear program strategies and ... superior P&L management + Driving financial strength of the Group Medicare business segment while positioning for future profitable growth + Deep engagement with… more
- UCLA Health (Los Angeles, CA)
- …managing processes that maintain essential elements of our compliance efforts within the Medicare Advantage program . In this role, you'll oversee policy and ... management , training, regulatory distribution, risk management , and incident management . Leveraging your deep knowledge of CMS Medicare Advantage and… more
