• Medicare Value - Based

    Bloom Healthcare (Lakewood, CO)
    Job Title: Manager, Medicare Value - Based Programs Location: Denver, Colorado Reports to : Vice President of Innovation About Bloom: Bloom Healthcare is a ... first. Position Overview: Bloom Healthcare is looking for a motivated Manager of Medicare Value - Based Programs to oversee the daily operations of our… more
    Bloom Healthcare (12/06/24)
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  • Senior Medicare Data & Finance Analyst

    AdventHealth (Altamonte Springs, FL)
    …risk- based Medicare Advantage and ACO REACH data + Perform analysis of risk- based Medicare populations and program data to identify key areas of ... teams, excellent analytical skills, a deep understanding of the Medicare Advantage program and data, and a...+ Minimum 5 years' experience in analytics with a Medicare Advantage Plan or senior value - based more
    AdventHealth (12/10/24)
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  • Medication and Pharmaceutical Policy Analyst

    American Institutes for Research (Rockville, MD)
    …familiarity with CMS, the ACA, Medicare Part D, and Medicare -specific value - based care policy and programs is preferred. + Knowledge of medications, ... care policy priorities, including the Affordable Care Act (ACA), value - based care models, and health care quality...related to AIR Health's work with the Centers for Medicare & Medicaid Services (CMS). In addition, the candidate… more
    American Institutes for Research (11/16/24)
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  • Post-Acute Liaison

    Methodist Health System (Dallas, TX)
    …under the ACO. * Design, implement and oversee hospice monitoring program for Medicare Advantage value based agreements. * Design, implement and oversee ... home health needs assessment and program for Medicare Advantage value based agreements. *Design, implement and oversee home health recertification … more
    Methodist Health System (10/08/24)
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  • Broker Relationship Manager - CenterWell Dallas

    CenterWell (Arlington, TX)
    …and nurture relationships with brokers and intermediaries specializing in senior healthcare, Medicare Advantage, and value - based care models. + Identify ... pivotal role in advancing our mission to deliver high-quality, value - based care to seniors across the nation....based care models. + Deep understanding of Original Medicare , Medicare Advantage, and other senior healthcare… more
    CenterWell (10/30/24)
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  • Population Health Strategy Consultant (Remote)

    CareFirst (Baltimore, MD)
    …systems ("providers") enrolled in CareFirst's government ( Medicare and Medicaid) & value - based programs to understand patterns in their population's ... patient, PCP, specialist and hospital. Recruits providers and negotiates terms of value based contracts, facilitates relationships between key stakeholders, and… more
    CareFirst (01/04/25)
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  • Sr Program Manager, Medicare Stars

    Molina Healthcare (Columbus, OH)
    …process to completion. * Manages, plana and executes Medicare Star Ratings programs . Assigns and monitors work of program management staff providing support ... the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs...outcomes measurement. * Monitors and tracks key performance indicators, programs and initiatives to reflect the value more
    Molina Healthcare (12/19/24)
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  • Medicare Advantage Quality Consultant…

    Highmark Health (Harrisburg, PA)
    …strategic plans to meet identified program targets across all the Organization's value - based programs for both the commercial and government business ... Medicare STARS, Medicaid HEDIS and risk revenue programs and clinical evidence- based guidelines.The Medicare...expert in government value - based reimbursement programs and data analysis.This includes presentation of program more
    Highmark Health (11/14/24)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C (medical drug) benefit programs . Configures, implements, maintains, and ... refills, and switch members to lower cost therapeutic alternatives based on discussions with providers. Documents all attempts in...with the Medicare Part D (pharmacy) and Medicare Part C (medical drug) benefit programs .… more
    Medical Mutual of Ohio (12/20/24)
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  • Medicare Sales Operations Specialist - Sr.

    Medical Mutual of Ohio (OH)
    …and experience. + 3 years of experience with government health insurance programs which includes exposure to Medicare Advantage, MA compliance protocols, ... oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to...sales compliance or equivalent experience with government health insurance programs which includes exposure to Medicare Advantage,… more
    Medical Mutual of Ohio (12/12/24)
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  • Lead Director, Medicare Operations

    CVS Health (New Albany, OH)
    …network providers, and distribution partners. + Serves in a strategic capacity overseeing value based provider contracting and performance. + Serves in a ... personal, convenient and affordable. **Position Summary** In support of the Chief Medicare Officer, the candidate has responsibility for ensuring that the local … more
    CVS Health (12/14/24)
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  • Senior Medicare Compliance Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …plans. Implements and manages the implementation and daily operation of the Medicare Advantage Compliance Program and all compliance-related activities for the ... and Federal Regulations that affect our various company products, specifically Medicare Advantage program regulations, and Statutory Requirements. . Proficiency… more
    Medical Mutual of Ohio (11/27/24)
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  • Medicare Products Analyst

    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 ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. The Medicare more
    Medical Mutual of Ohio (11/12/24)
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  • Medicare Advantage Customer Experience…

    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
    Medical Mutual of Ohio (11/15/24)
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  • Finance Medicare Reimbursement Analyst

    AdventHealth (Altamonte Springs, FL)
    …a working knowledge of current laws and regulations of the Federal Medicare and State Medicaid programs , including changes affecting hospital reimbursement ... . Well organized and detail-oriented **Preferred Qualifications** **:** . Knowledge of Medicare and state Medicaid program reimbursement laws and regulations .… more
    AdventHealth (12/14/24)
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  • VP, Medicare Regional President- Florida

    Humana (Miramar, FL)
    …networks to support profitable growth. + Lead the expansion and support for value - based care and innovation with internal and external providers. + Build ... part of our caring community and help us put health first** The VP Medicare Regional President will be responsible for the development and expansion of Humana's… more
    Humana (12/24/24)
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  • Clinical Services Support Specialist…

    Medical Mutual of Ohio (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
    Medical Mutual of Ohio (11/16/24)
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  • Product and Market Intern ( Medicare )

    BlueCross BlueShield of North Carolina (Durham, NC)
    …match, Paid Time Off (PTO), and competitive health benefits and wellness programs . _* Based on annual corporate goal achievement and individual performance._ ... dedicated to making healthcare better for ALL. Our internship program is highly regarded in our culture as a...work will be done at home, but we provide value -added opportunities for you to convene with your cohort… more
    BlueCross BlueShield of North Carolina (01/03/25)
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  • Health Plan Communications Specialist (Managed…

    Molina Healthcare (IA)
    …Writer, Campaign, Proposals, Creation, Digital Skills, Digital Marketing, Messaging, Communications, Medicaid, Medicare , VBC, Value Based Care, Managed Care, ... management of communications projects + 1+ year experience in Microsoft Office programs **Preferred Experience** + Experience in Associated Press (AP) Style +… more
    Molina Healthcare (12/14/24)
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  • Senior Medicare /Medicaid Research…

    Abt Global Inc. (Cambridge, MA)
    …add a talented researcher to its team of experts conducting policy-relevant Medicare and Medicaid research and evaluation. The successful candidate will leverage ... key technical roles on projects for the Centers for Medicare and Medicaid Services (CMS). As a member of...with clients, external partners, and the public. **What We Value ** + Demonstrated expertise and desire to further develop… more
    Abt Global Inc. (01/01/25)
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