- Atrium Health (Charlotte, NC)
- …quality of care metrics. Assumes accountability as delegated by the Director . Essential Functions: Position manages and develops interprofessional teams, providing ... critical workflows and is responsible for reporting and monitoring key performance measurement activities. Upholds all AAH leadership behaviors while performing… more
- Alameda Health System (Oakland, CA)
- …Collaborates with AHS leadership team to evaluate and complete the Periodic Performance Review (PPR) as required by the Joint Commission. Assists in organizing ... educational needs as requested by management and/or staff. Collaborates with the Director of Clinical Education in developing educational programs based on quality… more
- The Cigna Group (Bloomfield, CT)
- … significant opportunities for a leader to shape a significant component of the Medicare Growth strategy. The Director of Telesales will lead strategy and ... - United States** **Summary** The Direct to Consumer (DTC) Medicare channel is a significant driver of current and...sales execution. **_People_** + Build, motivate and lead a high- performance team. Develop direct reports and provide … more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Medicare Compliance works directly with the Vice President Medicare Compliance/National Medicare ... each CCA Program; and disseminating requirements to appropriate internal staff. The Director of Medicare Compliance is accountable to strengthen internal… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …true colors to blue. Reporting to the SVP, Sales & Client Management, the Director , Group Medicare Sales, is an integral member of the leadership team-driving ... management team to develop strategies that shape BCBSMA's overall direction in Medicare , achieve the company's performance goals and deliver an exceptional… more
- CVS Health (Hartford, CT)
- …strategic thought leader in support of business direction. Monitor and report on performance relative to plan and strategic alignment. Provide financial analysis ... team members as required in support of strategic initiatives. Provide business and financial expertise needed to set planning...supporting Medicare , as well as the core Medicare Finance team. This Executive Director will… more
- Somatus (Mclean, VA)
- Overview The Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment Programs to ... ensure program compliance with governing bodies' regulations, including the Center for Medicare and Medicaid Services. This role will partner with leadership to… more
- Elevance Health (Columbus, OH)
- ** Medicare Duals Management Director -Ohio** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 ... miles of our **Columbus, OH** Elevance Health PulsePoint location. The ** Medicare Duals Management Director ** is responsible for developing and ensuring the… more
- CVS Health (Hartford, CT)
- …will also play an important part in helping to align and communicate the Medicare Local Market teams around current performance , and the forecasts and Budgets ... Performance Management teams to drive local market performance and accountability across the 4-5 Medicare ...regions. Help set targets for unit cost, VBC and Provider Collaboration oversight, HHVs, Chart collection, In-Office Program, and… more
- Elevance Health (Richmond, VA)
- …content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve ... is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to… more
- The Cigna Group (Morris Plains, NJ)
- …located in multiple sites. + Work collaboratively with management team to provide career development opportunities, work direction, evaluate performance and ... The Director , Centene Account Management provides strategic, financial, clinical,...strategic, financial, clinical, relationship, and organizational leadership for the Medicare D and Exchange lines of business within the… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As an important member of our Medicare Advantage team, you will provide strategic oversight and leadership for our Member ... and Provider Contact Center. You will be responsible for ensuring...will lead, manage, coach, and develop teams to achieve high- performance standards in alignment with UCLA Health's mission and… more
- CVS Health (Hartford, CT)
- …enhancing data accuracy, and improving efficiency. * Guides management for individual performance evaluations aimed to provide critical feedback for skills ... CVS, we are looking for a leader who can provide strategic leadership and oversight for financial planning and...and oversight for financial planning and analysis for a Medicare Local Market by managing a team of financial… more
- The Cigna Group (Bloomfield, CT)
- …position within the Medicare Growth Analytics Team is an opportunity to provide leadership on our analytics strategy, to support our broader Medicare Growth ... on setting and executing the vision for how our Medicare Growth team can lead Cigna to achieving its...to achieving its goals. Reporting to the Growth Analytics Director , this position will coordinate with cross functional teams… more
- Elderwood (Buffalo, NY)
- …Medical Billing Specialist to join our team. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Elderwood Administrative Services is seeking a ... contract reimbursement and claim submission requirements. + Knowledgeable in Medicare and supplemental co-insurance billing. + Establish rapport with Managed… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …+ This role does not manage people + This role reports to this job: Director , Medicare Advantage Compliance & Medicare Compliance Officer + Necessary ... manages administrative elements of the Companies' (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program, including development and maintenance of program and… more
- Elevance Health (Columbus, OH)
- …Innovation with deep partnership with Health Care Networks (HCN). Oversee value-based provider performance . + Develop and implement network strategies specific ... **RVP & President Medicare Market (Ohio)** **Location:** This role requires the...implementation of high- performance networks, including facility and provider performance incentives. + Work with growth… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- Manulife (MA)
- …analyze key performance metrics to evaluate the effectiveness of preferred provider solutions. Identify areas for improvement and develop strategies to optimize ... We are a leading financial services provider committed to making decisions easier and lives...partners. Negotiate and finalize agreements to drive profitability and provide access to quality care. + Conduct ROI Analysis:… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual contributor ... + Accurately plan and scope projects; keep project leads, senior consultants, and Director informed of key issues/ risks and meet deadlines by tightly managing… more