- Olympus Corporation of the Americas (Center Valley, PA)
- …customers (physicians, purchasers, etc.) on reimbursement, coverage, coding, and Medicare payments. + Influence the purchasing and/or reimbursement decision-making ... Clinical, Policy, and C-Suite executives, physicians, biller, revenue cycle manager , VAC Committee members and national/regional payers + Establish critical… more
- Stanford Health Care (Palo Alto, CA)
- …EMTALA, the Stark Law, Conflicts of Interest, Gifts and Entertainment, and Medicare and Medicaid program requirements. + Develop written policies, procedures, ... but not limited to, HIPAA, Anti-Kickback Statute, EMTALA, the Stark Law, and Medicare and Medicaid program requirements. + Knowledge of general computer… more
- Commonwealth Care Alliance (Boston, MA)
- …and drive both program -wide and provider-specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation ... 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based… more
- Peoples Home Health, LLC (Fort Walton Beach, FL)
- …Assess patient's medical status, family needs, and collaborate with the clinical manager , attending physician and/or the hospice physician to determine the patient's ... other IDG staff, including a detailed report to the assigned Case Manager and other assigned disciplines. * Maintain accurate records, document actions, maintain… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Value-based program oversight and performance ... the demonstrated ability to handle multiple projects. - Strong understanding of Medicare , Medicaid, duals program , and health plan operations, including… more
- Lundbeck (Deerfield, IL)
- Senior Benefits and HR Systems Analyst Requisition ID: 6994 Location: Deerfield, IL, US Do you want to join a team where the mission is meaningful, the challenges ... programs and policies. Identifies and implements tools and resources for program administration with a focus on developing, standardizing, and improving processes,… more
- Wipfli LLP (Milwaukee, WI)
- …offers a career-defining opportunity. Job Summary Under the direction of the Partner/ Senior Manager leading the respective service area, region or industry, ... the Manager , Provider Compliance & Reimbursement is responsible for preparing...preparing cost reports and providing reimbursement consulting within the Senior Living space. This role includes reviewing skilled nursing… more
- Commonwealth Care Alliance (Boston, MA)
- …engagement The Manager of Provider Communications will report to the Senior Director of Delegation Partnerships and Performance and will support the ongoing ... complex, cross-functional projects and meeting deadlines. + Strong understanding of Medicare , Medicaid, duals program , and health plan operations, including… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, ... performance. By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role… more
- Commonwealth Care Alliance (Boston, MA)
- …Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory ... improvements, and enhance provider satisfaction and performance. - Partner with senior leaders to communicate resolution and outcomes and drive cross-functional… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Downers Grove, IL)
- …Special Needs Plans (SNPs) + Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, applicable ... heart, each and every day. **Position Summary:** The Sr. Manager is an experienced/career level compliance position that applies...+ 7+ years' experience in Medicare or Medicare Advantage government healthcare program compliance or… more
- CVS Health (St. Louis Park, MN)
- …we do it all with heart, each and every day. **Position Summary** As the ** Senior Manager of Stars** , you will lead the market-wide strategy, performance ... improvement, and execution of the Medicare Stars quality program for Allina Health...of strategic initiatives. + Comfortable presenting to and influencing senior leadership. **Preferred Qualifications** + Health plan experience. +… more
- CVS Health (Concord, NH)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... Medicare plans within the Market. + Direction of senior leaders of specific functional areas as assigned. Functional...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Amazon (FL)
- Description Application deadline: Jan 8, 2026 As a Program Manager II on the One Medical At -Risk team, you will be the primary builder of new and existing ... balancing time, quality, and resources to optimize project and program outcomes * Lead the end-to-end implementation of new...driving end to end delivery, and communicating results to senior leadership experience - 3+ years of driving process… more
- Humana (Sanford, FL)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and… more
- Fallon Health (Springfield, MA)
- …plans for member experience, service, and clinical quality. Fallon Health's NaviCare is a program for people age 65 and older, who live in our service area, and ... who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare ...achieves personal referral and outreach goals for the NaviCare program .Manages a territory and group of referral source accounts,… more
- Fallon Health (Worcester, MA)
- …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE ( Program of All-Inclusive Care for the ... by written directives or instructions with the Eligibility and Revenue Operations Coordinator, Senior Financial Support or Manager to determine course of action.… more
- Humana (Trenton, NJ)
- …are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager , Medicare Sales, must...+ This role is part of Humana's Driver safety program and therefore requires an individual to have a… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Sr. Program Manager , DC Market Operations provides leadership for the operation of a single jurisdiction Medicaid ... ensure the profitability, growth, and stability of the business. The Sr Program Manager will have responsibility for business direction, financial performance,… more
