- Advocate Aurora Health (Oak Lawn, IL)
- …related to care management activities with Director of Inpatient Care Management Operations , Physician Advisor and site Medical Staff Leadership as appropriate ... Department: 11224 Advocate Aurora Health Corporate - IL Inpatient Care Management Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule… more
- The ODP Corporation (Houston, TX)
- …Lead will quickly build and maintain customer relationships and become a trusted advisor by utilizing provided training to support sales offerings. The Team Lead ... and omnichannel presence, which includes world-class supply chain and distribution operations , dedicated sales professionals, online presence, and a network of… more
- South Orange County Community College District (Mission Viejo, CA)
- …within the past five (5) years); Master's thesis or Doctoral Dissertation advisor or supervisor (for faculty); Colleague(s) or co-worker(s) who can address ... adequate records and controls to assure instructional unit expenditures and operations remain within established budget limitations; monitor and approve purchase… more
- CVS Health (Jefferson City, MO)
- …with heart, each and every day. **Position Summary** The Health Plan Clinical Advisor is a client facing role that manages the clinical relationship by influencing ... other senior health plan leaders. The Health Plan Clinical Advisor should be able to manage at least 2...up to 4 market segments for any particular client ( Medicare , Medicaid, Exchange, and or Commercial). The Health Plan… more
- TEKsystems (Orlando, FL)
- Licensed Benefit Advisor 100% Remote - Equipment Provided Anticipated Start Date: September 2nd 2025 Pay: $21/hr + Commission (lump sum at end of AEP season) ... Health & Life Insurance License Description The Licensed Virtual Benefit Advisor 's responsibilities include selling and enrolling retirees into appropriate insurance… more
- The Cigna Group (St. Louis, MO)
- **Product Management Senior Advisor - Medicare Solutions, Express Scripts** **Description of Position:** + The Product Management Senior Advisor provides ... 5+ years relevant experience + Familiarity with pharmacy adjudication and other PBM operations + Experience in managing capabilities in Medicare and Medicaid… more
- Elevance Health (Costa Mesa, CA)
- …quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations . May identify cost of care ... **Medical Director- Medicare and Medicaid** Location: This role enables associates...will be responsible for utilization review case management for Medicare and Medicaid in the California market while also… more
- US Tech Solutions (May, OK)
- …Benefits Manager (PBM) **Skills:** + MUST HAVE MANAGED CARE exp and Medicare /Medicaid knowledge. + MUST HAVE 6 months of experienced with Prior ... Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. **Education:** + Pharm D. required… more
- Humana (Troy, MI)
- …report to the Plan Chief Executive Officer (CEO). The Strategy Advancement Advisor (HIDE-SNP Program Medicaid Liaison) will support Humana's Highly Integrated Dual ... This role will act as a link between Humana, MDHHS, and Centers for Medicare & Medicaid Services (CMS). + Supports all priority health plan and care delivery… more
- OhioHealth (Columbus, OH)
- …more - in our careers and in our communities. **Job Description Summary:** The Advisor , Value Based Contract Operations is charged with the daily management of ... Integrated Network. This includes the OhioHealth Clinically Integrated Network (CIN) Medicare Advantage and Commercial contracts, OhioHealth Venture Medicare … more
- CenterWell (Cheyenne, WY)
- **Become a part of our caring community and help us put health first** The Advisor of Strategy Advancement will play a pivotal role in advancing the strategic vision ... quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity… more
- Humana (Pierre, SD)
- …our caring community and help us put health first** The Strategy Advancement Advisor builds local market presence for Humana Healthy Horizons and prepares markets ... upcoming bids for state Medicaid managed care programs. The Strategy Advancement Advisor works with Business Development Market Vice Presidents (VPs) to understand… more
- AdventHealth (Orlando, FL)
- …in the medical community and a corporate environment Payor experience in operations **EDUCATION REQUIRED** **:** + Graduate from medical school and residency program ... practice experience **_Experience Preferred_** _:_ . Understanding of hospital Utilization Management/ Medicare Regulations . Two years or greater experience as a… more
- Commonwealth Care Alliance (Boston, MA)
- …Stars and other quality measures. Essential Duties & Responsibilities: * Knowledge of Medicare Star Rating methodology; NCQA HEDIS measures; CAHPS and HOS surveys * ... interact with all levels of management. * Knowledge of health plan operations , health care claims and other relevant data sources (eg EMR, Authorizations).… more
- Hackensack Meridian Health (Neptune City, NJ)
- …adherence to intake process for each referral from start to hand off to operations for scheduling. Meet productivity standards on a daily basis. Maintain an accurate ... off to F2F team with appropriate information. + Knowledgeable in current Medicare reimbursement criteria and insurance contracts for the organization product lines.… more
- University of Colorado (Aurora, CO)
- … operations and strategic initiatives, serving as a trusted advisor to senior leadership. The Director collaborates across departments and affiliate ... **Graduate Medical Education (GME) Director of Strategy & Operations ** **Description** **University of Colorado Anschutz Medical Campus** **Department: Office of… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Physician Advisor Operations Coordinator, Revenue Integrity and Utilization PRN/OCC, Variable Hours, Day Shift Covenant Health Overview: Covenant Health ... named a Forbes "Best Employer" seven times. Position Summary: The Physician Advisor Operations Coordinator will perform activities to help facilitate utilization… more
- Houston Methodist (Houston, TX)
- …by analyzing clinical protocols. + Escalates appropriate cases to the Physician Advisor (or services) for appropriate second level review, peer-peer discussions, and ... payer denial- appeal needs. Consults with physician advisor as necessary to resolve progression-of-care barriers through appropriate administrative and medical… more
- AON (Fort Washington, PA)
- …the AICPA Insurance Trusts (Trusts). The ideal candidate will serve as a key advisor and subject matter expert on the Trusts portfolio, providing guidance to the ... Term Care (New York Life), Auto & Home (Liberty Mutual), and Medicare Supplement (Transamerica). Your responsibilities will include managing complex client matters… more
- Banner Health (Phoenix, AZ)
- …for the delivery of legal services for the Banner health enterprise. An advisor to the organization's Senior Management on matters, perform direct legal services, ... in alignment and in furtherance of system strategic goals and ongoing operations , ensuring a collaborative, open, and inclusive work environment that is focused… more
