- Novo Nordisk Inc. (New York, NY)
- …exciting new therapies to market to improve patient outcomes. As a team member , you will connect therapies to new specialties, build cardiometabolic advocates, and ... level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary: Commonwealth Care Alliance's Long-Term Services and Supports (LTSS) team is responsible for ... appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of responsibilities including project management… more
- Tidelands Health (Myrtle Beach, SC)
- …people live better lives through better health!** **Supervisor Provider Coding Specialist ** Are you passionate about quality and committed to excellence? Consider ... mission to life each day. **A Brief Overview** The Supervisor, Provider Coding Specialist under the general supervision of the Coding Manager, is responsible for… more
- WesleyLife (Pella, IA)
- …growth and purpose. Come be a part of the revolution! ? **About the Role: MDS Specialist ** As a MDS Specialist , you'll play a key role in supporting the health, ... experience of the residents at WesleyLife **As a MDS Specialist , you will:** + Serve as a Clinical Resource...the state RAI's according to mandated timetable. + Follow Medicare guidelines to complete MDS assessments for skilled residents… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and ... regulatory compliance, and supporting operational excellence to enhance provider satisfaction and member access to care. Reporting to the Senior , Director of… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary** The Provider Relations Liaison is responsible for cultivating, maintaining and strengthening ... provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including… more
- Molina Healthcare (Warren, MI)
- …issues or questions. + Log all contacts in a database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being ... **Job Description** **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member … more
- Commonwealth Care Alliance (Boston, MA)
- …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider … more
- Molina Healthcare (Aurora, IL)
- Molina Healthcare of Illinois is hiring a Member Liaison, Growth& Community Engagement Specialist . This role will be a hybrid of working in the field ( ... We focus on Medicaid and MMP, and support MHI Medicare and Marketplace programs. Highly qualified applications will have...have the following experience - + Previous experience in member engagement in a healthcare related field… more
- Magellan Health Services (Albuquerque, NM)
- …Presents the program and offerings in group settings. Consistently achieves member engagement strategies while meeting quality performance standards. + ... with individuals with adverse childhood experiences. General Job Information Title CISC Member , Caregiver and Stakeholder Engagement Manager Grade 23 Work… more
- LA Care Health Plan (Panorama City, CA)
- …data to inform management with an integrated approach to outreach activities and targeted member engagement . Plan, develop, analyze and implement member and ... Community Resource Center Specialist III Job Category: Customer Service Department: Community...instructors. The role leads community and provider outreach and engagement initiatives to increase member traffic at… more
- CVS Health (Harrisburg, PA)
- …to meet performance and productivity metrics, including call volume, successful member engagement , and state/federal regulatory requirements. + **Professional ... every day. **Job Purpose and Summary** As an essential member of our Special Needs Plan (SNP) care team,...Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the… more
- Dana-Farber Cancer Institute (Boston, MA)
- …remote and 1 week onsite at Longwood Medical Center.** The Inpatient Authorization Specialist reports to and receives direction from the Access & Financial ... Engagement Supervisor to support inpatient registration and manage medical...admissions, and denial management. In addition, the Inpatient Authorization Specialist is responsible for the timely and accurate completion… more
- Dana-Farber Cancer Institute (Boston, MA)
- …Financial Engagement Supervisor, and under direct supervision, the Admitting Specialist is responsible for registering patients prior to admission to the ... consents and admissions documents. In addition, with direct supervision, the Admitting Specialist is responsible for the timely and accurate completion of assigned… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary: Commonwealth Care Alliance's Long-Term Services and Supports (LTSS) team is responsible for ... appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of responsibilities including project management… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II, D-SNP Team (12 month Assignment) Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more
- Centene Corporation (Harrisburg, PA)
- …Primarily all of NJ (40%) and Eastern PA (50%) with minimal engagement with Western PA/Pittsburgh (10%). **Position Purpose:** The Community Relations Specialist ... and new market initiatives, health fairs and community activities, training, member retention activities, sales visibility and business, broker, provider, market,… more
- Novo Nordisk (Elmira, NY)
- …exciting new therapies to market to improve patient outcomes. As a team member , you will connect therapies to new specialties, build cardiometabolic advocates, and ... impact + Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage… more
- BJC HealthCare (St. Louis, MO)
- …in a variety of situations. + The ability to promote teamwork and employee engagement is everyone's responsibility. This team member will work to create an ... Information About the Role** BJC is looking to hire a Authorization Specialist ! **Additional Preferred Requirements** + Remote Role Monday - Friday 8:00-4:30 Pm… more
- Novant Health (Salisbury, NC)
- …+ Our team members are part of an environment that fosters team work, team member engagement and community involvement. + The successful team member has ... cost of Medicare and Medicaid). In 2022, Novant Health community engagement contributed more than $1.9 million in charitable contributions to community partners… more
