- Atrium Health (Charlotte, NC)
- Atrium Health is seeking a Registered Nurse (RN) Manager , Clinic for a nursing job in Charlotte, North Carolina.Job Description & RequirementsSpecialty: ... on priorities for Enterprise Population Health within the Southeast region. The Manager of Clinical Documentation Integrity is responsible for the clinical and… more
- Healthfirst (NY)
- + Organizes and leads the project team through the entire project life cycle + Serves as the main point of contact for all the enabling tools and technology ... (software and hardware) that support the Medicare Sales and Retention team + Works with internal... sales business end users and leadership + Conducts project estimate sessions with project stakeholders to… more
- UCLA Health (Los Angeles, CA)
- …required + Minimum of 5 years' experience with CMS processes in a Medicare or Managed Care environment required + Project Management Professional certification ... at UCLA Health. As a key member of our Medicare Advantage Operations team, you will partner with business...technical teams as well as product owners/managers/directors to achieve project objectives and deliverables that include project … more
- BlueCross BlueShield of North Carolina (NC)
- …Leads and manages the day-to-day operational and tactical aspects of all Medicare related PBM (Pharmacy Benefit Manager ) activities, new initiatives, and ... resolves issues that conflict with PBM related deliverables. Collaborates closely with project team members, business owners and sponsors to develop and successfully… more
- LA Care Health Plan (Los Angeles, CA)
- Product Solutions Manager II ( Medicare ) Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... safety net required to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product Strategy, Sales and Marketing… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …manages administrative elements of the Companies' (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program, including development and maintenance of program and ... people + This role reports to this job: Director, Medicare Advantage Compliance & Medicare Compliance Officer...+ Ability to manage time and personnel on a project and everyday basis. + Working knowledge of relevant… more
- LA Care Health Plan (Los Angeles, CA)
- Product Solutions Manager III ( Medicare ) Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Product Solutions Manager III is responsible for assisting the product leadership...features of MS Office including Excel, PowerPoint, Word, MS Project , Visio. Ability to manage risk through change control… more
- Providence (Portland, OR)
- …the best people, we must empower them._** **Providence Health Plan is calling a Manager Actuarial Analytics who will:** + Lead the review of Medicaid capitation rate ... capitation rate setting + Provide expertise and consultation to support the Medicare bid process and pricing strategy + Evaluate the financial performance for… more
- Healthfirst (NY)
- …medical economics, risk adjustment, and population health strategy implement Medicare strategy for profitable performance and ensure seamless partnership and ... + Well versed on all aspects related to all Medicare products + Must be able to perform additional...develop plan of action, communicate effectively, and execute within project timelines + Strong public speaking and oral and… more
- Commonwealth Care Alliance (Boston, MA)
- …This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and oversight ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- The Cigna Group (Bloomington, MN)
- …non-standard reporting, submit client access requests, and assist with benefit set-up and project support as requested within the Medicare and/or Exchange lines ... **POSITION SUMMARY:** The Account Management Lead Associate (Account Manager ) will provide support to the Account team for their assigned Line of Business. The… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement III - Medicare Cost Report Audit** **Locations:** This is a virtual position; the ideal candidate will live within 50 miles of an Elevance ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Independent Health (Buffalo, NY)
- …first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Case Manager (CM) will be responsible for helping members achieve a level of ... members, using available resources to promote quality cost-effective outcomes. The Case Manager will apply the guiding principles for case management practice to… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Medicare Health Plan Operations Specialist - Remote **Job Description** The Associate Functional ... of business requirements, system specifications, process flows, process change and/or project management + Participates in adopting operational best practices and… more
- Corewell Health (Grand Rapids, MI)
- …of the member appeal and fair hearing review processes for all Medicare products to thoroughly investigate appeal requests, leveraging critical thinking skills, ... CMS, decisions are properly implemented. Assist the Lead, Supervisor and/or Manager in coordinating activities and in the development/collection of materials… more
- CVS Health (Hartford, CT)
- …and creation of best-in-class products for our customers. GRS is looking for a strategic project manager who will partner with and support the VP of New Business ... Overview: The Sales, Product & Innovation team within Group Medicare (Group Retiree Solutions) is a small, driven and...the organization. The ideal candidate will be equal parts project manager and creative solution & accountability… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Responsible for project management, stakeholder ... engagement, communications management, performance tracking and reporting, and project resource management. Works closely with a set of...equivalent work experience. . Proven experience as a Portfolio Manager or in a similar role. . 7 years'… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and help our members achieve their best possible health and quality of life. IT Project Manager I Assists in leading enterprise projects and teams in compliance ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.... status and track and report major issues. IT Project Manager II Leads enterprise projects and… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. A Brief Overview: The Marketing Communications Project Manager works with the B2B Marketing and other teams ... and content and flow of finalist meeting presentations. The Marketing Communications Project Manager continuously strives to increase their knowledge of Aetna… more
- Robert Half Technology (Eden Prairie, MN)
- Description Robert Half is excited to announce a Project Manager opportunity with one of our biggest clients in the healthcare industry: Implementation ... Project Manager : This position requires the use...Project Manager : This position requires the use of ...Six Sigma, Lean Training and/or Certification * Experience with Medicare Advantage plans and/or providing services to Medicare… more
