- Providence (WA)
- …and providing critical insights to enhance the performance of our Medicare Advantage plans **_Providence is welcoming 100% remote work from anywhere within ... to support the pricing and bidding process for our Medicare Advantage plans + Have a deep...study + Successful completion of 4+ exams of the Associate of the Society of Actuaries (ASA) designation +… more
- Providence (Portland, OR)
- …of study + 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development + Experience with writing queries ... set priorities for direct reports **_Providence is welcoming 100% remote work from anywhere within the United States with...of Actuaries (FSA or ASA) + Experience certifying the Medicare Advantage Bid + Experience with Commercial,… more
- Mitsubishi Chemical Group (Chicago, IL)
- …different access and reimbursement models, including Medicare Parts B and D, Medicare Advantage (eg, Medicare Coverage Determinations (NCDs, LCDs and ... objectives with assigned specialty distributor and specialty pharmacy accounts. The Associate Director of Trade will collaborate with members of Supply Chain,… more
- TEKsystems (Seattle, WA)
- …role in ensuring the accurate and efficient enrollment of members into Medicare Advantage plans. This position involves researching, processing, and coordinating ... tasks related to Employer Group, Individual and Family, and Medicare Advantage accounts. The successful candidate will...records of CMS-related and Employer Group data. Qualifications + Associate 's degree or a minimum of two (2) years… more
- TEKsystems (San Diego, CA)
- Remote Customer Service Associate REMOTE | $19 USD/hour Highlight: * Industry: Hospital & Healthcare * Employment Type: Contract (6-months) * Location: USA ( ... Remote ) Working with an extensive client base, TEKsystems is...supportive leadership and executives + Great Benefits - Take advantage of a Blue Cross Blue Shield benefits package… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive ... Type:** Full time **Shift:** **Description:** This position is fully remote **Why Mount Carmel?** With five hospitals (https://www.mountcarmelhealth.com/find-a-location/) ,… more
- Trinity Health (Farmington Hills, MI)
- …complete tasks/work assignments **ESSENTIAL FUNCTIONS** **Follow up Rep II for Medicare Advantage Claims** Knows, understands, incorporates, and demonstrates the ... Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position (Pay Range: $18.4663-$27.6994) Performs the day-to-day billing and… more
- CareFirst (Washington, DC)
- …incumbent will handle pre and post claim medical review for Commercial and Medicare Advantage Plans. This position assists in determining acceptable medical risk ... indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of...and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to… more
- Humana (Columbus, OH)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Columbus, OH)
- …report directly to the Regional Vice President of Operations in support of the Medicare Advantage line of business. The Market Finance Lead supports all Market ... & utilization reporting at all levels + Supports Humana's Medicare Advantage product strategy, budgets, and administrative...will be required to work EST Hours.** Work at Home/ Remote Requirements To ensure Home or Hybrid Home/Office employees'… more
- Humana (Indianapolis, IN)
- …other care team staff to address the member's identified needs + Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers ... and benefits of members who are also eligible for Medicare . + Primary point of contact for the Interdisciplinary...+ Where software engineers change lives. + Where every associate can build a professional path where they learn… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Medical Mutual' ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
- Humana (Miami, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... skills and experience at a time that is best for your schedule \#LI- Remote \#LI-JR1 **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects… more
- MetroLink (Los Angeles, CA)
- …Location California 90017, CA Job Type Temporary Special Services Employee Remote Employment Flexible/Hybrid Job Number 23-2400102 Department Finance Opening Date ... Ensure the efficient utilization of the payables system, taking advantage of system capabilities. + Enter and audit invoices...exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is… more
- CVS Health (Tallahassee, FL)
- …of a group of Community Health Care Workers. The team serves at risk Medicare Advantage members in a new innovative community-based program. This position ... ie team meetings, time and attendance, caseload balance and associate performanceAbility to manage a remote a...in person and telephonically + Experience in managing a remote -based team + Quality review experience + Medicaid/ Medicare… more
- Baylor Scott & White Health (Temple, TX)
- …issues, as needed. **KEY SUCCESS FACTORS** + Sales and regulatory experience in Medicare Advantage , Marketplace, and Commercial insurance. + Good written and ... **ESSENTIAL FUNCTIONS OF THE ROLE** + Will work primarily remote , but candidate needs to be local to Temple,...Texas Department of Insurance (TDI) and the Center for Medicare and Medicaid Services (CMS) regulations; maintains training log… more
- Highmark Health (Columbus, OH)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- CenterWell (Houston, TX)
- …administrators. Nearly 250,000 total patients served in 2022, including those in Medicare Advantage , value-based arrangements or other Medicare programs. ... Houston Clinic Region:** + Gulfgate Clinic + Pasadena Clinic + Jacinto City Clinic Associate will be assigned to one of the following clinics as homebased and will… more
- Humana (Frankfort, KY)
- …external benchmarks and systems to identify areas for improvement, competitive advantage , and Humana comparison and adoption + Collaborates with category managers, ... in a system analytics and/or data warehousing environment **Additional Information** Remote \#LI- Remote **Work-At-Home Requirements:** To ensure Home or Hybrid… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive ... and effectiveness. + Manages coding specialists in a centralized and remote environment through established monitoring of productivity and quality. + Fosters… more