- DHR Health (Edinburg, TX)
- …criteria and review processes highly desirable. Knowledge and understanding of Medicare and Medicaid guidelines and regulations pertaining to utilization review and ... Establishes and/or attempts appropriate caregiver forums to provide program teaching/ information and seeks program effectiveness feedback. Provides orientation and… more
- Winnebago Comprehensive Healthcare System (Winnebago, NE)
- …with business representatives are to elicit from these individuals information regarding their company's products and services available. Established good public ... or interaction with the container. Consults and provides a wide range of drug information to the community and clinic staff. Counsels patients on the use, storage,… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to help us transform healthcare? Bring your true colors to blue. Position Summary: The consultant in this role is a key member of the senior markets pricing team, ... competitive analytics, financial planning, and forecasting. In addition, the consultant in this role will be responsible for analyses...BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 million in ... growth strategies, working across multiple departments and teams, including business development, labor, advertising, client services, underwriting and planning and… more
- CVS Health (Charleston, WV)
- …Start times between 7:50 am and 11:45 am EST** The Worklife Resource Consultant is part of the Worklife Team and provides education about community resources, ... needs, elder/adult care, and health related needs. + The Resource Consultant assesses resource needs, proposes options and research/screens potential community… more
- Elevance Health (Indianapolis, IN)
- ** Business Information Consultant -...to Pharmacy cost of care, pharmacy trends, and other Medicare book of business ' related issues/metrics. **How ... **Work Hours:** Monday - Friday, 8:00am - 5:00pm The ** Business Information Consultant - Pharmacy...to identify cost drivers and trend patterns within the Medicare Part D Individual and Group markets + Identifies… more
- Molina Healthcare (Atlanta, GA)
- …data exchange of the Medicare /MMP product in support of strategic and corporate business objectives. Manage for all Medicare lines of business the annual ... iCat authoring process, ensuring compliance with CMS guidelines. Support Medicare and MMP line of business for...of progress and risks. + Serves in an internal consultant capacity and possesses ability to rapidly learn, assess,… more
- Elevance Health (Costa Mesa, CA)
- **Medical Director- Medicare and Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... will be responsible for utilization review case management for Medicare and Medicaid in the California market while also...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- Elevance Health (Mason, OH)
- …Will Make an Impact:** + Creates and maintains databases to track business performance + Analyzes data and summarizes performance using summary statistical ... procedures + Develops and analyzes business performance reports (eg for claims data, provider data,...background. **Preferred Qualifications:** + Medicaid Experience strongly preferred + Medicare experience nice to have + Advanced SQL experience… more
- IQVIA (Durham, NC)
- **Senior Consultant , Epidemiology, Government Solutions** **About IQVIA Government Solutions** IQVIA Government Solutions is dedicated to helping government clients ... studies across Federal, State and Local government clients. A Senior Consultant supports assignments ranging in complexity from pre-sales, proposal development,… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …assistance in the field and provide support where needed regarding new and existing business activity to include completion of group information . + Assists with ... and group administrators across all product lines. The Account Service Consultant (ASC) handles inquiries received through various channels, including telephone,… more
- The Joint Commission (Oakbrook Terrace, IL)
- …and comply with federal regulations and processes regarding the Medicare certification program and Federal survey methodology. Creatively approaches client ... or client educational updates when requested. Responsible for new CMS business development (to a defined expectation) inclusive of client relationship management,… more
- Waystar (Atlanta, GA)
- …team leaders regarding project issues, risks, and needs + Translate client and business feedback into actionable information + Identify, research, and make ... **ABOUT THIS POSITION** The Sr. Solution Adoption Consultant role will act as the primary client...and terminology quickly + Strength discussing both complex technical information and general revenue cycle operations + Ability to… more
- ChenMed (Miami Gardens, FL)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... JOB DUTIES/RESPONSIBILITIES:** + Nurtures, builds and cultivates direct-to-seniors and business -to- business partnerships to generate new patient opportunities… more
- ChenMed (Pembroke Pines, FL)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... + Begins to nurture, build and cultivate direct-to-seniors and business -to- business partnerships to generate new patient opportunities year-round.… more
- OhioHealth (Columbus, OH)
- …and in our communities. **Job Description Summary:** The Senior Research Finance Consultant for OhioHealth Research Institute (OHRI) will manage the full life cycle ... and varied fiscal administrative support functions such as analyzing Medicare Coverage Analysis documents, developing comprehensive internal study budgets,… more
- PruittHealth (Norcross, GA)
- …with development of plan of correction to survey deficiencies. 19. Reviewing additional information requests from Medicare and Medicaid as requested. 20. Assists ... **JOB PURPOSE:** The Home Health Consultant collaborates with the Home Health Agencies by...surveys may include research and documentation of medical record information , personnel files, committee reports, policies and procedures, and… more
- OhioHealth (Columbus, OH)
- …and in our communities. **Job Description Summary:** The Research Finance Consultant will perform specialized technical fiscal activities and financial reporting for ... through study or grant closeout. Responsible for interaction with Medicare and applying Medicare regulations for device...OHRI RBS. Auditing patient records in order to glean information related to research procedures and ensure adherence to… more
- MSys Inc. (Columbia, SC)
- …of Medicaid/ Medicare Services (CMS). This documentation involves drafting the business and technology narratives required to articulate the status of activities ... Job summary: Title: Medicaid/APD Consultant - Hybrid Location: Columbia, SC, United States...and stakeholders to support thegathering, analysis, and finalization of information + Work closely with the business … more
- Henry Ford Health System (Troy, MI)
- …GENERAL SUMMARY: Responsible for the growth of Large Group Commercial sales business . Support membership growth through the development and maintenance of ... consultant relationships, promotion of the HAP value proposition and...and implementation of specific sales and growth strategies including business development, client services, underwriting and marketing support. Primary… more
