- 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
- BlueCross BlueShield of North Carolina (NC)
- …of go-to-market strategies. + Develop and maintain actuarial models to support the Medicare Advantage Part D bid process + Provide proactive and strategic ... **Job Description** This Consulting Actuary with a Medicare Part D focus on the Medicare...of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have… 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
- BlueCross BlueShield of North Carolina (NC)
- …purpose to improve healthcare for all, + Deliver on optimal performance of the Medicare pharmacy program across Medicare Advantage , including DSNP. EGWP and ... Blue Cross NC Corporate Pharmacy Department is seeking an Associate Vice President (AVP) for Government Pharmacy. The role...of programs and services to meet the needs across Medicare Advantage , including DSNP, EGWP and the… more
- Marshfield Clinic (Marshfield, WI)
- …HCC and HCPCS coding. Knowledge of the different CMS guidelines that affect Medicare Advantage , HHS-ACA and DHS/BadgerCare Plus members as related to revenue ... missions in the world!** **Job Title:** SHP Coding/Auditing Specialist ( Remote -Hybrid) **Cost Center:** 682891390 SHP-Strategic Finance **Scheduled Weekly Hours:**… 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
- Molina Healthcare (Bronx, NY)
- …Whole Health by Molina_** **is a Managed Long-Term Care (MLTC), and Medicaid Advantage (MAP) plan. These plans streamline the delivery of long-term services to ... or disabled people who are eligible for Medicaid and Medicare .** **We are looking for a LPN or LVN...apply._** **Work hours: Monday - Friday 8:30AM- 5:00PM EST** ** Remote position with light travel- 10-15% for in person… more
- Highmark Health (Columbus, OH)
- …Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including ... Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines. Works closely with team… 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 (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
- Healthfirst (New York, NY)
- The Entitlement Advocate provides Healthfirst's Medicare Advantage Plan(MAP), Managed Long-Term Care Plan(LTC), Dual eligible Medicare Plan and Nursing Home ... department. + Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New Medicaid Applications. + Outreach… more
- Humana (New York, NY)
- … and Medicaid's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Manager, you will deconstruct issues ... Humana's businesses. The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana's largest, which comprises over 80% of the… 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
- Healthfirst (New York, NY)
- …office and report findings.. The Entitlement Advocate Liaison provides Healthfirst's Medicare Advantage Plan (MAP) and Senior Health Partners' (SHP) ... ensure all inquiries are processed timely. + Assists Marketing Specialists, Medicare representative, Care Teams and Entitlement department in gaining and regaining… 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
- Humana (Columbus, OH)
- …of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, and identifying improvement opportunities for a ... in the country. Role Overview The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises… more
- Elevance Health (Atlanta, GA)
- …communicating to Senior Leaders within a large company strongly preferred. + Experience with Medicare Advantage , Medicare Stars and/or Medicare CAHPS ... direction, annual planning, and business change management for the Medicare CAHPS Analytics Team. **Location:** This position will work...Team. **Location:** This position will work a hybrid model ( remote and in office one day per week). Ideal… 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