- Novo Nordisk Inc. (Montclair, CA)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer … more
- Lundbeck (Atlantic City, NJ)
- …to join the growing promotion of our CNS portfolio to primary care and specialties including Psychiatrist, Neurologist, and Institutional Accounts such as Skilled ... to deploy approved services necessary to meet the needs of each account/ customer . Our Neuroscience Account Managers are adept at executing against the toughest… more
- Lundbeck (White Plains, NY)
- …key internal and external partners and effectively addresses payer access issues ( Medicare , Medicaid , Commercial) using Lundbeck resources. Local Market & ... time to join our team as we lead the way in creating positive customer experiences!As a BioPharmaceuticals Account Manager, you lead the promotion of our infusion… more
- CareFirst (Baltimore, MD)
- …(strategy, design, execution, and optimization) for products and plans in the Medicare , Medicaid , and Federal Employee Health Benefits categories. Leads the ... performance, forecast sales and membership in line with growth objectives, in the Medicare Advantage Bid process annually, the cost and utilization of all benefits… more
- Medical Mutual of Ohio (OH)
- …internal and external teams including but not limited to: Pharmacy IT, Membership, COB, Care Management, Customer Care , and PBM to ensure that ... pharmacy, or PBM operations, which includes exposure to Centers for Medicare & Medicaid Services (CMS) guidelines, preferably Part D. . Certified Pharmacy… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …+ Educate prospects on CPHL MAP product designed for Full Medicaid and Medicare recipients that need in home care and Long-term care services, ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company...by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex… more
- Healthfirst (New York, NY)
- … Medicaid and other entitlement program issues and on changes in Medicaid / Medicare /HMO laws and shares information with Care Team Social Work and other ... by yearly audit plan in the areas of Enrollment, Medicaid and Customer Service surveys; tracking of...+ 1 year of healthcare experience in Managed Long-Term Care (MLTCP), Medicaid or Medicare .… more
- CVS Health (Harrisburg, PA)
- …vision. -May aid existing members with service issues Required Qualifications - Medicare experience/Basic understanding of Medicare / Medicaid - Active Health ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...Aetna, a CVS Health Company, we are expanding our Medicare Sales team and are looking for candidates who… more
- Mathematica (Washington, DC)
- …knowledge of administrative healthcare data (eg commercial claims, hospital claims, and Medicare or Medicaid (T-MSIS, TAF) data), healthcare informatics, or ... developing data-driven solutions that guide decision-making in US health care policy. This is a client-facing leadership role that...will eventually work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff… more
- Molina Healthcare (Glen Allen, VA)
- …3+ years supervisory/management experience in a managed healthcare environment. + Medicaid / Medicare Population experience with increasing responsibility. + 3+ ... a team of field Nurse Case Managers supporting our Medicaid program We are looking for someone with strong...assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term… more
- The Cigna Group (Atlanta, GA)
- … Medicare Stars department. The Star rating system was developed by the Centers for Medicare & Medicaid Services (CMS) to measure the quality of care ... health plan. This call center role performs telephonic outreach to Cigna Medicare customers, pharmacies, and providers for the purpose of addressing prescription… more
- Healthfirst (New York, NY)
- …explains program benefits in a manner that is compliant with the Center for Medicaid and Medicare Services (CMS) and company policies and regulations. This role ... The Medicare Outside Sales Representative is a top performing...health insurance coverage to avoid gaps or disruptions in care . Duties & Responsibilities : + Drive membership growth… more
- Houston Methodist (Katy, TX)
- …of compliance recommendations set forth by audits from Center for Medicare / Medicaid Services (CMS), other applicable regulatory agencies, and/or Houston ... Medicare compliance experience is preferred** **Note: Office for...Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450**… more
- Humana (Tampa, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... 2) assumes ownership and leads advanced and highly specialized administrative/operational/ customer support duties that require independent initiative and judgment. +… more
- Fairview Health Services (Minneapolis, MN)
- …5-10 years' experience; health care setting preferred. + Solid understanding of Medicare and Medicaid rules of billing related to transplant services + ... regulatory and financial implications of the Transplant components of the Medicare Cost Report (MCR). **Responsibilities Job Description** The Sr Financial Analyst… more
- Somatus (Mclean, VA)
- …and ensure program compliance with governing bodies' regulations, including the Center for Medicare and Medicaid Services. This role will partner with leadership ... Overview The Director, Medicare Risk Adjustment (MRA) will lead the execution...with knowledge of health plan operations ie Claim processing, customer service, enrollment etc. + Proven experience with commercial… more
- CVS Health (Tallahassee, FL)
- …leading member/ customer service team. Preferred Qualifications - Experience in a Medicaid and/or Medicare setting. - Spanish Bilingual abilities are a plus ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- TEKsystems (Plano, TX)
- …Skills: Payment posting, Medical, Payment poster, Data entry, Medical billing, Medicaid , Collection calls, Revenue cycle, outpatient, wound care , physical ... of the top services for OP such as: Wound Care , Hyperbaric, and Physical Therapy Job Description: + Respond...+ Assists with all calls, correspondence and concerns regarding Medicare claims with the FI's. + Take action on… more
- BrightSpring Health Services (Arlington, TX)
- …you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization ... Non-retail/Closed-door environment Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation… more
