- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …position manages administrative elements of the Companies' (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program , including development and ... and report on Compliance objectives, projects, timelines, and deliverables for the Medicare Advantage Compliance Program . Create and maintain compliance… more
- UCLA Health (Los Angeles, CA)
- …relationship-building skills with clinical and non-clinical personnel * Knowledge of the Medicare Advantage STARS program and NCQA technical specifications ... all this and more at UCLA Health. As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects while… more
- The Cigna Group (Birmingham, AL)
- …group contracting and negotiations** + **Experience with Healthcare - Commercial and Medicare Advantage ** + Experience in developing and managing key provider ... Alabama/Mississippi Market. Must live in either Alabama or Mississippi._** The ** Manager , Provider Contract Network Management** serves as an integral member of… more
- CareOregon (Portland, OR)
- …This position is responsible for managing actuarial analysis related to Medicaid and Medicare Advantage lines of business with a focus on supporting strategic ... includes analyzing Medicaid capitation rates, overseeing the actuarial components of the Medicare Advantage bid pricing, and analyzing historical and emerging… more
- CVS Health (Hartford, CT)
- …the Manager of Business Consultation is responsible for optimizing Medicare Advantage member journey through process improvement, engagement campaigns, and ... program development with the goal of improving ...is dedicated to achieving best-in-class quality and value to Medicare Advantage beneficiaries. Optimizing business performance and… more
- The Cigna Group (Baltimore, MD)
- Leads the development of customer onboarding and marketing plans for the Medicare Advantage customer journey. Communication plans will be multi-modal to include ... communications. The key responsibilities of this role include: + Development of Medicare Advantage customer communication strategy that accounts for customer… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Manager of Medicare Enrollment is responsible for managing the… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application… more
- CareOregon (Portland, OR)
- …Skills and Abilities Required Knowledge + Advanced knowledge of Medicare , the Medicare Advantage program and CMS + Strong understanding of managed ... Vice President of Medicare is responsible for strategy and execution of the Medicare Advantage line of business. The majority of time is focused on… more
- The Cigna Group (Miramar, FL)
- …Components** All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: + ... **Role Summary** The Provider Performance Enablement (PPE) Manager is a key member of a cross-functional,...HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage required + Ability and track… more
- CVS Health (Wellesley, MA)
- …direct-to-consumer marketing campaigns for Aetna Marketing to support the growing, fast-paced, Medicare Advantage and Dual Eligible Special Needs Plans (D-SNP) ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your… more
- The Cigna Group (Houston, TX)
- …All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: Growing ... experience with STARS, HEDIS, Risk Adjustment and medical expense reduction specific to Medicare Advantage required + Ability to apply an enterprise mindset with… more
- InnovaCare (San Juan, PR)
- …provider of healthcare management in North America. Through two it's main ways, Medicare Advantage and the provider network, we are committed to healthcare, ... passion and customer focus to the business. The Care Manager is responsible to assess all referred cases, plan,...that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries, through Medicare … more
- Fallon Health (Worcester, MA)
- …more information, visit fallonhealth.org. **Brief Summary of Purpose:** Principle responsibility of the Medicare 5 star Program Manager is to collaborate ... well as prioritize and recommend improvements through data-driven analysis. The Medicare 5 star Program Manager will also be responsible for investigating… more
- Cleveland Clinic (Cleveland, OH)
- …in the world. As part of the CCHS Value Based Performance team, the Program Manager will help support value based contracting, implementation, program ... and programs with commercial payors. The Value Based Performance Program Manager IV serves as a key...utilization data preferred. + Knowledge of ACO, Medicaid, and Medicare Advantage quality measures, NCQA and HEDIS… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... organization, and facilitation of the development of Prominence commercial and Medicare Advantage products, system and infrastructure improvements, and vendor… more
- CareOregon (Portland, OR)
- …execution, and management of the risk adjustment data analytics programs for the Medicare Advantage and Medicaid programs. Assists Director in developing a ... Job Title Risk Adjustment Analytics Manager Exemption Status Exempt Department Finance Manager...of the CDPS + Rx model + Understanding of Medicare Advantage and OHP risk adjustment regulations… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... State and Federal laws, regulations, policies and practices for the administration of Medicare Advantage , Prescription Drug Plan, and compliance programs in a… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... of and management of a comprehensive Care Management and Transitions of Care Program . The Clinical Manager is responsible for the implementation, and management… more
- Medical Mutual of Ohio (West Chester, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more