• Medicare Advantage Operations…

    UCLA Health (Los Angeles, CA)
    …can do all this and more at UCLA Health. As a key member of our Medicare Advantage Operations team, you will partner with business and technical teams as well ... of 5 years' experience with CMS processes in a Medicare or Managed Care environment required * Project... Medicare or Managed Care environment required * Project Management Professional certification is a plus * Experience… more
    UCLA Health (03/15/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Advantage Compliance…

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …manages administrative elements of the Companies' (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program, including development and maintenance of ... people + This role reports to this job: Director, Medicare Advantage Compliance & Medicare ...+ Ability to manage time and personnel on a project and everyday basis. + Working knowledge of relevant… more
    Blue Cross and Blue Shield of Louisiana (04/26/24)
    - Save Job - Related Jobs - Block Source
  • Application Manager , Tapestry…

    UCLA Health (Los Angeles, CA)
    Description Under the direction of the Medicare Advantage Director, the Application Manager (AM) will be the primary expert in support of the application. As ... of the System Development Life Cycle (SDLC) or relevant project management methodologies * Ensure adherence to test and...EPIC Tapestry and other related software in support of Medicare advantage health plan administration. Salary Range:… more
    UCLA Health (04/18/24)
    - Save Job - Related Jobs - Block Source
  • Manager , Medicare Markets

    Healthfirst (New York, NY)
    …Excel skills + Strong understanding of the healthcare industry marketplace, specific to Medicare Advantage + Self-motivated and driven + Understand and translate ... The Manager , Medicare Markets is passionate and...Strong understanding of the healthcare industry marketplace, specific to Medicare Advantage + Team player who contributes… more
    Healthfirst (04/05/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Stars Member Experience…

    CVS Health (Hartford, CT)
    …the Manager of Business Consultation is responsible for optimizing Medicare Advantage member journey through process improvement, engagement campaigns, and ... Medicare is dedicated to achieving best-in-class quality and value to Medicare Advantage beneficiaries. Optimizing business performance and Star Ratings is a… more
    CVS Health (03/10/24)
    - Save Job - Related Jobs - Block Source
  • Product Owner ( Medicare )

    BlueCross BlueShield of North Carolina (NC)
    …to oversee the strategy and implementation of projects and yearly renewals for Medicare Advantage , Medicare Supplement, Dual Special Needs Plans (DSNP), ... **Job Description** Reporting to the Manager of Product Development in the Digital Strategy...deep understanding of revenue strategy and quality programs within Medicare Advantage , Medicare Supplement, DSNP,… more
    BlueCross BlueShield of North Carolina (04/25/24)
    - Save Job - Related Jobs - Block Source
  • CRM Project Manager I-IV

    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' ... their best possible health and quality of life. IT Project Manager I Assists in leading enterprise...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and… more
    Medical Mutual of Ohio (02/16/24)
    - Save Job - Related Jobs - Block Source
  • Lead Project Delivery Manager

    Medical Mutual of Ohio (Brooklyn, OH)
    …including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Responsible for project management, stakeholder ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
    Medical Mutual of Ohio (03/27/24)
    - Save Job - Related Jobs - Block Source
  • Project Manager

    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 Project Manager at Prominence Health fulfills a role in managing… more
    Universal Health Services (04/17/24)
    - Save Job - Related Jobs - Block Source
  • Manager , SNP Project Management

    CVS Health (Scottsdale, AZ)
    …drive the segment communications within Aetna's SNP segment. The primary goal of the Project Manager , is to work with team members to facilitate effective and ... level communications Preferred Qualifications 5 or more years of experience in Medicare Advantage DSNP Experience Education BS/BA or equivalent experience and… more
    CVS Health (03/12/24)
    - Save Job - Related Jobs - Block Source
  • Product Development Manager

    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
    Universal Health Services (03/29/24)
    - Save Job - Related Jobs - Block Source
  • Risk Adjustment Analytics Manager

    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
    CareOregon (03/26/24)
    - Save Job - Related Jobs - Block Source
  • Provider Contract Manager

    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
    Medical Mutual of Ohio (04/25/24)
    - Save Job - Related Jobs - Block Source
  • Manager , Bus Consultant

    CVS Health (Trenton, NJ)
    …Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage withPrescription Drug ... Team role that will be a member of the Medicare / Medicaid Enrollment Configuration team tasked with developing...SRs and actively participates as a member of each project team supporting an application orset of applications.* Independently… more
    CVS Health (04/25/24)
    - Save Job - Related Jobs - Block Source
  • Manager Actuarial Analytics *Remote

    Providence (AK)
    …of study + 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development + Experience with writing queries ... must empower them._** **Providence Health Plan is calling a Manager Actuarial Analytics who will:** + Lead the review...of Actuaries (FSA or ASA) + Experience certifying the Medicare Advantage Bid + Experience with Commercial,… more
    Providence (04/04/24)
    - Save Job - Related Jobs - Block Source
  • Program Manager IV - Value Based…

    Cleveland Clinic (Cleveland, OH)
    …quality, cost, and utilization data preferred. + Knowledge of ACO, Medicaid, and Medicare Advantage quality measures, NCQA and HEDIS standards, and Medicare ... As part of the CCHS Value Based Performance team, the Program Manager will help support value based contracting, implementation, program management, and performance… more
    Cleveland Clinic (04/25/24)
    - Save Job - Related Jobs - Block Source
  • Pharmacy Benefit Operations Manager

    Universal Health Services (Reno, NV)
    …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... across all lines of business including Commercial fully-insured, self-insured, and Medicare Advantage products. The position will regularly interface with… more
    Universal Health Services (04/28/24)
    - Save Job - Related Jobs - Block Source
  • Senior Reimbursement Analyst

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does ... manage people + This role reports to this job: MANAGER , PROVIDER REIMBURSEMENT + Necessary Contacts: In order to...and/or conferences and exhibits. + Staff dedicated to supporting Medicare Advantage must have working knowledge of… more
    Blue Cross and Blue Shield of Louisiana (04/22/24)
    - Save Job - Related Jobs - Block Source
  • Product Solutions Manager II

    LA Care Health Plan (Los Angeles, CA)
    …well as strategic partnerships inclusive of entry onto the Covered CA market. Medicare : Required Medicare Advantage , with experience serving duals ... Product Solutions Manager II Job Category: Administrative, HR, Business Professionals... II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position… more
    LA Care Health Plan (04/18/24)
    - Save Job - Related Jobs - Block Source
  • Product Solutions Manager III

    LA Care Health Plan (Los Angeles, CA)
    …of business. Experience in improving Stars and Quality Measures. Experience in Medicare Advantage , with experience serving duals population. Direct experience in ... Product Solutions Manager III Job Category: Administrative, HR, Business Professionals... III Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position… more
    LA Care Health Plan (02/14/24)
    - Save Job - Related Jobs - Block Source