- Marion County (Salem, OR)
- …culture. Review supervisors work for completeness, accuracy, quality, and quantity. Provide regular feedback on performance to supervisors and their ... employees. Use reports and data to provide transparent, data-driven feedback on outcomes and ...from participation in the federal health care programs (Medicaid, Medicare and other federally funded programs that provide… more
- The University of Vermont Health Network (Elizabethtown, NY)
- Job Summary:The manager role is responsible for all aspects of employee health disease, exposure, pre-employment, and annual requirements. The manager is ... responsible for record keeping for all of employee health documents and reports. The manager is a registered professional nurse manager who is responsible for… more
- Marion County (Salem, OR)
- …and consultation to nurses on complex cases; provides input to the manager /supervisor concerning performance strengths and areas of improvement among nursing ... not be excluded from participation in the federal health care programs (Medicaid, Medicare and other federally funded programs that provide health benefits); AND… more
- Marion County (Salem, OR)
- …not be excluded from participation in the federal health care programs (Medicaid, Medicare and other federally funded programs that provide health benefits); AND ... support a high-risk and underserved population. In this position, you would provide mental health therapy to individuals diagnosed with serious and persistent mental… more
- The Cigna Group (Tucson, AZ)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager , Director, and ... is responsible for the financial and operational activities of provider networks and this position involves extensive interaction with...interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of… more
- Providence (Portland, OR)
- …to financial/encounter data submission in support of Medicaid capitation rate setting + Provide expertise and consultation to support the Medicare bid process ... must empower them._** **Providence Health Plan is calling a Manager Actuarial Analytics who will:** + Lead the review...and pricing strategy + Evaluate the financial performance for Medicaid/ Medicare lines of business +… more
- 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 program and ... role does not manage people + This role reports to this job: Director, Medicare Advantage Compliance & Medicare Compliance Officer + Necessary Contacts: In order… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …Aid internal teams to support clients and business partners. **Responsibilities** + Provide oversight of operational activities of Medicare Part D/EGWP programs ... minimum wage requirements. Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/12697/ manager -of- medicare -part-d-and-egwp-programs/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-NY-East… more
- The Cigna Group (Houston, TX)
- **Job Summary:** The Medicare Coding Quality Review Audit Manager is responsible for day-to-day oversight of the Risk Adjustment coding quality assurance ... Medicare 's QA of coding projects. + Monitors key performance indicators and works collaboratively with leadership to report...teams to establish metrics for critical coding activities and provide updates to segment leadership on a regular basis… more
- LA Care Health Plan (Los Angeles, CA)
- Product Solutions Manager II ( Medicare ) Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product… more
- UCLA Health (Los Angeles, CA)
- …regulatory and CMS compliance requirements. You will manage the coding consultants who provide audit, coding expertise, and provider education to internal and ... at UCLA Health. As a key leader within our Medicare Advantage team, you will develop and execute of...execute of strategies, programs, and projects while managing key performance indicators to drive operational excellence. You will be… more
- The Cigna Group (Bloomington, MN)
- **POSITION SUMMARY:** The Account Management Lead Associate (Account Manager ) will provide support to the Account team for their assigned Line of Business. The ... Account Management Lead Associate will provide client facing support, complete non-standard reporting, submit client...benefit set-up and project support as requested within the Medicare and/or Exchange lines of business. The primary focus… more
- The Cigna Group (Austin, TX)
- Cigna Supplemental Benefits (CSB) has been growing rapidly with Medicare Supplement (MedSupp) annual revenues now exceeding $1.2b. The Medicare Supplement ... new business pricing strategy to drive profitable growth in the Medicare Supplement marketplace. Effectively communicate pricing strategy, positions, and changes to… 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 team in ... assessing product performance , forecast sales and membership in line with growth...and membership in line with growth objectives, in the Medicare Advantage Bid process annually, the cost and utilization… more
- Centene Corporation (New York, NY)
- …field or equivalent experience. 4+ years of experience in Sales, Healthcare, Medicare , CMS Regulations and/or Management. Experience in working with or managing ... + Implements marketing strategies for specific geographic segment. + Develops provider -specific marketing plans to attain membership growth in designated provider… more
- Universal Health Services (Reno, NV)
- …enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Sr. Manager of Provider Network leads and manages provider ... education and support for all network products. The Sr. Manager of Provider Network analyzes specific issues...analysis, addendums and letters of agreement. + Knowledge of provider reimbursement, Medicare reimbursement, coding and HEDIS… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Claims Integrity Provider Remediation Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....net required to achieve that purpose. Job Summary The Manager , Claims Integrity Provider Remediation is responsible… more
- Commonwealth Care Alliance (Boston, MA)
- …to the Sr Director, **Quality Performance and Value Based Care,** the Provider and Facility Quality & Safety Manager is responsible for designing and ... implementing key population health and network quality initiatives to achieve high performance on CCA's Population Health goals; including Medicare Star… more
- Molina Healthcare (Springfield, IL)
- …directs the Provider Service staff including hiring, training and evaluating performance . * Assists with ongoing provider network development and the ... * Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or Medicaid… more
- The Cigna Group (Seattle, WA)
- …and/or physician leadership including creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on ... **Role Summary:** The Provider Performance Lead Analyst is a...and vision for assigned territory. Participating with the Senior Manager / Manager in monthly financial review. + Assisting… more
