- Medical Mutual of Ohio (OH)
- …responsible for leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage ... **Responsibilities:** + Manages the implementation and operation of the Medical Mutual Medicare Compliance Program. + Serves as Medical Mutual's Medicare … more
- CVS Health (PA)
- …can live anywhere in the United States* **Position Summary** As an Individual Contributor Manager of Medicare Complaints Operations - Technical, you will play a ... driving continuous improvement and ensuring the organization meets its operational goals. The Manager of Medicare Complaints Operations - Technical will be a key… more
- CVS Health (CT)
- …particularly those related to Medicare Star Ratings, quality improvement, and compliance . The Senior Program Manager will perform varied activities and ... And we do it all with heart, each and every day. **Position Summary** Senior Program Manager for Resources for Living is a high impact role, and we are in search for… more
- CVS Health (PA)
- …live anywhere in the United States* **Position Summary** As an Individual Contributor Manager of Medicare Complaints Operations - Business Insight, you will play ... this position, you will oversee support operations for the Medicare Complaints Department teams, manage the quality of the...aligned with the strategic goals of the organization. The Manager of Business Analytics will be a key player… more
- Houston Methodist (Katy, TX)
- …Access Services, and Utilization Review as needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medicare Broker Relations Manager drives broker channel growth and ensures sales success. This position is responsible for cultivating and ... with independent brokers and general agencies, while ensuring full compliance with Centers for Medicare & Medicaid...while ensuring full compliance with Centers for Medicare & Medicaid Services (CMS), state, and internal regulations.… more
- CVS Health (UT)
- …processes, procedures, and systems to ensure consistent results and organizational compliance with regulations related to the organization's Medicare Part ... with heart, each and every day. As the Senior Manager , Aetna Medical Pharmacy, you will be accountable for...business projects and programs and managing operations within the Medicare Part B Pharmacy Team. You will act as… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …value based contracts and gap closure work. This Population Health Clinical Quality Manager will support the Medicare Shared Savings Program (MSSP) value-based ... care model. **Primary Function/General Purpose of Position** The Manager of Population Health Clinical Quality is responsible for planning, directing, executing and… more
- AmeriHealth Caritas (Detroit, MI)
- …of Medicare LTSS Care Coordination Operations. Under the supervision of the Manager LTSS, the Supervisor, Medicare LTSS Operations is responsible to provide ... organizational processes and procedures to support the quality and compliance of operations for Medicare LTSS Care...the quality and compliance of operations for Medicare LTSS Care Coordination, including regulatory performance. + Ensures… more
- The Cigna Group (Bloomfield, CT)
- This position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This ... Drug or Part D bid development consulting experience preferred + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager (PBM) / Healthcare /… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Humana (Miami Lakes, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- AdventHealth (Maitland, FL)
- **Account Representative Manager Billing/Collections/Denials -AdventHealth** **Location Address:** **900 WINDERLEY PL, Maitland, 32751** **Top Reasons to work at ... local and industry standards, guidelines, rules and regulations to ensure compliance . + Manages department team members by providing application assistance and… more
- Fallon Health (Springfield, MA)
- …in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more
- Healthfirst (NY)
- …State Producer License. + Experience with CRM; Salesforce a plus. ** Compliance & Regulatory Responsibilities:** Noted above **License/Certification:** N/A WE ARE AN ... EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information,… more
- Molina Healthcare (Caldwell, ID)
- …business areas and owners to ensure processes and reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with ... to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Atlantic Health System (Morristown, NJ)
- The Compliance and Privacy Manager oversees, in pertinent part, the following compliance risk areas: (i) general compliance and compliance program ... privacy, information governance, and data risk classification; (iv) accountable care organization compliance ; (v) Medicare C & D/ Medicare Advantage … more
- Project Renewal, Inc. (New York, NY)
- Title: Senior Manager , Compliance Program: Legal, Varick Headquarters Salary Range: $90,000 - $100,000 per year Overall Responsibilities: The Senior Manager , ... in healthcare and related human services. The Senior Manager , Compliance reports to the Director of...state, and local healthcare regulations (eg, HIPAA, Stark Law, Medicaid/ Medicare , Part 2). + Ensure the organization's compliance… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with ... leadership and team management skills_** **Position Purpose:** Manage the Dual compliance department functions, including but not limited to, regulatory and D-SNP… more