- Highmark Health (Charleston, WV)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Humana (Oviedo, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... contributes to the development, implementation, and management of the company's Medicare /Medicaid Five-Star Quality Rating System. The Senior Stars Improvement,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00 ... Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location:...Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Serves as ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment. * Certified Risk Adjustment Coder (CRC) ... The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll...certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines… more
- Health Care Service Corporation (Nashville, TN)
- …analysis for the Government Business segment, with a primary focus on the Medicare Advantage business. This role is responsible for developing in-depth medical ... of a purpose-driven company that will invest in your professional development. The Senior Analytics Consultant - Medical Economics role supports medical cost trend… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- 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. **Provides ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Medical Mutual of Ohio (Dublin, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Account ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- CenterWell (Savannah, GA)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- CenterWell (Phoenix, AZ)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- ChenMed (Miami, FL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- Commonwealth of Pennsylvania (PA)
- …Contact Email ###@pa.gov + Description + Benefits + Questions THE POSITION Take advantage of your experience in nursing as a professional representative of the ... of nursing homes in Pennsylvania, you will evaluate the quality of services provided and determine the eligibility for...training and Test (SMQT) provided by the Centers for Medicare and Medicaid Services or an equivalent certifying body… more
- ChenMed (Miami, FL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Richmond, VA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive ... ensures an environment of patient safety, promotes evidence-based practice and quality initiatives and exhibits professionalism in nursing practice within the model… more
- ChenMed (Houston, TX)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- ChenMed (Miami Gardens, FL)
- …Experience in handling large data sets and relational databases + Experience in Medicare Advantage data analytics and strategy planning preferred + Experience in ... projects and are responsible for all aspects of data sourcing, migration, quality , design, and implementation. This position aligns and oversees the management,… more
- Provider Solutions & Development (Walla Walla, WA)
- …southeast Washington. A Level III trauma center, Providence St. Mary has a five-star quality rating from the Centers for Medicare and Medicaid Services. With its ... a large research network, and opportunities for investigator-initiated trials. Take advantage of all these professional growth opportunities while enjoying life in… more
- ChenMed (Berwyn, IL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more