- The Cigna Group (Houston, TX)
- …high-quality, and competitive solutions to the market. This critical role on the Medicare Performance Optimization team will be accountable for financial ... The Medicare Affordability Director serves as the...stream strategy, along with plans designed to ensure Cigna's Medicare programs meet key business performance goals.… more
- The Cigna Group (Bloomfield, CT)
- … significant opportunities for a leader to shape a significant component of the Medicare Growth strategy. The Director of Telesales will lead strategy and ... - United States** **Summary** The Direct to Consumer (DTC) Medicare channel is a significant driver of current and...sales execution. **_People_** + Build, motivate and lead a high- performance team. Develop direct reports and provide … more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …true colors to blue. Reporting to the SVP, Sales & Client Management, the Director , Group Medicare Sales, is an integral member of the leadership team-driving ... management team to develop strategies that shape BCBSMA's overall direction in Medicare , achieve the company's performance goals and deliver an exceptional… more
- CVS Health (Hartford, CT)
- …strategic thought leader in support of business direction. Monitor and report on performance relative to plan and strategic alignment. Provide financial analysis ... team members as required in support of strategic initiatives. Provide business and financial expertise needed to set planning...supporting Medicare , as well as the core Medicare Finance team. This Executive Director will… more
- Somatus (Mclean, VA)
- Overview The Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment Programs to ... ensure program compliance with governing bodies' regulations, including the Center for Medicare and Medicaid Services. This role will partner with leadership to… more
- Elevance Health (Woodland Hills, CA)
- ** Medicare Star Business Strategy Plan Director ** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live ... of one of our Elevance Health PulsePoint locations. The ** Medicare Star Business Strategy Plan Director ** will...work, with a focus on clinical quality and HEDIS(R) performance . **How you will make an impact:** + Understands… more
- CVS Health (Hartford, CT)
- …will also play an important part in helping to align and communicate the Medicare Local Market teams around current performance , and the forecasts and Budgets ... Performance Management teams to drive local market performance and accountability across the 4-5 Medicare ...regions. Help set targets for unit cost, VBC and Provider Collaboration oversight, HHVs, Chart collection, In-Office Program, and… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Regulatory Compliance works directly with the Vice President Health Plan Regulatory Compliance/National ... Medicare Compliance Officer to develop and maintain an effective...Program; and disseminating requirements to appropriate internal staff. The Director of Regulatory Compliance is accountable to strengthen internal… more
- Elevance Health (Richmond, VA)
- …content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve ... is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director works on problems of diverse scope and complexity...healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative Law Judge hearings.… more
- Elevance Health (Woodland Hills, CA)
- ** Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... miles of our Elevance Health PulsePoint location in Woodland Hills, CA. The ** Director of Medicare Risk Adjustment Analytics and Reporting** is responsible for… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As an important member of our Medicare Advantage team, you will provide strategic oversight and leadership for our Member ... and Provider Contact Center. You will be responsible for ensuring...will lead, manage, coach, and develop teams to achieve high- performance standards in alignment with UCLA Health's mission and… more
- CVS Health (Hartford, CT)
- …enhancing data accuracy, and improving efficiency. * Guides management for individual performance evaluations aimed to provide critical feedback for skills ... CVS, we are looking for a leader who can provide strategic leadership and oversight for financial planning and...and oversight for financial planning and analysis for a Medicare Local Market by managing a team of financial… more
- The Cigna Group (Bloomfield, CT)
- …position within the Medicare Growth Analytics Team is an opportunity to provide leadership on our analytics strategy, to support our broader Medicare Growth ... on setting and executing the vision for how our Medicare Growth team can lead Cigna to achieving its...to achieving its goals. Reporting to the Growth Analytics Director , this position will coordinate with cross functional teams… more
- Elderwood (Buffalo, NY)
- …Medical Billing Specialist to join our team. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Elderwood Administrative Services is seeking a ... contract reimbursement and claim submission requirements. + Knowledgeable in Medicare and supplemental co-insurance billing. + Establish rapport with Managed… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …+ This role does not manage people + This role reports to this job: Director , Medicare Advantage Compliance & Medicare Compliance Officer + Necessary ... manages administrative elements of the Companies' (LHSIC, HMOLA, and VHP) Medicare Advantage Compliance Program, including development and maintenance of program and… more
- Elevance Health (Columbus, OH)
- …Innovation with deep partnership with Health Care Networks (HCN). Oversee value-based provider performance . + Develop and implement network strategies specific ... **RVP & President Medicare Market (Ohio)** **Location:** This role requires the...implementation of high- performance networks, including facility and provider performance incentives. + Work with growth… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual contributor ... + Accurately plan and scope projects; keep project leads, senior consultants, and Director informed of key issues/ risks and meet deadlines by tightly managing… more
- Manulife (MA)
- …analyze key performance metrics to evaluate the effectiveness of preferred provider solutions. Identify areas for improvement and develop strategies to optimize ... We are a leading financial services provider committed to making decisions easier and lives...partners. Negotiate and finalize agreements to drive profitability and provide access to quality care. + Conduct ROI Analysis:… more