- Molina Healthcare (Bellevue, WA)
- …issues or questions. + Log all contacts in a database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being ... **Job Description** **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member … more
- Commonwealth Care Alliance (Boston, MA)
- …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider … more
- Wider Circle (Southmont, NC)
- …and disadvantaged communities. Job Overview: Wider Circle is seeking a passionate and dedicated Member Engagement Lead to play a vital role in our groundbreaking ... group events, home visits, and telephone outreach. As a Member Engagement Lead, they will be seen...video conferencing. + A genuine interest in working with Medicare /DSNP/Medicaid populations and a commitment to building strong, supportive… more
- Lumeris (NH)
- …its people and empowers you to make an impact. **Position:** Provider Engagement Specialist **Position Summary:** Responsible for improving Accountable Care Team ... (Provider) engagement . Establishes significant "mindshare" within our Accountable Care Team...subject matter expertise in any of the following areas: Medicare advantage, Medicare Shared Savings Program (MSSP),… more
- Magellan Health Services (Albuquerque, NM)
- …Presents the program and offerings in group settings. Consistently achieves member engagement strategies while meeting quality performance standards. + ... with individuals with adverse childhood experiences. General Job Information Title CISC Member , Caregiver and Stakeholder Engagement Manager Grade 23 Work… more
- LA Care Health Plan (Los Angeles, CA)
- …data to inform management with an integrated approach to outreach activities and targeted member engagement . Plan, develop, analyze and implement member and ... Community Resource Center Specialist III Job Category: Customer Service Department: Community...instructors. The role leads community and provider outreach and engagement initiatives to increase member traffic at… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating appropriate length of… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12405 ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more
- Medtronic (Minneapolis, MN)
- …supports engagement with commercial payers, managed care organizations, and Medicare Advantage plans. Additionally, this role requires experience and skill in ... seeking a US Payer Advocacy and Market Access Principal Specialist , a role responsible for driving patient and market...is responsible for executing our market access strategies through engagement and support of clinical stakeholders and other key… more
- Novant Health (Salisbury, NC)
- …+ Our team members are part of an environment that fosters team work, team member engagement and community involvement. + The successful team member has ... cost of Medicare and Medicaid). In 2022, Novant Health community engagement contributed more than $1.9 million in charitable contributions to community partners… more
- Elevance Health (Washington, DC)
- **Medical Management Specialist I** **Location:** Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and ... to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and… more
- Waystar (Louisville, KY)
- …Specialist who is passionate, curious, and radiates optimism. The Enterprise Technical Research Specialist will serve as a versatile team member , acting as a ... and concise updates to the support team. + Client Engagement and Documentation: Support "Client of the Week" initiatives...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Centene Corporation (Bronx, NY)
- …Hindi, Bengali or Urdu** **Position Purpose:** The Community Relations Specialist is responsible for leading activities to achieve membership/enrollment goals ... and new market initiatives, health fairs and community activities, training, member retention activities, sales visibility and business, broker, provider, market,… more
- Humana (Salt Lake City, UT)
- …Health Outcomes Survey Program Delivery Lead will work to develop a member engagement strategy that delivers insights and enables comprehensive analytics ... new technologies + Conduct, leverage, and apply new insights from research to member engagement strategy + Develop foundational interventions based on pilots and… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …relationships. The Immunology/Neurology/Acute SSR will focus on sales performance and engagement with the prescribers, office decision makers and account targets. ... to move at a rapid pace using digital resources for customer engagement and to use technology for call planning/targeting, field communications, field reporting,… more
- Highmark Health (Pittsburgh, PA)
- …with all applicable guidelines, regulations and laws established by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services ... the strategy and capabilities to develop risk management and physician / member initiatives that support provider documentation and coding accuracy. Executes audits… more
- Somatus (Macon, GA)
- …, Medicaid or Special Needs populations. + Medical Assistant, Licensed Practical Nurse, Engagement Specialist or Community Health Worker Experience. + Ability to ... Wellness Benefits supporting teammates physical and mental well-being + Community engagement opportunities + And more! **Somatus offers a Hybrid Telehealth… more
- Tidelands Health (Myrtle Beach, SC)
- …identification of and implementation of proactive denial mitigants, and staff engagement . + Responsible for maintaining current knowledge of applicable medical ... laws, rules, and regulations, Follows compliant charge capture in accordance with Medicare , Medicaid or Third-Party payer guidelines. + Assists with development of… more