- CVS Health (Frankfort, KY)
- …day. **Position Summary** This individual contributor position reports to the Lead Director, Medicare Member Materials. This is an exciting opportunity to join ... to see the value in project **Required Qualifications** + 3+ years of Medicare member materials experience at a regional or national health plan + 3+ years… more
- CVS Health (Boise, ID)
- …with Duals Center of Excellence, clinical, compliance, analytics and network teams, the Senior Manager drives innovation and operational excellence to optimize ... lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** This role oversees the Medicare Prescription Payment Plan (M3P), working closely with internal matrix partners and external vendors to ensure all ... administered timely, accurately and in compliance with the Centers for Medicare and Medicaid Services (CMS) requirements. Ensures that future program enhancements… more
- Point32Health (Canton, MA)
- …are often intended for senior leadership and/or strategy teams. The Sr Pharmacy Program Manager supports the Pharmacy department in conducting industry ... and vendors to develop and implement strategic projects. The Sr Pharmacy Program Manager functions as a senior project manager /advisor on strategic… more
- CVS Health (Austin, TX)
- …to service performance, customer satisfaction, financial performance, and quality. The Sr . Manager will collaborate with upstream and downstream functional ... the PA programs across our book of business for Medicare , Commercial (Health Plan, Employer, Coalition) and Marketplace Exchange...that have delegated PA services to the PBM. The Sr . Manager may have 4-6 direct work… more
- Molina Healthcare (Tucson, AZ)
- **Job Description** **Job Summary** The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member ... lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs in accordance with… more
- Humana (Jacksonville, FL)
- **Become a part of our caring community and help us put health first** Our Senior Manager , Medicare Sales - CarePlus motivates and drives a team of ... Annuity, Indemnity, Dental, Vision, Prescription plans, and more. The Senior Manager , Medicare Sales -...Information** + Any Humana associate who speaks with a member in a language other than English must take… more
- CVS Health (Hartford, CT)
- …compassionate. We do it all with heart, every single day. We are seeking a ** Senior Manager of Provider Contract & Pricing Testing** to join our expanding ... assurance of Provider Contracts and Pricing, ensuring that both Provider and Member Experiences meet or exceed expectations through the use of test automation… more
- Aston Carter (Honolulu, HI)
- …interdepartmental activities, and the reference materials supporting these Ensuring that all Medicare member records are in compliance with CMS requirements and ... Description The Senior Enrollment Manager is responsible for...for handling plan enrollment and disenrollment transactions, tracking/monitoring of Medicare ESRD members, generation of member notices,… more
- Humana (Oklahoma City, OK)
- …are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales motivates and drives a team of ... train, and discipline a team of sales individuals. The Senior Manager , Medicare Sales must...+ A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information + **Must reside in… more
- University of Pennsylvania (Philadelphia, PA)
- …and resources, and much more. Posted Job Title Research Coordinator - Sr . Research Coordinator Job Profile Title Research Coordinator Job Description Summary This ... proposals and manuscripts for publication. Job Description The Research Coordinator/ Sr . Research Coordinator will be responsible for implementing day-to-day… more
- Humana (Baton Rouge, LA)
- …and help us put health first** Humana Healthy Horizons is a seeking a Senior Project Manager (Medicaid Network Implementation) who is accountable for working ... of end-to-end provider-related functions in new Medicaid market implementations. The Senior Project Manager makes decisions supporting technical and operational… more
- Elevance Health (Indianapolis, IN)
- National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the ... and Medicaid Services to transform federal health programs. **Audit & Reimbursement Sr ** **Location:** This role enables associates to work virtually full-time, with… more
- CareOregon (Portland, OR)
- …Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Sr Accountant - Reporting and Analysis Department Finance Exemption Status Exempt ... Requisition # 24971 Direct Reports N/A Manager Title Director, Financial Reporting & Analysis Pay & Benefits Estimated hiring range $88,430 - $108,080 / year, 5%… more
- Amazon (Seattle, WA)
- …relationships with payer organizations that desire innovation in their end-to-end member experience. This role will manage critical relationships with external ... Partner with counterparts on the Health Insurer's team to create a differentiated member experience. - Identify opportunities to drive member education and… more
- Elevance Health (Atlanta, GA)
- …as necessary. + Strong negotiation skills for successfully securing Commercial, Medicare and Medicaid rate agreements with complex providers. + Proven ability ... Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are… more
- Elevance Health (Denver, CO)
- …throughout Colorado (25% - 30% of the time.) The **Care Consultant Sr .** for **Provider Success** is responsible for consulting with providers (Commercial, ... Medicare Advantage and Medicaid Lines of Business) to assess...benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all… more
- Point32Health (Canton, MA)
- …service to our members, partners, colleagues and communities. **Job Summary** The Senior Clinical Pharmacist is responsible for the development and maintenance of ... and accreditation requirements and to meet Point32Health's corporate priorities. The Senior Clinical Pharmacist also oversees the structure and activities of the… more
- CVS Health (St. Louis Park, MN)
- …more than $387M in annual revenue. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for Individual Medicare ... market performance, cost structure and local execution of medical costs management, Medicare Stars, member engagement, compliance, and revenue integrity efforts… more
- Commonwealth Care Alliance (Worcester, MA)
- …care system, ensures the members know how to get services and answers member questions on obtaining needed care. The Care Coordinator communicates with members, via ... the method, mechanism and cadence that works best for each member , including in-person visits, to provide engagement, promote establishment of trust, and ensure… more