- Centene Corporation (Austin, TX)
- …As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **This individual needs ... to be located in TX.** **Position Purpose:** The Provider Growth Consultant leads large scale, cross-functional initiatives to strategize, plan, and execute on… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …need: As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual ... guidance including UM operational procedures, and CMS guidance including coverage and benefit conditions included in Medicare laws, National Coverage Decisions… more
- CVS Health (Moon Township, PA)
- …Supervisor + Keep a positive attitude as changes occur Preferred Qualifications + Medicare industry experience. + Familiarity with Medicare Enrollment systems + ... communities. The Company offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k) retirement savings plan,… more
- CVS Health (Phoenix, AZ)
- …health care more personal, convenient and affordable. Position Summary As a Sr. Billing Consultant Ops. within the Medicare D Premium Billing group, Good Cause, ... knowledge of Microsoft Office products (Word, Excel, PowerPoint,Outlook) and Internet Explorer. Medicare D or other highly regulated government programs is a plus.… more
- CareOregon (Portland, OR)
- …on strategies to impact rates. + Oversee and coordinate external actuarial consultant 's work preparing the annual Medicare Advantage bid; advise internal ... or Wisconsin. Job Title Actuarial Services Manager - Medicaid and Medicare Exemption Status Exempt Department Finance Manager Title Director, Actuarial Services… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …blue. Reporting to the SVP, Sales & Client Management, the Director, Group Medicare Sales, is an integral member of the leadership team-driving BCBSMA's purposeful ... re-entry into the Group Medicare Advantage Market. The role will have responsibility for...short-term objectives + Actively develops new business through the broker/ consultant channels + Partners and consults with senior leaders… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Director, Group Medicare Sales and Labor Relations sells health insurance and related products to new ... 300+ contracts) and leads the Labor Relations team. The Director, Group Medicare Sales and Labor Relations requires an in-depth understanding of how organization… more
- CVS Health (Hartford, CT)
- …of the Appeals area objectives. + Executes review of all clinical and benefit documentation for complaint and appeal requests. + Develops strategy for review ... of complex delegation arrangements, coding logic, contracts, clinical criteria, benefit plan structure, and regulatory requirements to support appeals review.… more
- CVS Health (Hartford, CT)
- …occasional rotational weekend and holiday coverage. Position Summary The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... Medicare Part C appeals from both members and providers....role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include, but are… more
- CVS Health (Austin, TX)
- …Monday Through Friday , 11:45 am t0 8:15 pm Easter Times The WorkLife Consultant (WLC) is part of the WorkLife Team and provides education about community resources, ... communities. The Company offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k) retirement savings plan,… more
- CVS Health (Austin, TX)
- …- 5:00 pm EST and Tuesdays 9:00 am - 1:00 pm EST. The WorkLife Consultant (WLC) is part of the WorkLife Team and provides consultation, assessment, and resource ... communities. The Company offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k) retirement savings plan,… more
- WellSense (Boston, MA)
- Provider Relations Consultant (Boston/Northeast MA) - $5000 sign on bonus! WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25...no matter their circumstances. As a WellSense Provider Relations Consultant , you'll act as the primary liaison between WellSense's… more
- CVS Health (Austin, TX)
- …schedule is Monday through Friday 11:00 am to 7:30 pm EST. The WorkLife Consultant (WLC) is part of the WorkLife Team and provides consultation, assessment, and ... communities. The Company offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k) retirement savings plan,… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state.Normal ... Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan,… more
- CVS Health (Springfield, IL)
- …more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... in EST zone with rotating weekends and holidays. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan,… more
- AbbVie (Minneapolis, MN)
- …pharmaceutical sales experience required *Experience selling in a "buy and bill" Medicare part B/Medical benefit environment and understanding of reimbursement ... will be hired at a level commensurate with experience. The Account Consultant position manages sales processes for AbbVie's therapeutic products in accordance with… more
- Signature Healthcare (OH)
- …Modern Healthcare's "Best Places to Work!" Overview The ideal Signature Clinical Care Consultant Candidate would have working knowledge of Medicare , Medicaid and ... 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded...Fayette County, and Signature HealthCARE of Galion. Our exceptional Benefits Package and Signature Perks include the following and… more
- Elevance Health (Tampa, FL)
- …or ask you for payment as part of consideration for employment. **Group Underwriting Consultant Sr.** + Job Family: UND > Group Underwriting + Type: Full time + ... work and in office days 1-2 times per week. The **Group Underwriting Consultant Sr.** is responsible for determining acceptability of insurance risks and appropriate… more
- Humana (Washington, DC)
- …Management, Strategy Alignment, Strategy Reporting and Change Management. The Corporate Strategy Consultant will work with company leaders at all levels of the ... and, at times, lead enterprise-wide strategic initiatives. The Corporate Strategy Consultant will also report progress to strategy leadership and the executive… more
- ChenMed (St. Petersburg, FL)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... talks, etc.) to help reach our ideal patients (ie, medically underserved, Medicare -eligible seniors, age 55 and older). + Start cultivateing strong relationships… more