- Elevance Health (Columbus, OH)
- …ask you for payment as part of consideration for employment. **Marketing Manager - Medicare Strategy Consultant ** + Job Family: MKT > Marketing, Prog/Proj & ... days in office per week. The **Marketing Manager - Medicare Strategy Consultant ** is responsible for developing...and/or 5+ years' work experience. + Proven experience in Medicare related to either strategic planning, business … 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 ... to matrix and leverage relationships within HMM and with outside business partners regarding advancing quality improvement goals, corrective action plans, and… more
- CareOregon (Portland, OR)
- …This position is responsible for managing actuarial analysis related to Medicaid and Medicare Advantage lines of business with a focus on supporting strategic ... actuarial analysis of the financial performance of Medicaid and Medicare lines of business in alignment with...to impact rates. + Oversee and coordinate external actuarial consultant 's work preparing the annual Medicare Advantage… 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 ... and leads the Labor Relations team. The Director, Group Medicare Sales and Labor Relations requires an in-depth understanding...up to 3,000 enrolled members. In addition, they will lead our Labor Relations team, ensuring effective alignment and… more
- Elevance Health (Atlanta, GA)
- …check, or ask you for payment as part of consideration for employment. **Financial Consultant Manager/ Lead ** + Job Family: AFA > Financial Reporting, Planning & ... of preparation and interpretation of complex financial analysis for Medicare lines of business . Has end to...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- CVS Health (Dover, DE)
- …convenient and affordable. Position SummaryThe Revenue Integrity (RI) Sr. Manager, Business Consultant (Risk Adjustment) is responsible for the management ... maximize RA activities and initiatives for the designated market/territory. Specifically, the Business Consultant will be responsible for increasing market level… more
- Elevance Health (Indianapolis, IN)
- …background. **Preferred Skills, Capabilities and Experiences:** * Must have experience with Medicare & Commercial Lines of Business . * Experience with relational ... part of consideration for employment. **Provider Contract/Cost of Care Consultant ** + Job Family: RDA > Health Economics &...Works on complex enterprise-wide initiatives and acts as project lead . **How you will make an impact:** * Creates… more
- Humana (Washington, DC)
- …to define and evaluate strategic objectives, measures, targets and, at times, lead enterprise-wide strategic initiatives. The Corporate Strategy Consultant will ... Management, Strategy Alignment, Strategy Reporting and Change Management. The Corporate Strategy Consultant will work with company leaders at all levels of the… more
- Public Consulting Group (Columbus, OH)
- …is changing, and PCG is at the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our growth efforts. Deep Medicaid ... experience is critical, as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined modular certification (SMC)… more
- Elevance Health (Houston, TX)
- …check, or ask you for payment as part of consideration for employment. **Strategic Vendor Consultant ** + Job Family: PUR > Vendor Relations + Type: Full time + Date ... Grand Prairie, TX Elevance Health office locations.**_ The **Strategic Vendor Consultant ** will be responsible for managing relationships with vendors, stakeholders,… 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
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- Provides clinical leadership and serves as an internal medical consultant to various divisions and committees to support the development, implementation and ... accuracy and reliability of UM and Appeals reviews\. + Lead and serve on various committees in order to...the performance of administrative duties only\. + Based on business need, an unencumbered and unrestricted license in an… more
- The Joint Commission (Oakbrook Terrace, IL)
- **Overview** **GENERAL SUMMARY:** The Team Lead for Standards Interpretation Group will assist the Senior Director of Standards Interpretation and Senior Associate ... and ability to provide high quality, safe patient care. Participates as a consultant in the development and revision of standards and survey process. Participates in… more
- Medical Mutual of Ohio (OH)
- …project management experience.** **.** **Knowledge of CMS pricing methodologies preferred.** ** Lead Provider Analyst** **.** **Bachelor's degree in business ... and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider… more
- MetroLink (Los Angeles, CA)
- …the day-to-day management of the Engineering Design Department. The Director will lead a team of staff, consultants, and contractors in successfully delivering ... funding ends, time expires, or due to lack of business need for the position. Limited Term employees receive...Direct the Authority's infrastructure design and engineering functions and lead the implementation of the SCORE program. + Proactively… more
- Highmark Health (Charleston, WV)
- …as requested. + Become familiar with network issues and how to act as consultant to physicians at hospitals and health care management. + Identify specific factors ... expand the network, retain practitioners and providers, and complete similar business initiatives. + Participate in network promotional activities with members and… more
- Silicon Valley Power (Santa Clara, CA)
- …. The **Traffic Engineering Division** provides traffic engineering ( lead and support for the design and construction of ... operation services for the City. The division receives and investigates resident/ business inquiries related to street parking, traffic calming, intersection control… more
- HCA Healthcare (Brentwood, TN)
- …but are not limited to: MACRA/MIPS, 21st Century CURES, Centers for Medicare and Medicaid Innovation (CMMI) projects; Accountable Care Organizations (ACO); Advanced ... Alternative Payment Models (AAPM); Medicare Advantage; and commercial payer value programs. This position will have particular emphasis on overseeing these programs… more
- NASCO (Columbus, OH)
- **Overview** Under general direction, the Executive Director, Compliance will lead and provide oversight and management of Compliance and Privacy functions and serve ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
- Highmark Health (Pittsburgh, PA)
- …with regulatory requirements and in support of overall quality goals and objectives (eg Medicare STARS). + Lead and evolve teams responsible for internal quality ... with organizational goals, regulatory requirements, and population health priorities. + Lead c cross functional initiatives to improve quality and optimize resource… more