- The Cigna Group (Bloomfield, CT)
- **Legal Compliance Advisor - Medicare Part D/ Rx Service Operations** _Medication Therapy Management (MTM), Formulary, Drug Utilization Review (DUR), Opioid ... Abuse (FWA,) and Clinical Decision Making_ **Role Summary** The Medicare Part D Legal Compliance Advisor is...also offer 401(k) with company match, company paid life insurance , tuition reimbursement, a minimum of 18 days of… more
- CVS Health (Austin, TX)
- …care more personal, convenient and affordable. Position Summary The Clinical Operations Advisor is a client facing role that collaborates with Health Plan Clinical ... Advisor to understand the client's clinical strategy and roadmap...health plan clients across multiple lines of business including Medicare , Medicaid, Exchange, and Commercial. This position can be… more
- Medical Mutual of Ohio (Brooklyn, OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans....both tactical and strategic levels. The Insights & Analytics Advisor II possesses the technical skills and abilities to… more
- Trinity Health (South Bend, IN)
- …allow us to set the standard for quality care. **About the Job:** + The Insurance Agent & Advisor impartially provides education about the availability of health ... + Adheres to all Federal Center for Medicaid and Medicare Services (CMS) regulations governing health insurance ...and Medicare Services (CMS) regulations governing health insurance sales and enrollment. + Responsible for securing all… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Strategy Advancement Advisor plays a crucial leadership role that provides data-driven strategic guidance to ... consistent and best-in-class Provider Engagement function. The Strategy Advancement Advisor enhances operational stability and effectiveness for market-based processes… more
- Atria Wealth Solutions (Marion, IN)
- …relationship with CUSO Financial Services, LP (CFS) Via Credit Union is seeking a Financial Advisor to join their team in the Marion, IN area. Are you interested in ... a positive impact? Do you enjoy educating others? The Licensed Financial Advisor provides expertise on products and services to members and non-members regarding… more
- AdventHealth (Altamonte Springs, FL)
- …**FT** **Shift** : **Days** **The role you'll contribute:** The Onsite Physician Advisor provides primary support for Care Management (CM) and Clinical Documentation ... campus, as well as, the medical liaison for payor escalations. The Physician Advisor is responsible for educating, informing and advising members of the, Care… more
- CommonSpirit Health (Houston, TX)
- …states will be considered for future openings.** As the Utilization Management Physician Advisor II, the Physician Advisor (PA) conducts clinical case reviews ... Understand the intricacies of ICD-9-CM, ICD-10-CM/PCS, MS-DRG, APR-DRG, and the Medicare Inpatient Prospective Payment System (IPPS) to make medical determinations… more
- WTW (Houston, TX)
- …we unlock potential. Learn more at wtwco.com . **Job Description** As a Benefit Advisor , you will have the rewarding opportunity to speak with Medicare eligible ... participants across the country to assist them in selecting insurance plans that meet their needs. You will spend...in order to be eligible to enter the Benefit Advisor Training program. + After passing the licensing exam… more
- St. Luke's Health System (Boise, ID)
- …from the acute care setting to the post-acute care setting. + Evaluates patient insurance resources including, but not limited to Medicare , Medicaid, HMO and ... **Overview** St. Luke's Health System is seeking a Post-Acute Care Advisor to join our Health Partners team.This role offers a variety of flexibility including the… more
- Humana (Louisville, KY)
- …our caring community and help us put health first** The Strategy Advancement Advisor will support strategic planning and operations for the HQRI leadership team. ... quality and timely submission of key priority deliverables. The **Strategy Advancement Advisor ** works on problems of diverse scope and complexity ranging from… more
- Conviva (Hialeah, FL)
- …our caring community and help us put health first** The Patient Service Advisor is an embedded growth and retention associate responsible for executing initiatives ... and providing a personalized care journey. The Patient Service Advisor plays a key role in ensuring success of...with Senior population + Knowledge of Managed care and Medicare + Experience using a Customer Relationship Management (CRM)… more
- The Cigna Group (Westerville, OH)
- This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region ... Adjustment Operations teams. The Prospective Program Solutions & Performance Advisor works with aligned region supporting prospective risk adjustment initiatives… more
- Dignity Health (Gilbert, AZ)
- …Twitter (https://twitter.com/ChandlerRegiona) . **Responsibilities** **Job Summary:** The Physician Advisor plays a critical role in promoting evidence-based ... and State regulations. **Job Standards:** + Mitigate denials for payment from insurance payers by providing valid and effective secondary medical necessity reviews.… more
- AbbVie (San Antonio, TX)
- …+ Proven record of comprehensive work with accounts at all levels + Payer/ insurance coverage experience with Medicare , Medicare Advantage, Commercial and ... Facebook, Instagram, YouTube and LinkedIn. Job Description The Reimbursement Business Advisor (RBA) shares expertise and educates on Medical and Pharmacy benefits,… more
- CommonSpirit Health (Rancho Cordova, CA)
- …week, or five 8-hour shifts per week.** As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case management staff ... quality care management. + Understand the intricacies of the Medicare Inpatient Prospective Payment System (IPPS) to make medical...Minimum of 1 year of experience as a Physician Advisor required. + Minimum of 5 years of clinical… more
- AbbVie (Baltimore, MD)
- …Instagram, YouTube and LinkedIn. Job Description The Reimbursement Business Advisor (RBA) educates health care professionals (HCP), administrative staff, and ... for specialty medicines and/or medical devices. + Payer coverage experience with Medicare , Medicare Advantage, Commercial and Medicaid plans + Well-developed… more
- Humana (Macdill AFB, FL)
- …T-5 East Region, the next generation of military health contracts. The Market Development Advisor is part of a team that is responsible for military health system ... a week and work at home the other days.** The Market Development Advisor has full responsibility and accountability for the daily administration and management of… more
- The Cigna Group (Bloomfield, CT)
- …an optimal healthcare experience and customer satisfaction. Serves as clinical advisor to the sales organization, providing ongoing product and industry ... Serve as business owner to necessary client work for non- Medicare operational and implementation benefits changes . Understand client's...excellent customer service and act as a trusted client advisor . Work with internal partners to ensure all… more
- Humana (Columbus, OH)
- …to address healthcare opportunities and challenges with technology-enabled solutions. As an Advisor in our team you'll enable Humana leaders as they leverage modern ... technology to deliver health care and insurance for patients and members. Our team operates at...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more