- Zelis (St. Petersburg, FL)
- Position Overview The Senior Member Advocate is a vital role in ensuring service excellence to Zelis clients and their members. The Senior Member Advocate ... to effectively multitask, and to consistently meet or exceed performance standards. The Senior Member Advocate is a subject matter expert for the team. All job… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of...+ Trouble shoot claims issues for providers + Investigate member grievances within network. + Attend various meetings and… more
- Centene Corporation (Austin, TX)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Act as an advocate for the Member and a liaison between the Health Plan ... ensure availability and access to care. Establish a community presence, promote Member education, identify and resolve any systemic barriers that limit Members… more
- The Cigna Group (Miramar, FL)
- …Summary** The Provider Performance Enablement (PPE) Manager is a key member of a cross-functional, collaborative organization (which includes Market Provider ... members contribute to the growth and profitability of the Medicare Advantage business in their market in the following...groups or territories** **)** as evidenced by physician and member satisfaction, improvements on Star Rating and NPS score.… more
- The Cigna Group (Houston, TX)
- **The Provider Performance Lead Analyst is a key member of the market that assists in the growth and development of the provider network. The Lead Analyst is the ... All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: Growing the MA… more
- The Cigna Group (Bloomfield, CT)
- …Scope:** + Manages/coordinates an active caseload of case management cases for Cigna Medicare . Uses clinical knowledge to assess the treatment plan and goals and ... Establishes patient centric goals and interventions to meet the member 's needs. + Interfaces with the member ,...Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.… more
- Healthfirst (New York, NY)
- …in systems. + Serve as the liaison between all parties and acts as Member advocate maximizing the participant's support network and obtaining needed services. + ... The Entitlement Advocate provides Healthfirst's Medicare Advantage Plan(MAP),...Monitor Medicaid re-certification time frames for each active Medicaid member . + Ensure Human Resource Administration and/or Department of… more
- CVS Health (Springfield, IL)
- …questions are thoroughly answered and/or triaged and responded to. + Acts as an advocate for our Medicare members health needs and helps coordinate care between ... health care more personal, convenient and affordable. Position Summary The Health Advocate within the Healthy Outcomes Team interacts with members via multiple… more
- The Cigna Group (Bloomfield, CT)
- …+ Establishes a collaborative relationship with client (plan participant/ member ), family, physician(s), and other providers to determine medical ... as appropriate. + Promote consumerism through education and health advocacy. + Assesses member 's health status and treatment plan and identifies any gaps or barriers… more
- The Cigna Group (Bloomfield, CT)
- …- Knoxville/Chattanooga_** The **Director, Provider Network Contracting** serves as an integral member of the Provider Contracting Team and reports to the AVP, ... group contracting and negotiations** + **Experience with Healthcare - Medicare Advantage** + Analytical skills a plus + Experience...Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.… more
- The Cigna Group (Bloomfield, CT)
- …Answer, abandonment rate) + Determine authorization requirements based on company policy, member benefit grid and provider status + Review customer coverage and ... knowledge of departmental policies and procedures + Knowledge of Medicare Regulatory Requirements If you will be working at...Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.… more
- The Cigna Group (Birmingham, AL)
- …Mississippi._** The **Manager, Provider Contract Network Management** serves as an integral member of the Provider Contracting Team and reports to the Provider ... and negotiations** + **Experience with Healthcare - Commercial and Medicare Advantage** + Experience in developing and managing key...Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.… more
- Universal Health Services (Mcallen, TX)
- …Job Summary: Care Advocates are health care professionals who compassionately and quickly advocate for our member 's care by going the extra mile and ... 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage, Accountable Care Organizations, and commercial payer… more
- CVS Health (St. Louis Park, MN)
- …and affordable. Position Summary The Sr. Service Advocate will drive member retention in the Minnesota Medicare market by supporting service operations ... which could include calls, claims, correspondence, and face-to-face member appointments. Advocates must be able to interact compassionately with Medicare … more
- Somatus (Shelbyville, IN)
- …+ Participates in the integrated care team meetings. + Act as the patient advocate and support the member through their patient journey starting with initial ... from accessing resources to adhering to a physician's treatment plan. The CHW-Patient Advocate will work as an extension of the clinical care team, specifically… more
- Somatus (Woodstock, NY)
- …+ Participates in the integrated care team meetings. + Act as the patient advocate and support the member through their patient journey starting with initial ... from accessing resources to adhering to a physician's treatment plan. The CHW-Patient Advocate will work as an extension of the clinical care team, specifically… more
- Universal Health Services (Mcallen, TX)
- …scheduling member appointments, navigating bills, and arranging transportation for Medicare lines of business. Benefit Highlights: + Loan Forgiveness Program + ... 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage, Accountable Care Organizations, and commercial payer… more
- Actalent (Tigard, OR)
- …of business and protected health information. Acts as a liaison and member advocate between the member /family physician and facilities/agencies. ... Complete 10-20 calls a day. Skills: HEDIS, medical record, quality improvement, member outreach, medicare , chart review, NCQA, insurance, case management,… more
- Somatus (Cleveland, OH)
- …accessing resources to adhering to a physician's treatment plan. The Patient Health Advocate - Practice Lead will work closely with Somatus patients and physician ... time working from within physician offices. The Patient Health Advocate - Practice Lead will be the first and...partnered physician practices. He/she will be the key team member to establish trust with physicians and practices and… more
- CVS Health (Fresno, CA)
- …of this team are responsible for working along side peers who take Medicare individual inbound calls. Service advocates are a library of knowledge that assist ... are struggling with while on active calls. The service advocate is expected to be able to find and...timely support. Employee's in this roll may also support member directly if they become escalated and will be… more