- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As a key member of our Medicare Advantage Operations team, you will partner with business and technical teams as well ... of 5 years' experience with CMS processes in a Medicare or Managed Care environment required * Project... Medicare or Managed Care environment required * Project Management Professional certification is a plus * Experience… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …help us transform healthcare? Bring your true colors to blue. What We Need The Medicare Advantage Network Performance Manager , as a member of a ... and coding, and product management and marketing. To accomplish this work, the Medicare Advantage Network Performance Manager will work closely with… more
- UCLA Health (Los Angeles, CA)
- Description Under the direction of the Medicare Advantage Director, the Application Manager (AM) will be the primary expert in support of the application. As ... of the System Development Life Cycle (SDLC) or relevant project management methodologies * Ensure adherence to test and...EPIC Tapestry and other related software in support of Medicare advantage health plan administration. Salary Range:… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is ... and compliance audits with the compliance officer and the manager of coding and education. The Assistant Director of...STARS and quality measures, preferred * CPC, CRC, and project management certifications, highly desired * Health plan and/or… more
- Healthfirst (New York, NY)
- …Excel skills + Strong understanding of the healthcare industry marketplace, specific to Medicare Advantage + Self-motivated and driven + Understand and translate ... The Manager , Medicare Markets is passionate and...Strong understanding of the healthcare industry marketplace, specific to Medicare Advantage + Team player who contributes… more
- CVS Health (Phoenix, AZ)
- …/program expertise in stakeholder facilitation, communications and relationship management + Medicare Advantage Products, including a basic understanding of ... + Key concepts (high level) of provider networks as they pertain to Medicare Advantage products (contracting, adequacy, value-based payment models) Skills In: +… more
- CVS Health (Hartford, CT)
- …the Manager of Business Consultation is responsible for optimizing Medicare Advantage member journey through process improvement, engagement campaigns, and ... Medicare is dedicated to achieving best-in-class quality and value to Medicare Advantage beneficiaries. Optimizing business performance and Star Ratings is a… more
- CVS Health (Hartford, CT)
- …managing, or reviewing CMS Annual Medicare member materials for a Medicare Advantage health plan. This includes Evidence of Coverage (EOC), Annual ... 3 days a week Position Summary This position reports to the Director, Medicare Member Materials. This is an individual contributor role. Responsible for end-to-end… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... their best possible health and quality of life. IT Project Manager I Assists in leading enterprise...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Responsible for project management, stakeholder ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Project Manager at Prominence Health fulfills a role in managing… more
- CVS Health (Hartford, CT)
- …the Business Project Program Senior Manager for oversight of product and project buildout of Medicare Advantage Dental products. Leads the work and ... implementation, that impact multiple processes, systems, functions, and products. Length of project may run multiple years in duration. . Develops and implements… more
- CVS Health (Scottsdale, AZ)
- …drive the segment communications within Aetna's SNP segment. The primary goal of the Project Manager , is to work with team members to facilitate effective and ... level communications Preferred Qualifications 5 or more years of experience in Medicare Advantage DSNP Experience Education BS/BA or equivalent experience and… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... organization, and facilitation of the development of Prominence commercial and Medicare Advantage products, system and infrastructure improvements, and vendor… more
- CareOregon (Portland, OR)
- …execution, and management of the risk adjustment data analytics programs for the Medicare Advantage and Medicaid programs. Assists Director in developing a ... Job Title Risk Adjustment Analytics Manager Exemption Status Exempt Department Finance Manager...of the CDPS + Rx model + Understanding of Medicare Advantage and OHP risk adjustment regulations… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. The Manager , HRIS manages the selection, ... Leads implementation of new systems including managing matrixed personnel, project teams, budgets, project plans, etc. Manages...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Providence (AK)
- …of study + 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development + Experience with writing queries ... must empower them._** **Providence Health Plan is calling a Manager Actuarial Analytics who will:** + Lead the review...of Actuaries (FSA or ASA) + Experience certifying the Medicare Advantage Bid + Experience with Commercial,… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does ... manage people + This role reports to this job: MANAGER , PROVIDER REIMBURSEMENT + Necessary Contacts: In order to...and/or conferences and exhibits. + Staff dedicated to supporting Medicare Advantage must have working knowledge of… more
- LA Care Health Plan (Los Angeles, CA)
- …well as strategic partnerships inclusive of entry onto the Covered CA market. Medicare : Required Medicare Advantage , with experience serving duals ... Product Solutions Manager II Job Category: Administrative, HR, Business Professionals... II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position… more
- LA Care Health Plan (Los Angeles, CA)
- …of business. Experience in improving Stars and Quality Measures. Experience in Medicare Advantage , with experience serving duals population. Direct experience in ... Product Solutions Manager III Job Category: Administrative, HR, Business Professionals... III Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position… more