• Medicare Member Materials Manager

    Molina Healthcare (Cincinnati, OH)
    …data exchange of the Medicare /MMP product in support of strategic and corporate business objectives. Support for all Medicare lines of business the ... and MMP Welcome Kits, National Coverage Determinations, Mid-year change notices, and legal documents (ie Notice of Privacy...of Availability, etc.), in various formats and languages. Supports Medicare and MMP lines of business for… more
    Molina Healthcare (04/30/25)
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  • Sr Program Manager , Medicare Stars

    Molina Healthcare (NM)
    **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement initiatives and ... education programs to support improved Star Ratings. Responsible for Medicare Star projects and programs involving enterprise, department, cross-functional and… more
    Molina Healthcare (04/17/25)
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  • Program Manager , Medicare Stars…

    Molina Healthcare (Lexington, KY)
    **Job Description** **Job Summary** Molina Medicare Stars Program Manager functions oversees, plans and implements new and existing health care quality ... improvement initiatives and education programs. Responsible for Medicare Stars projects and programs involving enterprise, department or cross-functional teams of… more
    Molina Healthcare (05/14/25)
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  • Associate Director, Medicare Product…

    RVO Health (Charlotte, NC)
    **AT A GLANCE** RVO Health is looking for an Associate Director, Medicare Product Manager to improve how seniors find and select their Medicare plans. 88% of ... seniors report that they find enrolling in a Medicare plan to be confusing and overwhelming. Our mission...of RVO Health is Healthline Media and Distribution, a business that attracts nearly 90MM unique visitors per month… more
    RVO Health (05/07/25)
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  • Medicare Behavioral Health Case…

    Fallon Health (Worcester, MA)
    …integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of ... quality. **Brief Summary of Purpose:** The Behavioral Health Case Manager (BHCM) is responsible for assessing a member's behavioral...social care need or as indicated behavioral health clinical change (not otherwise accounted for by a medical … more
    Fallon Health (04/16/25)
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  • Sr. Manager Medicare Testing

    CVS Health (Hartford, CT)
    …+ Adept at execution and delivery (planning, delivering, and supporting) skills + Knowledge of Medicare lines of business + Ability to work in a hybrid work ... every day. **Position Summary** At Aetna, our health benefits business , we are committed to helping our members achieve...ways every day. Aetna is currently seeking a **Senior Manager for the Test Center of Excellence** team. This… more
    CVS Health (03/19/25)
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  • Telephonic Care Manager (RN)…

    UPMC (Pittsburgh, PA)
    …Health Plan is hiring a full-time Telephonic Care Manager to support the Medicare line of business within the Allegheny Care Management Team. The position ... through Friday with occasional evenings and weekends required. The Telephonic Care Manager is responsible for care coordination and health education for identified… more
    UPMC (05/21/25)
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  • Billing Follow Up Medicare

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …TPL (Third Party Liability) claims and conditional billing + Current knowledge of Medicare Transmittal, Change Requests and the ability to understand and ... The Medicare Billing and Follow-up Representative are responsible for...with systems , payers , and processes to the manager in a timely manner . Education and Experience… more
    Chesapeake Regional Healthcare (03/28/25)
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  • Innovation Specialist - Primary Care/…

    CareOregon (Portland, OR)
    …Primary Care/ Medicare Exemption Status Exempt Department Technical Assistance Manager Title Network Innovation Supervisor Direct Reports n/a Requisition # 24968 ... to primary care medical home improvement and practice transformation or to the Medicare Advantage performance measures such as Stars, CAHPS, HCC coding and Risk… more
    CareOregon (05/09/25)
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  • Health Plan Associate Director Medicare

    Banner Health (AZ)
    …reduce healthcare costs while keeping members in optimal health. If you're ready to change lives, we want to hear from you. Recognized nationally as an innovative ... leader in health care, Banner Plans & Networks (BPN) integrates Medicare and private health plans to reduce healthcare costs while keeping our members in optimal… more
    Banner Health (05/21/25)
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  • Contract Strategy & Business Engagement…

    Abbott (Austin, TX)
    …**Austin, TX (or Alpharetta, GA)** is looking for a **Contract Strategy & Business Engagement Manager ** **.** This person will spearhead the development, ... long-term business growth. + Ensure strict compliance with Medicaid, Medicare , and other relevant regulatory programs, and provide guidance on legislative… more
    Abbott (05/02/25)
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  • Business Office Manager

    Signature Healthcare (Terre Haute, IN)
    …and ability to maintain confidentiality. MUST have experience in prior business office in healthcare, knowledge of Medicare /Medicaid/ Cash collections. ... real quality of life initiatives. The vision, to radically change the landscape of healthcare, forever. Through education and...4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded… more
    Signature Healthcare (05/13/25)
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  • Business Office Manager

    Skyline Nursing Center (Dallas, TX)
    …+ Dental + Vision + PTO + 401K Objective Direct the overall Business Office activities in accordance with current applicable federal, state, and local standards, ... and as directed by the Administrator, to assure that Business Office tasks are done correctly and on schedule,...ensures that the Centralized Statement process is followed. Manages Medicare ADRs and appeals per established procedure. Ensures that… more
    Skyline Nursing Center (05/08/25)
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  • Manager , Business Transformation

    Waystar (Atlanta, GA)
    **ABOUT THIS POSITION** The Manager of Business Transformation will drive strategic, cross-functional transformative initiatives that are key to achieving our ... strategy with hands-on execution, offering a unique opportunity to make a meaningful business impact. The Manager of Business Transformation will work… more
    Waystar (05/16/25)
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  • Assistant Business Office Manager

    Signature Healthcare (Prestonsburg, KY)
    …Healthcare's "Best Places to Work!" Overview Together We Can Do More! While assisting the Business Office Manager in the overall functioning of the Business ... to long-term skilled nursing services. The vision, to radically change the landscape of healthcare, forever. Through education and...duties in the Business Office. + Assist Business Office Manager is day-to-day operation of… more
    Signature Healthcare (05/18/25)
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  • Compliance Manager - D-SNP Product

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …our business partners, the State Medicaid Office and/or the Centers for Medicare and Medicaid Services (CMS). The Compliance Manager will work closely with ... + Experience with D-SNP SMAC, regulatory requirements and/or operations required + Medicare managed health experience required + Business analytical skills:… more
    DOCTORS HEALTHCARE PLANS, INC. (05/16/25)
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  • Manager II - Project Controls

    MetroLink (Los Angeles, CA)
    Manager II - Project Controls Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4934751) Apply  Manager II - Project Controls Salary $99,799.00 ... Pacific + Description + Benefits + Questions SUMMARY PURPOSE OF POSITION The Manager will oversee certain functions associated with the department and will maintain… more
    MetroLink (05/09/25)
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  • Nurse Case Manager

    Medical Mutual of Ohio (OH)
    …We are looking for applicants that have a strong clinical case management background. Medicare experience is a plus. Founded in 1934, Medical Mutual is the oldest ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Under limited supervision,… more
    Medical Mutual of Ohio (05/09/25)
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  • Lead Compliance Program Manager

    Point32Health (Canton, MA)
    …projects associated with federal and state regulations for applicable lines of business (Corporate, Commercial, Medicare , Duals and/or Medicaid). This work ... maintain an effective compliance program. The Lead Compliance Program Manager should make recommendations for change by...for resolution; + Ability to conceptualize the impact of change and propose new methods of conducting business more
    Point32Health (05/24/25)
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  • Field Reimbursement Manager (New Haven)

    Endo International (New Haven, CT)
    …we serve live their best life. **Job Description Summary** The Field Reimbursement Manager (FRM) is a critical front-line member of the Endo Access and Reimbursement ... of the above products. **Job Description** The Field Reimbursement Manager (FRM) position is a critical front-line member of...dispense. + Partner with the ASMs to build local business plans; participate in district business reviews… more
    Endo International (04/30/25)
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