- SCAN (Long Beach, CA)
- …corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 300,000 members in California, ... ideal candidate will have experience managing AEP readiness efforts within a Medicare Advantage environment and supporting other enterprise programs requiring… more
- SCAN (Long Beach, CA)
- …corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 285,000 members in California, ... on LinkedIn; Facebook; and Twitter. The Job The Program Manager is responsible for overseeing our enterprise-wide Voice of...Manager will work across the organization (sales, marketing, product , operations, service, IT, etc.) to build a unified… more
- Providence (WA)
- **Description** **Quality Program Manager - Medicare Advantage Stars** **The Quality Program Manager - Medicare Advantage Stars is tasked with ... result in improved Star ratings.** **The Stars Quality Program Manager will:** + Develop and implement strategies to improve... will:** + Develop and implement strategies to improve Medicare Advantage Star Ratings, driving clinical quality… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …create monthly business review report that displays the key metrics of BCBSMA's Medicare Advantage business + Design and develop metrics, reports, and dashboards ... healthcare? Bring your true colors to blue. The Senior Manager of Medicare Strategy and Business Planning...We're Looking for : + Experience in Government Programs, Medicare Advantage Preferred + Ability to develop… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …key relationships throughout the organization including, but not limited to, Medicare Product , Provider Contracting, Health and Medical Management, Actuarial, ... transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will...recommendations We're Looking for : + Excellent knowledge of Medicare Advantage risk adjustment programs and industry… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... Advisor Primary Responsibilities: + Educate prospects on CPHL MAP product designed for Full Medicaid and Medicare ...issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application… more
- Datavant (Lincoln, NE)
- …outcomes, measure product impact, and support value-based client delivery across Medicare Advantage , ACA, and Medicaid programs. The ideal candidate combines ... to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... of project communications and work with project sponsors or product owners to resolve issues, address changes and identify...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- CVS Health (Austin, TX)
- …available for highly motivated individual to lead a core team as a Hybrid Field Sales Medicare Manager . This position will be a part of a specialized team who ... achieve monthly sales goals using our competitive portfolio of Medicare Advantage & DSNP products within the... & DSNP products within the assigned market. The manager will support their team with a proven ability… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …activities to ensure that all Commercial (Pharmacy and Medical benefits) and Medicare Advantage Part D coverage determination requests are processed ... to internal partners including but not limited to Member Service, Medicare Operations, Compliance, Legal, Medical Directors, Sales/Marketing/ Product and external… more
- Deloitte (Tempe, AZ)
- …working knowledge of the individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or Medicare ... including disability, long term care, etc. + Experience with product design and/or product strategy + Experience with reimbursement models - including value… more
- Sanofi Group (Nashville, TN)
- **Job Title:** Field Reimbursement Manager , Tzield, Nashville TN **Location:** Nashville, TN (Field Based) **About the Job** Sanofi General Medicines is currently ... billing and coding processes and providing support through (1) product -specific provider reimbursement support, (2) coordination of HUB/Patients Services… more
- Commonwealth Care Alliance (Boston, MA)
- …**Desired Experience (nice to have):** + Experience working in a health plan, with Medicare Advantage and/or dually eligible population + Experience with a care ... Alli-Care Management **Position Summary:** Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently licensed behavioral… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise. MSHP is a fast growing business unit within… more
- Martin's Point Health Care (Portland, ME)
- …and support to the company, including responsibility for the actuarial support of Medicare product bids, US Family Health Plan (USFHP) rate negotiations with ... a matrix management environment. Job Description Key Outcomes: + Support the annual Medicare Advantage and Prescription Drug (MA/PD) bid development by working… more
- Elevance Health (Norfolk, VA)
- …trends throughout Virginia, positively impacting the affordability of respective Medicaid and Medicare Advantage health plan products. + Develops new provider ... is a proud member of the Elevance Health family of companies offering Medicare plans, Medicaid, individual and family plans, and group insurance plans in Colorado,… more
- Trinity Health (Columbus, OH)
- …Day Shift **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... Health Plan brands. + Collaborates with subject matter experts, product leaders, sales and broker team, and freelancers to...or related experience. Health care and insurance experience preferred; Medicare or Medicaid experience would be a bonus. +… more
- Trinity Health (Columbus, OH)
- …Day Shift **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... assuring that messaging effectively engages target audience and reflects the individual product brands. + Develops newsletters for health plan members and provider… more
- Sedgwick (Meridian, ID)
- …of experts to both learn from and to share your insights. + Take advantage of a variety of professional development opportunities that help you perform your best ... Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier;...of adjusters, clerical staff and provides feedback to hiring manager .\ + Provides limited assistance/support to team lead with… more
- WTW (Fort Lee, NJ)
- …a leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage , Medicare Supplement and Life & Supplemental ... and diverse group of practitioners who collaboratively support all our product categories and cross-functional stakeholders in the finance, marketing, sales,… more
