- 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
- Arizona Department of Administration (Phoenix, AZ)
- …outlines AHCCCS benefits and co-pays. *Providing or assisting with required certification to Medicare Advantage plans that are applying to CMS. *Interfacing with ... as an in-house expert on Medicare law and regulations pertaining to Medicare Advantage Plans will focus on the Special Needs Plans serving the duals eligible… more
- Senior Benefits Agency (Baltimore, MD)
- … Sales Agent, you'll play a pivotal role in guiding clients through their Medicare options, including Medicare Advantage and Supplement plans. Your ... with clients to assess their healthcare needs. Educating clients on Medicare plans and retirement protection options. Utilizing our state-of-the-art lead generation… more
- CenCal Health (Santa Barbara, CA)
- …with Federal and State regulatory requirements, the DHCS Medi-Cal Managed Care Contract, Medicare Advantage and Medicare Part D regulations and guidance, ... departments and external partners to ensure compliance with Medi-Cal and Medicare regulatory and contractual requirements, and operational plan requirements, as well… more
- UHS (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... plan experience, in claims or customer service, 3-5 years' experience with Medicare Advantage , HMO, PPO, and self-funded products preferred Excellent verbal… more
- Athari (New York, NY)
- …ICM ( Medicare ) provides clinical and administrative oversight for the Medicare Advantage and Integrated Benefits for Dually Eligible ("IB-Dual") populations, ... also known as the Medicare dual eligible special needs plan (D-SNP) line of...line of business. This role ensures adherence to the Medicare Model of Care, CMS regulatory requirements, established policies… more
- Medix (Huntington Beach, CA)
- …Examiner responsible for the accurate review, processing, and adjudication of complex Medicare Advantage medical claims. The role involves analyzing claims ... Responsibilities / Job Duties Accurately review, process, and adjudicate complex Medicare Advantage medical claims including inpatient, outpatient, professional,… 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 300,000 members in California, ... management, contact center support, or sales operations, ideally in a Medicare Advantage or healthcare setting. Proficiency in WFM tools (eg, Genesys, NICE,… more
- Martin's Point Health Care (Portland, ME)
- …in a matrix management environment. Job Description Key Outcomes: Support the annual Medicare Advantage and Prescription Drug (MA/PD) bid development by working ... and support to the company, including responsibility for the actuarial support of Medicare product bids, US Family Health Plan (USFHP) rate negotiations with the… more
- American Health Partners (Twin Falls, ID)
- …for care coordination for a group of members who are associated with a Medicare Advantage plan. Visit (in person and/or telephonic) patients to ensure proper ... case management strategies for care coordination for patients associated with a Medicare Advantage plan. ESSENTIAL JOB DUTIES: To perform this job, an individual… more
- West Tennessee Healthcare (Jackson, TN)
- …modify, or change information on the UB04 and CMS-1500 claim forms for Medicare , Medicare Advantage , Medicaid/TennCare, BCBS, Commercial, and/or other ... follow-up necessary to bill primary claims to appropriate insurance companies. Update Medicare Common Working File if necessary. Identifies denied or rejected claims… more
- National Recruiters (Olympia, WA)
- …interested in a flexible PRN role conducting in-home Health Risk Assessments (HRAs) for Medicare Advantage members. This is a great way to supplement your ... physicians included What you'll do: Complete comprehensive in-home HRAs for Medicare Advantage patients Review each patient's medical history, current… more
- Iconma LLC (Lansing, MI)
- …Business Analyst who can bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will ... Program Knowledge: Understanding of relevant risk adjustment programs, such as Medicare Advantage , and their specific compliance requirements. Regulatory… more
- Belong Health (Houston, TX)
- Hello, we're Belong. We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products. With a dual focus on data-driven, proactive ... Belong has completely reimagined health insurance for seniors and other Medicare -eligible individuals who have been disregarded and deprioritized for far too… more
- Oxford Global Resources (Dallas, TX)
- …of diagnosis coding Contribute to the overall development and maintenance of the Medicare Advantage internal share point site and related reference materials ... coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI...for government programs and other third party payers Review Medicare and Commercial payer publications on a frequent basis… more
- EvergreenHealth (Kirkland, WA)
- …multiple systems and/or educates patients on co-insurances/co-pays, self-pay, L&I, MVA, Medicaid, Medicare / Medicare Advantage , etc. Markets the benefits of ... the patient portal and assists patients with the enrollment process. Manages multi-line telephone system (incoming and outgoing). Follows guidelines to identify and direct patients calling with emergent/urgent symptoms to appropriate clinical staff for… more
- EvergreenHealth (Kirkland, WA)
- …multiple systems and/or educates patients on co-insurance/co-pay, self-pay, L&I, MVA, Medicaid, Medicare / Medicare Advantage , etc. Enrolls patient on patient ... portal and explains its attributes, benefits and recommended use. Requests, confirms and validates interpreter services. Greets patients and completes check-in process. Directs and assists patients with completion of appropriate paperwork. Monitors various… more
- TRANZACT (Fort Lee, NJ)
- …a leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage , Medicare Supplement and Life & Supplemental ... insurance policies. Our focus is on leveraging our highly skilled team of over 3,000 professionals to deliver innovative solutions for our insurance carrier partners and provide consumers with a best-in-class experience. We work with some of America's largest… more
- CenterWell Primary Care (Morrow, GA)
- …DEA license Medicare Provider Number/ Medicaid Provider Number Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... care environment in a value based relationship environment. Knowledge of Medicare guidelines and coverage. Knowledge of HEDIS quality indicators. Additional… more
- SonderMind Careers (New York, NY)
- …Insurance Payor Access: Only SonderMind provides complimentary credentialing for both traditional Medicare and Medicare Advantage plans, including Humana and ... United Healthcare. Free and stress-free credentialing with major insurers: We have streamlined the credentialing process and handle all the hard stuff for you so that you can expand your practice by accepting insurance from major payors in your state in weeks,… more
Related Job Searches:
Advantage,
Assistant Director Medicare Advantage,
Medicare,
Medicare Advantage Actuarial Analyst,
Medicare Advantage Insurance Sales,
Medicare Advantage Plan Sales,
Medicare Advantage Product Manager,
Medicare Advantage Provider Performance,
Medicare Advantage Quality Consultant,
Medicare Advantage Sales