- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... and CPT (II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications, required + Six or more… more
- UCLA Health (Los Angeles, CA)
- Description As an important member of our Medicare Advantage leadership team, you will provide tactical execution and leadership for our Member and Provider ... This role will be responsible for supporting the day-to-day management of the Medicare Advantage department. You will: * Coordinate schedules to efficiently… more
- CVS Health (Des Moines, IA)
- …and lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans ... - Direct product enhancements **Required Qualifications** 7+ years of experience with Medicare Advantage , DSNP, HIDE and FIDE plans. **Preferred Qualifications**… more
- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... department measurements used in both internal and external reporting. You will: + Ensure data quality and accuracy through rigorous assurance checks. + Develop and maintain reports, from ad hoc requests to scheduled production reports. + Write clear… more
- Centene Corporation (Jefferson City, MO)
- …As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Applicants for this job ... have the flexibility to work remote from home anywhere in the Continental United States.** **Position Purpose:** Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic… 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 ... equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process + Ensures prospective members are… more
- BrightSpring Health Services (Louisville, KY)
- …Business Signature Advantage , an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare ... Our Company Signature Advantage Overview Seeking a Sales Account Representative/Executive for...and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and… more
- Independent Health (Buffalo, NY)
- …presentation skills with an ability to design and develop adult learning programs OR Medicare Advantage or Part D experience required. + Experience in quality ... (or be a) subject matter expert within product team in the review of Medicare Advantage and Part D operations and requirements. + Provide support in Medicare … more
- CVS Health (St. Louis Park, MN)
- …Manager who has Medicare market specific P&L accountability for Individual Medicare Advantage products, supporting sales and customer experience agendas in ... Stars, member engagement, compliance, and revenue integrity efforts for all Medicare Advantage products. The Market GM will drive local product strategy and… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- …submission per Medicare , Commercial, and Medicaid billing guidelines + Submission of Medicare Advantage Copy claims + As Medicare payment occurs, ... Medicare Biller The CommuniCare Family of Companies currently...living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in Cincinnati,… more
- CVS Health (Atlanta, GA)
- …will direct key team resources and associated project responsibilities managing Individual Medicare Advantage , Special Needs Plans (SNP) including Medicare ... ways every day. Aetna is recruiting for a VP, Medicare Territory Leader who will have overall accountability for...the territory P&L and general management responsibilities for the Medicare business in the Southeast territory which includes the… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Under limited ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace… more
- Molina Healthcare (Covington, KY)
- …Education** BA/BS or equivalent experience **Required Experience** Seven years + Medicare Advantage product development expertise, including direct experience ... Summary** This position is responsible for supporting development and pricing of Medicare products, which include today MMP, D-SNP and MA-PD, with additional… more
- CareOregon (Portland, OR)
- …to primary care medical home improvement and practice transformation or to the Medicare Advantage performance measures such as Stars, CAHPS, HCC coding and ... Job Title Innovation Specialist - Primary Care/ Medicare Exemption Status Exempt Department Technical Assistance Manager...care, access, clinic support structures, and care management. + Medicare focus - Medicare Stars, CAHPS, and… more
- Humana (St. Augustine, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... exceed $113K depending on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the… more
- CVS Health (Salem, OR)
- …fully remote opportunity to make a meaningful difference in the lives of our Medicare Advantage members. Our CSRs are trusted advocates who provide proactive, ... by Workforce Management (WFM). **Key Responsibilities** + Respond to inquiries from Medicare Advantage members via inbound calls, online messages, and written… more
- Centene Corporation (Providence, RI)
- …and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). This role ... the organization drive population health improvements and financial sustainability through Medicare VBP strategies. + Partner with Contract management and Service… more
- Commonwealth Care Alliance (Boston, MA)
- …ensuring accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of ... Experience (nice to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred. **Required Knowledge,… more
- BroadPath Healthcare Solutions (Honolulu, HI)
- …lead a high-performing team of licensed sales agents who help consumers enroll in Medicare Advantage and Prescription Drug Plans. This is your chance to step ... in telesales + 1+ year of recent **healthcare experience** , preferably in Medicare Advantage + Proven ability to coach agents to meet call center performance… more
- CVS Health (Atlanta, GA)
- …provides actuarial support to ensure business strategy achieve optimal outcomes within the Medicare Advantage and PDP Markets. The colleague will work with ... government services pharmacy business. The primary focus is the Medicare Part D product strategy and pricing of MAPD,...attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience… more
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