- CVS Health (Boise, ID)
- …and lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans ... (D-SNP). This role is responsible for aligning product offerings with CMS regulations, market trends and value-based... enhancements **Required Qualifications** 7+ years of experience with Medicare Advantage , DSNP, HIDE and FIDE plans.… more
- Tufts Medicine (Burlington, MA)
- …This position focuses on the Medicare Shared Savings Program (MSSP) and Medicare Advantage programs, plays a crucial role in overseeing clinical operations, ... operation of Medicare Accountable Care Organizations (ACOs) and Medicare Advantage Plans, including performance improvement, clinical alignment, health… more
- CVS Health (St. Louis Park, MN)
- … who has Medicare market specific P&L accountability for Individual Medicare Advantage products, supporting sales and customer experience agendas in market ... member engagement, compliance, and revenue integrity efforts for all Medicare Advantage products. The Market GM will...Advantage products. The Market GM will drive local product strategy and local market intelligence, be responsible for… 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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …+ Maintain strong relationships throughout the organization including, but not limited to, Medicare Product , Medicare Operations, Medicare Compliance, ... the Associate Director of Project Portfolio Management. The Program Manager of Production Operations will direct a Production Operations...demonstrated + Medicare experience a plus + Medicare Advantage and Prescription Drug Plan experience… more
- BrightSpring Health Services (Louisville, KY)
- …Overview The Chief Operations Officer (COO) is a pivotal member of the Signature Advantage Medicare Advantage (MA) health plan's Executive Leadership team. ... and efficiency. + Deep understanding of all operational aspects of the Medicare Advantage Special Needs Plan including enrollment, claims administration,… more
- Providence (Portland, OR)
- …a related field. + 5 years healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development. + Experience with writing ... **Description** **Senior Manager Actuarial Analytics \*Remote * Candidates residing in...Experience certifying Commercial Rate Filing + Experience certifying the Medicare Advantage Bid + Experience with Commercial,… more
- Trinity Health (Des Moines, IA)
- …This position is remote. **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... and do the right thing. **Position Purpose:** The Market Manager - Provider Relations and Network Development is responsible...Working knowledge of protocols and procedures of Centers for Medicare and Medicaid Services + Proven ability to work… more
- ChenMed (Metairie, LA)
- …+ Direct-to-patient sales and marketing experience preferred. + Experience within the Medicare Advantage population strongly preferred. Experience working for a ... we need great people to join our team. The Manager , Market Sales is responsible for leading a team...personal contact and rapport with key local communities serving Medicare -eligible seniors. Leverages connections to increase community events and… more
- ChenMed (Maple Heights, OH)
- …+ Direct-to-patient sales and marketing experience preferred. + Experience within the Medicare Advantage population strongly preferred. Experience working for a ... Sales leaders to develop sales strategies that improve market share in all product lines. Assists sales personnel in establishing personal contact and rapport with… 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
- 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
- Highmark Health (Latham, NY)
- …Medicare services (CMS) laws and regulations, policies and guidelines regarding Medicare Advantage and Medicaid plans; HIPAA privacy and security regulations. ... may participate as a regional representative on key operational / product /medical management/reimbursement projects/initiatives that impact providers. The incumbent will… 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
- Elevance Health (Nashville, TN)
- …trends throughout Tennessee, positively impacting the affordability of respective Medicaid and Medicare Advantage health plan products. + Develops new provider ... a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid… 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
- 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
- Kelsey-Seybold Clinic (Pearland, TX)
- …will develop and conduct training programs to support the Operations Department of the Medicare Advantage plan and commercial product lines to ensure that ... of state and federal laws and regulations and how they apply to Medicare and commercial insurance products. Experience in classroom training and development of… more
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …Group's 2025 Vision to become a "Global Pharma Innovator with Competitive Advantage in Oncology," Daiichi Sankyo is primarily focused on providing novel therapies ... disorders. **Summary:** The Associate Director, Oncology Value & Market Dynamics Training Manager is responsible for developing & deploying a strategic training plan… more
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