- Highmark Health (Charleston, WV)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Humana (Campbell, CA)
- …priority strategy projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Consultant , you will deconstruct issues and ... need it. These efforts are leading to a better quality of life for people with Medicare ,...better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CVS Health (Trenton, NJ)
- …Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage withPrescription Drug ... is a Scrum Team role that will be a member of the Medicare / Medicaid Enrollment Configuration team tasked with developing purposebuilt capabilities for our… more
- Elevance Health (West Des Moines, IA)
- … Sr.** for **Provider Success** is responsible for consulting with providers ( Medicare Advantage and Medicaid) to assess and deploy appropriate interventions ... Care Consultant Sr. (Provider Success) - JR119118 **Location** :...action plans around population health management, patient satisfaction and quality and cost performance. + Facilitation of collaborative meetings… more
- Northern Light Health (Brewer, ME)
- …and measurements. Additionally, this position will be responsible for all NLH Medicare Advantage or Managed Medicaid and Exchange products. This responsibility ... department and all Northern Light Health Organizations. The Contract Consultant serves as an analytical and process improvement leader....that we all work as a team and the quality and timeliness of work impacts everyone involved. +… more
- CVS Health (Columbus, OH)
- …CPC AAPC or CCA AHIMA certification- 3+ years risk adjustment experience in Medicare advantage or commercial- 3+ years of provider education experience- ... clinical documentation skills to support efforts to improve the overall quality and completeness of clinical documentation in outpatient physician practices.… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Universal Health Services (Reno, NV)
- …in 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage , Accountable Care Organizations, and commercial ... State and Federal laws, regulations, policies and practices for the administration of Medicare Advantage , Prescription Drug Plan, and compliance programs in a… more
- ChenMed (Miami, FL)
- …departments across the organization and will make data-driven strategy recommendations in the Medicare Advantage and health care industry. With the right mix of ... PowerBI and/or SSRS; statistical modeling. + Experience in health care models including Medicare Advantage Programs and provider risk models preferred. + Prior… more
- Medical Mutual of Ohio (OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans ... in the development and testing of major system modifications. Acts as a consultant to other departments (ie: Training, Benefit Services, etc.) regarding the impact… more
- Scripps Health (San Diego, CA)
- …targets through contract negotiations with Commercial HMO/PPO payers, California Medi-Cal, Medicare Advantage Plans, County Medical Services, TriCare, and other ... partners. Will lead a cross functional teams that have substantial impact on quality , revenue and growth across all Scripps Health business units. The Vice President… more
- Commonwealth Care Alliance (Boston, MA)
- …& Abilities Required:** + **Market Prominence** Knowledge of MHK's Market Prominence Medicare Advantage Member Management Platform + **Agile Product Owner** ... Product Owner will review documentation and provide feedback on quality and accuracy related to the product portfolio and...the overall business strategy. The product owner is business consultant and a representative of business interests to IT… more
- ChenMed (Chicago, IL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Delray Beach, FL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Louisville, KY)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... demonstrates 1) success in developing providers to deliver high quality , cost-effective care; 2) effective dyad partnership with the...Act as a health coach, rather than just a consultant for sickness, by helping patients set short and… more
- ChenMed (Columbus, OH)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Detroit, MI)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- The Mount Sinai Health System (NJ)
- …Develop standards of care in accordance with The Valley Medical Group's Quality Assurance/ Quality Improvement process **REPORTS TO** **: Chair, Primary ... immunize patients from communicable diseases. 10. Refers patients to specialist for consultant services when necessary for the patient's well being. 11. Physician… more
- ChenMed (Metairie, LA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Richmond, VA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more