- Dana-Farber Cancer Institute (Brookline, MA)
- …designates medical procedures/services based on relevant regulations and determinations. The Senior Medicare Coverage Analyst applies subject matter expertise to ... any state in the US (except Hawaii).** The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical...which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies… more
- Prime Healthcare (Inglewood, CA)
- …seeking new members to join our corporate team! #LI-JV1 Responsibilities The Senior Medicare -Medicaid Biller/Collector is responsible for both billing and ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228937/ senior - medicare -medicaid-biller-collector/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... not directly reporting to the Division. + Ability to work with and support Senior Management and to disseminate and summarize information into a format that can… more
- The Cigna Group (Bloomfield, CT)
- …team. The leadership and strategic direction you'll provide will better educate our Medicare clients on the products we offer and give their members' access to ... role, you will serve as the primary contact for Medicare strategic initiatives and market development. You will become...You will become a subject matter expert (SME) on Medicare Prescription Drug Coverage, Express Scripts Medicare … more
- Prime Healthcare (Redding, CA)
- …their family. For more information, visit www.shastaregional.com . Responsibilities The Senior Medicare -Medicaid Biller/Collector is responsible for both billing ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare -Medicaid. This includes maintaining the deficiency lists used to obtain… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Humana (Frankfort, KY)
- …to detail and creative thinking **Preferred Qualifications** . Experience marketing Medicare Advantage or senior -focused insurance products . Familiarity with ... is advancing its agent-focused marketing strategy to support growth across its Medicare Advantage and specialty product portfolio. We're seeking a strategic and… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement ... and education programs to support improved Star Ratings. Responsible for Medicare Star projects and programs involving enterprise, department, cross-functional and… more
- Bausch + Lomb (Bridgewater, NJ)
- …prescription portfolio, with a focus on Commercial insurance plans, PBMs, and Medicare . The Senior Manager collaborates cross-functionally to support brand ... leading the advancement of eye health in the future. **Overview** The ** Senior Manager, Payer Marketing** role supports the market access strategic marketing efforts… more
- CVS Health (Hartford, CT)
- …and every day. **Position Summary** This position will work closely with the Medicare Finance Lead Directors to analyze financial results, help to identify variance ... drivers, and aid in the communication of performance to the Chief Medicare Officers. In this role, a qualified candidate will support the Lead Director to gather… more
- Humana (Nashville, TN)
- …BSS, claims operations, and other business teams involved in the administration of Medicare business at Humana. The Senior Business Intelligence Engineer will ... a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer… more
- Humana (Trenton, NJ)
- …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ... mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve,… more
- The Cigna Group (St. Louis, MO)
- **Product Management Senior Advisor - Medicare Solutions, Express Scripts** **Description of Position:** + The Product Management Senior Advisor provides ... will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide… more
- BlueCross BlueShield of North Carolina (NC)
- …of degree, 7+ years of experience in related field **Bonus Points** + Deep Medicare and/or Medicare Advantage regulatory experience + Extensive Medicare / ... Medicare Advantage investigative experience **What You'll Get** + The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community + Work-life balance, flexibility, and the autonomy to do great work +… more
- Insight Global (Woonsocket, RI)
- Job Description Insight Global is seeking a Senior Project Manager to support a large health insurance client of ours. This resource will be responsible for taking ... on a variance of projects including business process improvements along with technical implementations, mainly relating to claims processing. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic… more
- Rhythm Pharmaceuticals (Boston, MA)
- …access and coverage for Rhythm's portfolio across key commercial self-insured employers and Medicare Part D payers. The Senior NAD will develop and maintain ... learn, and our tenacity to overcome barriers, together. Opportunity Overview The Senior National Account Director (NAD) will be a field-based strategic leader… more
- CenterWell (Baton Rouge, LA)
- …Carolina and Texas. CenterWell Senior Primary Care has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and is ... a leading health and wellness destination for communities in key Medicare markets. CenterWell Senior Primary Care's national primary care centers serve more than… more
- Ankura (New York, NY)
- …accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director ... to complex litigation, enforcement, and regulatory challenges. Role Overview The Senior Director will support the Healthcare Payer team within Ankura's Disputes… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Medicare Enrollment Coordinator** **Job Class: Human Services Program Representative 1** **Agency: Human Services Dept** + **Job ID** : 90208 + ... eligible for telework.** This position reports to the TPA Medicare Enrollment Team within the Managed Care Contracting and...requirements and policies as they relate to the Minnesota Senior Health Options (MSHO) or Special Needs BasicCare (SNBC)… more
- The Cigna Group (Bloomfield, CT)
- …position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This actuarial ... a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with...and digestible data driven takeaways to internal and external senior leadership teams preferred If you will be working… more
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