- BlueCross BlueShield of North Carolina (NC)
- **Job Description** We're seeking a Senior Clinical Pharmacist in Medicare Formulary Strategy . In this critical role, you will plan, coordinate and manage ... for both internal and external audiences. + Pursue active membership in professional organizations and seek continual professional development in an effort… more
- UCLA Health (Los Angeles, CA)
- Description We're seeking a strategic Senior Product Manager to lead the design, development, and implementation of our Medicare Advantage products. In this ... role, you'll partner with the Director of Medicare Product Development and Bids to guide the annual...+ Translate regulatory changes and market insights into product strategy . Salary Range: $105,700 - 234,500/annuallyQualifications We're seeking a… more
- Health Care Service Corporation (Chicago, IL)
- …that will invest in your professional development. **Job Summary** The Medicare Senior Business Consultant is responsible for providing internal consulting ... including senior management. This position supports the prioritization of Medicare activities and tracks progress to goals. **Required Job Qualifications:** +… more
- Humana (Orange City, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to… more
- UPMC (Pittsburgh, PA)
- Purpose: Reporting to the CMO of Government Products, the AVP, Medicare Medical Services serves as one of the strategic and tactical leaders who works with providers ... and stakeholders to develop and execute on our population health strategy , clinical and provider operations, and State contract and CMS requirements for the… more
- CVS Health (St. Louis Park, MN)
- …As the ** Senior Manager of Stars** , you will lead the market-wide strategy , performance improvement, and execution of the Medicare Stars quality program for ... Allina Health | Aetna Medicare membership in Minnesota. Your goal is to achieve...of strategic initiatives. + Comfortable presenting to and influencing senior leadership. **Preferred Qualifications** + Health plan experience. +… more
- Health Care Service Corporation (Nashville, TN)
- …be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for driving delivery, contingency ... planning, business results, and strategic planning for Medicare Part D Pharmacy consisting of multiple programs, complex...and initiatives in support of assigned line of business strategy and multi-year plan. Oversees the day-to-day activities of… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Strategy Advancement Professional will support the design, implementation, and ... UM processes, improve clinical outcomes, and enhance member and provider experiences. The Senior Strategy Advancement Professional helps develop and execute… more
- CenterWell (Santa Fe, NM)
- …all projects + Document and circulate project risks, and develop risk mitigation strategy + Set clear expectations on project timelines, scope, etc. + Identify and ... many other opportunities. Application Deadline: 01-22-2026 **About us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive,… more
- Molina Healthcare (Sterling Heights, MI)
- …functional field of knowledge although they may have technical team members. Senior Program Management professional . Responsible for overall governance across ... gaps and barriers in implementation and compliance to AVP, VP and senior management + Consultative role, develops business case methodologies for programs, develops… more
- CenterWell (Phoenix, AZ)
- …part of our caring community and help us put health first** The Senior Provider Engagement Professional develops and grows positive, long-term relationships with ... within the contracted working relationship with the health plan. The Senior Provider Engagement Professional work assignments involve moderately complex… more
- Elevance Health (Independence, OH)
- …Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare...strategy but will also lead to personal and professional growth for our associates. Our values and behaviors… more
- Humana (Washington, DC)
- … and Medicaid's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Manager, you will deconstruct issues ... majority of its earnings. Team members partner with the senior leaders of the business unit, and more broadly...leaders. This role will have a particular focus on Medicare enrollment growth strategy and investment optimization.… more
- Humana (South Bend, IN)
- …Dual Eligibility Special Needs Plan (HIDE SNP) in Michigan is seeking a Senior Consumer Experience Professional who will ensure optimized interaction between ... Humana and our members. The Senior Consumer Experience Professional will work assignments...Care (LTC) ombudsman. + Understands department, segment, and organizational strategy and operating objectives, including their linkages to related… more
- Humana (Carson City, NV)
- …a part of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and ... abusive practices. The Senior Fraud and Waste Professional work assignments...complex investigative and audit reports. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues… more
- Humana (Cheyenne, WY)
- …a part of our caring community and help us put health first** The Senior Configuration Professional work focuses on accessing and configuring an application or ... building modules, developing tables/reports, and creating complex functions. The Senior Configuration Professional work assignments involve moderately complex… more
- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** As a Senior Network Performance Professional at Humana, you will play a pivotal role in ... of results for the department and begins to influence the department's strategy . **Key Responsibilities:** + Provider Collaboration: Work with providers to define… more
- Humana (Raleigh, NC)
- …community and help us put health first** The Senior Technology Solutions Professional devises an effective strategy for executing and delivering on IT ... business initiatives. The Senior Technology Solutions Professional work assignments involve moderately complex to complex issues where the analysis of situations… more
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** The Senior Market Finance Professional collects, analyzes and reports on various market data ... to connect financial outcomes with operational effectiveness. The Senior Market Finance Professional work assignments involve moderately complex to complex… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ... develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately… more