- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. As a key member of our Medicare Advantage Operations team, you will partner with business and technical teams as ... of 5 years' experience with CMS processes in a Medicare or Managed Care environment required + Project... Medicare or Managed Care environment required + Project Management Professional certification is a plus + Experience… more
- CVS Health (Frankfort, KY)
- …management, including implementation, in a highly matrixed environment + 2+ years Medicare industry experience, specifically Medicare Advantage product ... team that will be responsible for CMS Bid Submission, implementation, and ongoing operations of special supplemental benefits. This role will maintain a focus on… 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 ... across all lines of business including Commercial fully-insured, self-insured, and Medicare Advantage products. The position will regularly interface with… more
- The Cigna Group (Westerville, OH)
- This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region ... Provider Performance Enablement teams, Provider Education, and the Risk Adjustment Operations teams. The Prospective Program Solutions & Performance Advisor works… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …with Marketing, Market Research, Sales, Operations , and Compliance + Oversee Medicare Market project management resources and ensure management of all ... bid process, Blue-to-Blue conversion (age-in) initiatives. Product portfolio includes: Direct Pay Medicare ( Medicare Advantage Prescription Drug Plan, … more
- Humana (Columbus, OH)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid requirements, and will ... **Preferred Qualifications:** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Columbus, OH)
- …directly to the Regional Vice President of Operations in support of the Medicare Advantage line of business. The Market Finance Lead supports all Market ... financial, cost & utilization reporting at all levels + Supports Humana's Medicare Advantage product strategy, budgets, and administrative staffing and expenses… more
- CVS Health (Trenton, NJ)
- …Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage withPrescription Drug ... the team to deliver purpose built configuration for the Medicare Enrollment Operations Team on the NextGeneration...SRs and actively participates as a member of each project team supporting an application orset of applications.* Independently… more
- Nucleusteq (AZ)
- …warehouse structures as well as owning data inflows and outflows that support the Medicare Advantage Risk Adjustment teams and efforts. * Design & Development, ... applications consistent with the established specifications and business requirements for the Medicare Advantage Risk Adjustment teams to deliver business value;… more
- Trinity Health (Canal Winchester, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive ... and addresses opportunities and barriers as they arise. 11. Provides regular project status updates to customers and leadership especially when there are delays… more
- Humana (Columbus, OH)
- …of the Intermountain Region Finance department. This position will support the annual Medicare Advantage bid process, membership reporting and analytics, as well ... as internal data management and Network Operations . The Senior Market Finance Professional works with Actuary,...Region Finance department. This position will support the annual Medicare Advantage bid process, membership reporting and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. The Clinical ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
- American Institutes for Research (MA)
- …new business with CMS, AHRQ, or other HHS agencies. + Extensive knowledge of Medicare payment policy, Medicare Advantage , and/or Medicaid. + Knowledge of ... agencies, including but not limited to the Centers for Medicare and Medicaid Services (CMS). Candidates hired for the...legal compliance to its full integration in our strategy, operations , and work environment. At AIR, we define diversity… 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** ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Network Operations , IT, Medical Management, Benefits Administration and Medicare Advantage . Providers, provider representatives, vendors and consultants to ... + Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage staff to support internal strategies and external… more
- Trinity Health (Columbus, OH)
- …**Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... health insurance industry specific to sales and marketing roles (related to Medicare Advantage or another government-related insurance line) + Experience… more
- Medical Mutual of Ohio (Dublin, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Our plans… more
- VIP Care (Tampa, FL)
- …medical management and performance improvement strategies to ensure success in our existing ( Medicare Advantage ) as well as net new LOBs. They will also ... + Experience in Utilization Management and Physician Improvement Programs + Experience in Medicare Advantage + Experience in Value-Based model of care +… more
- Medical Mutual of Ohio (Columbus, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Our plans… more