- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (KY)
- …compassionate. And we do it all with heart, each and every day. As the Senior Manager , Aetna Medical Pharmacy, you will be accountable for leading the ... and organizational compliance with regulations related to the organization's Medicare Part B program operations. + Triage...related to the organization's Medicare Part B program operations. + Triage escalation requests to the correct… more
- Molina Healthcare (Louisville, KY)
- …**Job Summary** Establish a specifically designed Operational Regulatory Oversight program that effectively prevents and/or detects violation of applicable laws ... provisions, and internal policies and procedures. * Supports the Operational Oversight Manager , Director, and team in the general development of the Operational… more
- Humana (Louisville, KY)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and… more
- Humana (Frankfort, KY)
- …are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager , Medicare Sales, must...+ This role is part of Humana's Driver safety program and therefore requires an individual to have a… more
- Elevance Health (Louisville, KY)
- …Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- CVS Health (KY)
- …and every day. **Position Summary** We are seeking a highly skilled and experienced Senior Data Engineering Manager to lead and mentor our data engineering team ... team that is responsible for processing Claims, Revenue, and Medicare Specific files and data from 30+ payors into...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Humana (Louisville, KY)
- … senior leadership to develop functional strategies that broadly impact the Medicare Stars program . This role will also develop partnerships with analytics ... first** Humana seeks a strategic and results-driven Lead Product Manager to oversee the end-to-end lifecycle of the Patient...leadership to develop functional strategies that broadly impact the Medicare Stars program . This role will also… more
- CenterWell (Frankfort, KY)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- CenterWell (Frankfort, KY)
- …appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a ... services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. +… more
- Humana (Frankfort, KY)
- …Experience Platform (AEP) and Next Best Action (NBA) execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our… more
- CenterWell (Lexington, KY)
- …caring community and help us put health first** Join a Team That's Redefining Senior Primary Care: Humana's Primary Care Organization is one of the largest and ... fastest-growing senior -focused, value-based care providers in the country. With over...daily huddles. + Helps Regional Medical Director and Clinic Manager in setting a tone of cooperation in practice… more
- CenterWell (Frankfort, KY)
- …responsible for the medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary Care's) Home-Based ... Care portfolio, serving the highest-need and most complex senior patients. This role will lead clinical strategy, quality improvement, and care delivery innovation… more
- CenterWell (Frankfort, KY)
- …(ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + Member of the American Academy of Actuaries + ... Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and… more
- CenterWell (Lexington, KY)
- …in field sales or grassroots marketing; ideally field sales with a focus on senior value-based care models or Medicare Advantage. + In-depth knowledge of ... of industry trends, competitor activities, and emerging opportunities within the senior healthcare market adjusting sales strategies and identify new growth avenues.… more
- Waystar (Louisville, KY)
- …well. **WHAT YOU'LL DO** + Proposes technical solutions to the Manager , Application Engineering + Designs/develops/tests/implements improvements or new features into ... solution meets the business requirements + Communicates the development progress daily to senior -level team members + Attends to any work items assigned through the… more
- CenterWell (Mayfield, KY)
- …+ Primarily conduct facility visits at the physicians' request to assist program clinical team in determining eligibility. + Ensure effective communication and ... collaboration with program staff and other field sales resources via weekly...license. + Must have strong knowledge of governmental regulations, Medicare eligibility requirements, comprehensive understanding of potential care plan… more
- Molina Healthcare (KY)
- …skills. * Microsoft Office suite (including Excel), and applicable software program (s) proficiency. **Preferred Qualifications** * Medicare Part D and/or ... care team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...pharmacy call center team under the direction of pharmacy senior leadership. * Identifies and implements programs to improve… more
- CenterWell (Lexington, KY)
- …equivalent + Completion of Certified Nursing Assistant or Certified Home Health Aide Program within the last 24 months + Must meet applicable state certification ... and have completed HHA/CNA course to work for a Medicare certified agency. + At least one year experience...paid time off, 401(k) retirement savings plan, employee assistance program , business travel and accident. **About Us** About CenterWell… more
- CenterWell (Frankfort, KY)
- …the delivery of home health services preferred + Working knowledge of Medicare enrollment and guidelines governing home health agencies preferred + Demonstrate ... eligible dependents + Caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more