- Molina Healthcare (Meridian, ID)
- **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 (Boise, ID)
- …Duals Center of Excellence, clinical, compliance, analytics and network teams, the Senior Manager drives innovation and operational excellence to optimize member ... lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This… more
- CVS Health (Boise, ID)
- …for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements ... with others to meet/exceed expectations **Preferred Qualifications** + Experience in Medicare Advantage and/or Value Based Contracting + Ability to remain flexible… more
- Travelers Insurance Company (Meridian, ID)
- …of employment. As part of our comprehensive compensation and benefits program , employees are also eligible for performance-based cash incentive awards. **Salary ... Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where Wage… more
- Humana (Boise, ID)
- …a part of our caring community and help us put health first** The Senior Coding Educator will work closely with providers to identify documentation and coding ... in the risk adjustment methodology. This role reports to the Risk Adjustment Manager and will work closely with market operations, finance, and clinical team to… more
- Humana (Boise, ID)
- …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
- CVS Health (Boise, ID)
- …Ensures compliance with contractual requirements. Coordinates and collaborates with program integrity staff, compliance, and senior leadership. Contributes ... A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / ...Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and… more
- CenterWell (Boise, ID)
- …of our caring community and help us put health first** The Program leader, Provider Education builds strategies for development, engagement, best clinical practices ... and processes for clinical community within the enterprise. The Program leader, Provider Education requires a solid understanding of how organization capabilities… more
- CenterWell (Boise, ID)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CVS Health (Boise, ID)
- …the delivery of high quality care to the Medicare population. As a Senior Product Manager , you will be responsible for driving the strategic direction of ... a core part of our platform. Through partnership with senior business and engineering leaders, you will oversee the...experience **Preferred Qualifications** 4+ years operating in a Product Manager role (or similar) MA / MBA in any… more
- CenterWell (Boise, ID)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more