- Molina Healthcare (Nampa, 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
- Humana (Boise, ID)
- …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
- CVS Health (Boise, ID)
- …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
- 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
- CenterWell (Boise, ID)
- …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 (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)
- …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
- Molina Healthcare (Nampa, ID)
- …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