- Highmark Health (Charleston, WV)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Humana (New York, NY)
- …priority strategy projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Consultant , you will deconstruct issues and ... need it. These efforts are leading to a better quality of life for people with Medicare ,...better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CVS Health (Trenton, NJ)
- …Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage withPrescription Drug ... is a Scrum Team role that will be a member of the Medicare / Medicaid Enrollment Configuration team tasked with developing purposebuilt capabilities for our… 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** ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… 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 ... State and Federal laws, regulations, policies and practices for the administration of Medicare Advantage , Prescription Drug Plan, and compliance programs in a… more
- HCA Healthcare (Brentwood, TN)
- …projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models (AAPM); Medicare Advantage ; and commercial payer value programs. This ... projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models; Medicare Advantage ; commercial pay for performance programs, Meaningful… 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 ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- ChenMed (Miami, FL)
- …departments across the organization and will make data-driven strategy recommendations in the Medicare Advantage and health care industry. With the right mix of ... PowerBI and/or SSRS; statistical modeling. + Experience in health care models including Medicare Advantage Programs and provider risk models preferred. + Prior… more
- Medical Mutual of Ohio (OH)
- …offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans ... in the development and testing of major system modifications. Acts as a consultant to other departments (ie: Training, Benefit Services, etc.) regarding the impact… more
- Scripps Health (San Diego, CA)
- …targets through contract negotiations with Commercial HMO/PPO payers, California Medi-Cal, Medicare Advantage Plans, County Medical Services, TriCare, and other ... partners. Will lead a cross functional teams that have substantial impact on quality , revenue and growth across all Scripps Health business units. The Vice President… more
- ChenMed (Chicago, IL)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Louisville, KY)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... demonstrates 1) success in developing providers to deliver high quality , cost-effective care; 2) effective dyad partnership with the...Act as a health coach, rather than just a consultant for sickness, by helping patients set short and… more
- ChenMed (Columbus, OH)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Columbia, SC)
- …physicians are true hands-on caregivers transforming the health and lives of seniors on Medicare Advantage . Through our Value Based Care approach, you and your ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Gretna, LA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- ChenMed (Richmond, VA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- The Mount Sinai Health System (NJ)
- …Develop standards of care in accordance with The Valley Medical Group's Quality Assurance/ Quality Improvement process **REPORTS TO** **: Chair, Primary ... immunize patients from communicable diseases. 10. Refers patients to specialist for consultant services when necessary for the patient's well being. 11. Physician… more
- ChenMed (Detroit, MI)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- ChenMed (Fort Myers, FL)
- …when leading their care teams towards their performance goals. "IntuneHealth is for Medicare Advantage seniors seeking PCP-led, high- quality care when and ... serves as a health coach, rather than just a consultant for sickness, by helping patients set short and...to ensure compliance with guidelines. Participates in risk and quality management programs, clinical meetings and other meetings that… more
- ChenMed (Savannah, GA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... **Coaching for health** : Act as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more