- Highmark Health (Buffalo, NY)
- …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
- Health Care Service Corporation (Tulsa, OK)
- …invest in your professional development. **Job Summary** The Medicare Advantage Bid Optimization Principal Divisional Strategy Consultant will support MA ... This position is responsible for assisting with leading the team with all Medicare Advantage short-term and multi-year planning, assisting the leadership team on… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00 ... Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location:...Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer… more
- Health Care Service Corporation (Chicago, IL)
- …**Preferred Job Qualifications:** + Health insurance or healthcare industry experience supporting Medicare Advantage + Knowledge of Medicare Advantage ... the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network… more
- Cassia (Edina, MN)
- …for Medicaid, Medicare A&B, Hospice, MSHO products, LTC insurance, coinsurance, Medicare Advantage & various other insurance payers. + Complete proper ... Cassia, a nonprofit, senior living organization, is hiring an Accounts Receivable Consultant to join our growing team! Based at our Edina, MN home office, you will… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment. * Certified Risk Adjustment Coder (CRC) ... The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll...certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines… more
- Humana (Sacramento, CA)
- …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- ChenMed (Miami, FL)
- …with ability to handle rejection and maintain motivation + Familiarity with Medicare Advantage basics, and senior-focused service delivery + Knowledge of ... need great people to join our team. The Growth Consultant (Virtual) is a healthcare sales adviser responsible for...seniors a plus, as is a general understanding of Medicare Advantage + Relevant experience establishing and… more
- CenterWell (Phoenix, AZ)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- CenterWell (Atlanta, GA)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- Deloitte (Chicago, IL)
- Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk and ... for this role ends on Feb 28, 2026 Work you'll do As a Senior Consultant in our Regulatory, Risk, & Forensic Healthcare Practice, you will have the opportunity to… more
- Brockton Hospital (Brockton, MA)
- Signature Healthcare is Southeastern Massachusetts' premier local provider of quality , personalized medical services. We are comprised of the award-winning ... should be: medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference in the… more
- Trinity Health (Boise, ID)
- …improvement role preferred. + Knowledge of NCQA and HEDIS standards and Medicare Advantage Star ratings gained through experience strongly desired. + ... as a key member of the Saint Alphonsus Health Alliance (Alliance) Quality and Performance Improvement team. This position works collaboratively with internal (ie… more
- ChenMed (Tampa, FL)
- …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
- Commonwealth of Pennsylvania (PA)
- …25, 2025 TO OCTOBER 8, 2025, YOU CANNOT SUBMIT A NEW APPLICATION. Take advantage of your experience in nursing as a professional representative of the Department of ... of nursing homes in Pennsylvania, you will evaluate the quality of services provided and determine the eligibility for...training and Test (SMQT) provided by the Centers for Medicare and Medicaid Services or an equivalent certifying body… 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
- ChenMed (Miami, FL)
- …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 (Houston, TX)
- …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 (Miami Gardens, FL)
- …Experience in handling large data sets and relational databases + Experience in Medicare Advantage data analytics and strategy planning preferred + Experience in ... projects and are responsible for all aspects of data sourcing, migration, quality , design, and implementation. This position aligns and oversees the management,… more
- Provider Solutions & Development (Walla Walla, WA)
- …southeast Washington. A Level III trauma center, Providence St. Mary has a five-star quality rating from the Centers for Medicare and Medicaid Services. With its ... a large research network, and opportunities for investigator-initiated trials. Take advantage of all these professional growth opportunities while enjoying life in… more