• Medicare Advantage Network Performance…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …us transform healthcare? Bring your true colors to blue. What We Need The Medicare Advantage Network Performance Manager, as a member of a cross-functional team, ... + Conduct competitive intelligence research to inform the strategic direction of the Medicare Advantage Network Performance work. *This document is not an… more
    Blue Cross Blue Shield of Massachusetts (03/15/24)
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  • Medicare MAP Advisor

    Centers Plan for Healthy Living (Staten Island, NY)
    Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #266 Monday, April 1, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and...events. + Requires the ability to carry marketing table, materials , give-away items and boxes. + Requires a proactive… more
    Centers Plan for Healthy Living (04/02/24)
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  • Customer Solution Center Member Navigator…

    LA Care Health Plan (Los Angeles, CA)
    …at other Community Resources Center locations as needed. Duties Coordinate multi-departmental ( Member Services, PNO, Claims, UM, Sales, Medicare enrollment and ... to follow through on all cases forwarded to other areas for assistance; C. Document all transportation services provided to each member . Ensure to confirm… more
    LA Care Health Plan (03/27/24)
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  • Licensed Benefits Advisor (Field Based)

    Centers Plan for Healthy Living (Bronx, NY)
    …need for healthy living. JOB SUMMARY : The Licensed Benefits Advisor- Medicare Sales, maintains relationships, services our existing customers and secures new ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and...events. + Requires the ability to carry marketing table, materials , give-away items and boxes. + Requires a proactive… more
    Centers Plan for Healthy Living (04/02/24)
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  • Product Solutions Manager II

    LA Care Health Plan (Los Angeles, CA)
    …teams including assistance with benefit trainings, explanation of benefit design, member materials development and distribution, sales and marketing collateral, ... Solutions Manager II Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position Type: Full… more
    LA Care Health Plan (04/18/24)
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  • Director of the UCCS Aging Center

    University of Colorado (Colorado Springs, CO)
    …offer some of the best benefits of the industry while encouraging every team member to grow, collaborate, and provide input on how to consistently make the workplace ... referral of cases to clinical students, staff, and contractors + Provides Medicare services + Plans, coordinates, and provides clinical training during orientation… more
    University of Colorado (03/02/24)
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  • Prior Authorization and Payer Reimbursement…

    University of Colorado (Aurora, CO)
    …reports to professional, State and Federal requirements; including but not limited to Medicaid, Medicare , case logs, and drug logs as required. + Follow up on denied ... reports to professional, State and Federal requirements; including but not limited to Medicaid, Medicare , case logs, and drug logs as required. + Follow up on denied… more
    University of Colorado (04/12/24)
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  • Customer Solution Center Even MORE Service Liaison…

    LA Care Health Plan (Los Angeles, CA)
    …(call, web, email) consistently and accurately. The Liaison will proactively identify, document , investigate, and resolve member issues in a timely and ... for Health Risk Assessments for CalMediConnect members and SPD members. Facilitate member choice assignment and fulfillment of materials in the appropriate… more
    LA Care Health Plan (04/19/24)
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  • Clinical Pharmacy Specialist - Drug Information

    Lancaster General Health (Lancaster, PA)
    …supporting the Pharmacy and Therapeutics Committee structure by preparing materials (monographs, annual reviews, medication use evaluations, agenda/minute prep, etc) ... therapy evaluations as requested. Active participation in Care Management Teams. + Document drug use patterns, detect and evaluate adverse drug effects, evaluate… more
    Lancaster General Health (04/25/24)
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  • Utilization Management Nurse Specialist RN II

    LA Care Health Plan (Los Angeles, CA)
    …status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for ... concurrent review, and collaborates with on site staff, physicians, providers, member /family interaction to develop and implement a successful discharge plan. Works… more
    LA Care Health Plan (04/09/24)
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  • Food Service Supervisor I (Temporary/9 months)…

    State of Colorado (Golden, CO)
    …rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the ... responsibility for the security and control of equipment, tools, materials , and other resources. Positions are actively involved in...pat searches are conducted by a same sex staff member , except in the case where a juvenile identifies… more
    State of Colorado (04/17/24)
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  • Sales Support Specialist - Marketing - Paramount…

    ProMedica Health System (Toledo, OH)
    …group contracts. * Prepare new hire packets, renewal packages, and other marketing materials as necessary. 3. Document Management * Complete lifecycle management ... 685 employees dedicated to serving their health plan members. Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families.… more
    ProMedica Health System (04/24/24)
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  • Health Plan Enrollment Specialist

    Apex Health Solutions (Houston, TX)
    …in managed care or healthcare customer service, eligibility, finance, or member services; commercial and Medicare experience preferred Knowledgeable of ... with external entities to resolve any questions. Processes updates to member eligibility and demographics per information from brokers, employer human resources… more
    Apex Health Solutions (02/25/24)
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  • Medical/Health Care Program Analyst

    MyFlorida (Tallahassee, FL)
    …families across the state, AHCA invites you to apply to become an essential member of our team. As one of Florida's leading state agencies, AHCA's diverse workforce ... encounter submissions, and provider enrollment. - Remain informed about Medicare policies, national Medicaid-related research and demonstration projects, Medicaid… more
    MyFlorida (04/26/24)
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  • Engineering Aide (Electric)

    Silicon Valley Power (Santa Clara, CA)
    …hardware and software, including word processing, spreadsheet, and database programs * Document control, retrieval, and filing systems Ability to: * Prepare neat and ... Select and use appropriate drafting, and duplicating equipment and materials * Read, interpret and apply engineering terminology and...formula - employee pays 7.00% of gross pay + Medicare and Social Security (FICA) + Employee pays 6.20%… more
    Silicon Valley Power (02/22/24)
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  • Customer Solution Center Appeal and Grievance…

    LA Care Health Plan (Los Angeles, CA)
    …processing timeliness and accuracy of loading members, timeliness of ID Card and member materials , outbound health risk assessment (HRA) calls for Seniors and ... This position will complete targeted, focused and random audits related to member interactions and outcomes to ensure all elements are compliant. These results… more
    LA Care Health Plan (02/20/24)
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  • Pharmacy Benefit Specialist II

    CareOregon (Portland, OR)
    …staff about the CareOregon formularies and pharmacy benefit policies. + Document all customer service activities according to organization requirements. + Follow ... unit protocols. + Perform data entry into the claims processing system, document management systems, databases and spreadsheets as assigned. + Clerical Assistance… more
    CareOregon (03/21/24)
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  • Health Care Nurse Surveyor

    Commonwealth of Pennsylvania (PA)
    …care field. You may be assigned to function independently, with a partner, as a member of a team, or as the designated team coordinator during on site surveys. This ... training and Test (SMQT) provided by the Centers for Medicare and Medicaid Services or an equivalent certifying body...the posting closing date. Late applications and other required materials will not be accepted. + Failure to comply… more
    Commonwealth of Pennsylvania (04/27/24)
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  • Advanced Practice Provider - Nurse Practitioner…

    University of Colorado (Aurora, CO)
    …in order to obtain full prescriptive authority and DEA registration. + Medicare /Medicaid credentials. + Unrestricted DEA license and current CPR license. + National ... on patient care and administrative issues. + Able to document history, physical examinations, assessments and treatment plans for...office problems. + Ability to participate effectively as a member of a team. + Ability to simultaneously perform… more
    University of Colorado (04/18/24)
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  • Advanced Practice Provider - Nurse Practitioner…

    University of Colorado (Aurora, CO)
    …in order to obtain full prescriptive authority and DEA registration. + Medicare /Medicaid credentials. + Unrestricted DEA license and current CPR license. + National ... on patient care and administrative issues. + Able to document history, physical examinations, assessments and treatment plans for...office problems. + Ability to participate effectively as a member of a team. + Ability to simultaneously perform… more
    University of Colorado (04/17/24)
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