- Sedgwick (Richmond, VA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Medicare Specialist ( Remote ) **PRIMARY PURPOSE** **:** To coordinate, ... analyze and facilitate Medicare Compliance and Medicare Set-Aside (MSA) functions within the assigned team. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** +… more
- Wider Circle (Richmond, VA)
- Wider Circle is looking for a Community Health Engagement Specialist in Richmond, VA, to play a vital role in our groundbreaking program, which connects neighbors ... time and ability to track and report out on hours worked in a remote Physical Demands: To successfully execute their role, Community Health Engagement Associates and… more
- CVS Health (Richmond, VA)
- …help to support various Scorable Action Items (SAI) programs in the Medicare population, including Fraud, Waste, and Abuse (FWA), Formulary Education, Therapeutic ... for: + Performing pharmacy reviews and making evidence-based recommendations regarding Medicare members + Identifying opportunities within the health plan for… more
- Highmark Health (Richmond, VA)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Highmark Health (Richmond, VA)
- …Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but ... Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines. Works closely with team… more
- Merck (Richmond, VA)
- …with a driven, customer-focused and collaborative team. As an Oncology Sales Representative/ Specialist , you will be a key member partnering with customers to address ... Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more. **Qualifications:** **Minimum Requirements:** +… more
- Elevance Health (Richmond, VA)
- **Medical Management Specialist I** _Location:_ While remote , candidate must reside in Virginia and be ideally located within 50 miles of a PulsePoint. The ... **Medical Management Specialist I** is responsible for providing non-clinical support to...Capabilities and Experiences:** + Understanding of managed care or Medicaid/ Medicare strongly preferred. + For URAC accredited areas, the… more