- Cambia Health Solutions, Inc (Renton, WA)
- MEDICARE SALES BROKER MANAGER (HEALTHCARE)Telecommute Option - Must reside WESTERN WASHINGTONWHO WE NEEDAre you a sales leader with a passion for driving growth and ... and achieving membership goals? We're searching for a talented Medicare Sales Broker Manager to join our team!As a... Sales Broker Manager to join our team!As a Medicare Sales Broker Manager, you'll lead appointed producers to… more
- Cambia Health Solutions, Inc (Portland, OR)
- …projects may be assigned as needed.We are seeking an individual with Medicare compliance experience to assist in prevention, detection, and remediation activities. ... Experience in risk adjustment compliance ( Medicare and ACA) as well as a coding certification...related experience, with experience in a health care or Medicare -regulated environment preferred.Compliance Specialist III would have at least… more
- Cambia Health Solutions, Inc (Renton, WA)
- Provider Performance Director, Medicare Advantage (HEALTHCARE)Telecommute or Tele-Flex Options (Depending on location) - Must reside in ID, OR, UT or WAWHO WE ... performance improvements in critical objectives such as population health management, Medicare Stars, and Risk Adjustment.Here are some of the exciting… more
- U of C NORC (Bethesda, MD)
- …surveys, interviews, focus groups, and site visits; secondary data such as Medicare anRESPONSIBILITIES:Play a lead role in growing NORC's portfolio in the area ... at least 5 years of policy project managementExpert knowledge of Traditional Medicare , Medicare Parts C & D, and Medicaid policy including ongoing value-based… more
- Accounting Now (Tampa, FL)
- Medicare Appeals Specialist Do you like challenging payers? Enjoy that feeling of satisfaction when your appeal is overturned? Then, this position may is right for ... you! The ideal candidate will be well versed in the Medicare managed care appeals and grievance process. Must have strong knowledge of Medicare payer guidelines… more
- Novo Nordisk Inc. (Valdosta, GA)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... Requirements, Step Therapy, Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to… more
- Merck & Co. (New Orleans, LA)
- …Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more. Qualifications: Minimum Requirements: Bachelor's ... degree with at least 6 years of sales experience OR a minimum of high school diploma with at least 10 years of equivalent experience.Equivalent experience can be professional sales experience, work experience in the healthcare/scientific field (including… more
- Lundbeck (Rockford, IL)
- …to promoted portfolio using Lundbeck resources. Utilize deep understanding of Medicare payer landscape in addition to other payer channels including Medicaid ... and Commercial. Pharmaceutical Environment/Compliance - Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of… more
- Merck & Co. (North Wales, PA)
- …agency partners and focus on customer segments (eg health plans, Medicare , Medicaid, federal, pharmacy, hospital, Group Purchasing Organization s, etc.). Primary ... Responsibilities: Work closely with our Company's internal functions (promotions, communications, medical affairs, brand marketing, etc.) and external agency partners to develop customer specific strategies and execute as appropriate to achieve access for… more
- Lundbeck (Las Vegas, NV)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - ... Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.REQUIRED EDUCATION,… more
- Lundbeck (Queens, NY)
- …internal and external partners and effectively addresses payer access issues ( Medicare , Medicaid, Commercial) using Lundbeck resources. Local Market & Therapeutic ... Area Expertise - Gather and validate key trends and dynamics in the market, map account linkages, and apply comprehensive therapeutic knowledge to uncover and prioritize unique opportunities. Demonstrates a clear and detailed understanding of the disease state… more
- Daiichi Sankyo, Inc. (Basking Ridge, NJ)
- …association, think tank, or pharmaceutical company required- Expertise in Medicare , Medicaid, 340B, and/or commercial insurance market required- Strong knowledge ... of federal legislative and rulemaking processes; experience researching and analyzing complex public policy issues required- Expertise in oncology and physician-administered medicines preferred Travel Ability to travel up to 20% Travel for business meetings as… more
- Merck & Co. (North Wales, PA)
- …promotional initiatives for US Payer & PBM (Health Plan, PBM, Medicaid, Medicare , Federal, Employer) to achieve market access goals.Proactively enable the US Payer ... strategy and tactics with members of the Integrated Account Management (IAM) organization, including customer-facing account executives and account directors.Leverage data and insights to analyze reimbursement and coverage trends across prioritized customers,… more
- Insmed Incorporated (Bridgewater, NJ)
- …compliance requirements, including the ACA, ERISA, COBRA, FMLA, ADA, Section 125, Medicare , and Social Security and DOL requirements. Experience in the day-to-day ... operation of US Health & Welfare plans Experience managing US leaves of absence, California specific experience a plusEffective planning and priority setting and project management experienceAble to work at a detailed level to complete or review analysis and… more
- U of C NORC (Mesa, AZ)
- …a formal Salary Review Committee (SRC). Other Important Details to Note The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a ... nationally representative sample of the Medicare population, conducted by the Office of Enterprise Data...Enterprise Data and Analytics (OEDA) of the Centers for Medicare & Medicaid Services (CMS).This is an SCA project,… more
- Cambia Health Solutions, Inc (Portland, OR)
- …WAWHO WE NEEDThe Product Implementation Manager (I or II) ensures that new Medicare Advantage products and product enhancements are implemented and delivered to the ... market timely, in compliance with Centers of Medicare and Medicaid Services (CMS) and First Tier, Downstream, and Related Entities (FDRs) requirements. This role… more
- Creative Financial Staffing (Huntington, IN)
- …are seeking a detail-oriented and experienced Billing Specialist with extensive knowledge of Medicare and Medicaid billing procedures to join our team. As a Billing ... Responsibilities of the Medical Billing Specialist: Prepare and submit claims to Medicare and Medicaid in compliance with their billing guidelines and regulations.… more
- Fidelity TalentSource LLC (Westlake, TX)
- …of the Carrier Management Team as we look to help millions of Americans make Medicare decisions. You will support our team as we look to expand our business ... and problem-solving skills Experience in the healthcare industry or Medicare is preferred, but not required Skills Superb communication...enables our sales team to be able to offer Medicare coverage solutions to our customers. We do this… more
- Accounting Now (Pinellas Park, FL)
- …documenting related account activities, posting adjustments and collections of Medicare , Medicaid, Medicaid Managed Care, and commercial insurance payers. The ... collection specialist must possess critical thinking skills and understanding of Medicare , Medicaid eligibility requirements as well as commercial insurance payer… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …and Unique Knowledge, Skills and AbilitiesExperienced enrolling providers in the Medicare and Medicaid programsStrong written and verbal communication skills and the ... Essential Tasks and ResponsibilitiesOn an on-going basis prepares and submits Medicare and Medicaid provider enrollment and revalidation applications for NGPG… more
