- Alternate Solutions Health Network LLC (Columbus, OH)
- …for our patients like they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and ... Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers. Based on this regulation,...the order sets and goals created by the Case Manager . Interacting with patients' families while caring for your… more
- LA Care Health Plan (Los Angeles, CA)
- Product Solutions Manager III ( Medicare ) Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... safety net required to achieve that purpose. Job Summary The Product Solutions Manager III is responsible for assisting the product leadership team within the… more
- LA Care Health Plan (Los Angeles, CA)
- Product Solutions Manager II ( Medicare ) Job Category: Administrative, HR, Business Professionals Department: Medicare Product Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product...strategic partnerships inclusive of entry onto the Covered CA market . Medicare : Required Medicare Advantage,… more
- CVS Health (Hartford, CT)
- …to fill - one in Arizona and the other in New England** The Medicare Sales Manager will manage sales, retention, relationships and recruitment efforts for ... product portfolios to increase sales and maximize revenue. Required Qualifications ** Medicare experience is required** Licensed Health license is required. * 1… more
- Healthfirst (NY)
- …improvement opportunity and to make informed business decisions. + Leverage market and competitive intelligence reporting that summarizes and provides updates on ... the competitive landscape to help identify new opportunities based on market trends and changing regulations. + Identify key member cohorts and opportunities for… more
- Centene Corporation (New York, NY)
- …field or equivalent experience. 4+ years of experience in Sales, Healthcare, Medicare , CMS Regulations and/or Management. Experience in working with or managing ... brokers/agents along with territory management experience is preferred. + Develops market -specific sales plans to maximize enrollment growth. + Develops, nurtures… more
- CareFirst (Baltimore, MD)
- …(strategy, design, execution, and optimization) for products and plans in the Medicare , Medicaid, and Federal Employee Health Benefits categories. Leads the team in ... performance, forecast sales and membership in line with growth objectives, in the Medicare Advantage Bid process annually, the cost and utilization of all benefits… more
- CVS Health (Hartford, CT)
- …with Informatics, Part D Product SMEs, Part C Product SMEs, and supports Medicare local markets . Participates and manages CMS Rx bid process from ... for software coding. Required Qualifications Must have in-depth knowledge of Medicare regulatory environment. Well versed in pharmacy benefits and PBM functions… more
- CVS Health (Santa Ana, CA)
- …business. CVS Health/Aetna is working to transform the way California Medicare beneficiaries experience health care - improving quality, emphasizing whole-person ... driving down costs. Aetna is hiring a local Broker Manager to support the growth of our industry leading... to support the growth of our industry leading Medicare business. This is a highly collaborative role in… more
- CVS Health (Lansing, MI)
- …convenient and affordable. Position Summary CVS Health/Aetna is hiring a Broker Manager to support our growing Sales Organization. CVS Health/Aetna is working to ... driving down costs. Aetna is hiring a local Broker Manager to support the growth of our industry leading... to support the growth of our industry leading Medicare business. This is a highly collaborative role that… more
- The Cigna Group (Bloomington, MN)
- …or 5-8 years of relevant experience preferred. + Experience working within regulated markets , including Medicare and Exchange. + Strong PC skills including ... **POSITION SUMMARY:** The Account Management Lead Associate (Account Manager ) will provide support to the Account team...benefit set-up and project support as requested within the Medicare and/or Exchange lines of business. The primary focus… more
- The Cigna Group (Bloomfield, CT)
- …organized and outstanding learning and performance professional for the role of ** Medicare Sales Effectiveness Training Manager ** . This role is responsible ... team is driving growth in our national and local markets . Our environment is fast paced, the work is...business areas in sales and across the enterprise. The ** Medicare Sales Effectiveness Training Manager ** will model… more
- The Cigna Group (Phoenix, AZ)
- …about the role:** **SUMMARY:** Responsible for the execution of the Cigna Medicare strategy for local topline sales agencies, directly contracted agents, and broker ... down-line sales within their market for the book of business they manage through...out appropriate sales activity standards as directed by their manager + Responsible for reporting their daily activities to… more
- EssilorLuxottica (Mason, OH)
- …Tribal Law. **Nearest Major Market :** Cincinnati **Job Segment:** Operations Manager , Medicaid, Medicare , Manager , Operations, Healthcare, Management ... Manager - Operations (Business Configuration Quality) Date: May...Claims, Provider, Network, Product Benefit Configuration + Knowledge of Medicare and Medicaid programs Employee pay is determined by… more
- HCA Healthcare (Dallas, TX)
- …to be a part of our team. **Job Summary and Qualifications** As Reimbursement Manager you will complete Medicare and Medicaid cost reports to obtain appropriate ... Do you want to join an organization that invests in you as a Reimbursement Manager ? At Medical City Healthcare, you come first. HCA Healthcare has committed up to… more
- The Cigna Group (Birmingham, AL)
- **_LOCATION: Hybrid/Remote position aligned to the Tri-South Alabama/Mississippi Market . Must live in either Alabama or Mississippi._** The ** Manager , Provider ... management activities for a local given territory within the Tri South market . **DUTIES AND** **RESPONSIBILITIES** + Manages contracting and negotiations for fee for… more
- The Cigna Group (Franklin, TN)
- **LOCATION: Supports the Franklin, TN market and will work in the Franklin, TN office several days per week** ** Medicare Advantage position** The **Provider ... of the Provider Contracting Team and reports to the Provider Contracting Senior Manager . This role assists in developing the strategic direction and management of… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement Senior- Medicare Cost Report Audit** **_Location: This is a virtual position, the ideal candidate will live within 50 miles of one of our ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement III - Medicare Cost Report Audit** **Locations:** This is a virtual position; the ideal candidate will live within 50 miles of an Elevance ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- University of Rochester (Rochester, NY)
- …and/or trends that require management intervention; share with Supervisor and or Manager . Assist Supervisor with Medicare and Medicaid credit balance audits, ... Excel, Access, Email, Emdeon (Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems...refund of credits + Review and advise supervisor or manager on trends of incorrectly paid claims from specific… more
