- UCLA Health (Los Angeles, CA)
- …level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM ... coordinators and nurses. You'll work closely with Medicare Advantage leadership to plan, execute, and manage various initiatives related to UM administrative,… more
- UCLA Health (Los Angeles, CA)
- …Senior Product Manager to lead the design, development, and implementation of our Medicare Advantage products. In this role, you'll partner with the Director ... and compliance throughout the member lifecycle. Key Responsibilities: + Lead end-to-end Medicare Advantage product development. + Support and help manage the… more
- Humana (Los Angeles, CA)
- …Based Role:** + **Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of… more
- Humana (Sacramento, CA)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will ... Utilization management experience in a medical management review organization such as Medicare Advantage , managed Medicaid, or Commercial health insurance +… more
- Amazon (San Francisco, CA)
- …will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and ... TME performance compared to plan expectations. Key job responsibilities -Analysis of Medicare Advantage and Accountable Care Organization data primarily -Medical… more
- Sharp HealthCare (La Mesa, CA)
- …Rights. More fields may be added as regulations change.In cases where Tricare or Medicare / Medicare Advantage is primary or secondary, use scripting to review ... coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi-Cal.Use Coordination of Benefits (COB) standards to prioritize billing order… more
- Humana (Sacramento, CA)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Sacramento, CA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage , and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Sacramento, CA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Sacramento, CA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
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