- Humana (Atlanta, GA)
- …+ Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... Information** + This role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside of bid season + The… more
- PruittHealth (Norcross, GA)
- …for health plans * Knowledge of CMS required contracting language for Medicare Advantage Plan agreements * Demonstrate compliance with CMS regulations ... regarding Medicare Advantage Plans and PruittHealth Code of Conduct. * Exceptional organizational skills; strong written and verbal communication and… more
- Humana (Atlanta, GA)
- … and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures ... success working through ambiguity **Preferred Qualifications** + Master's Degree + Medicare Stars experience **Additional Information** As part of our hiring process… more
- Humana (Atlanta, GA)
- … and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures ... + Master's Degree + HEDIS Controlling Blood Pressure measure experience + Medicare Stars experience **Additional Information** As part of our hiring process for… more
- Humana (Atlanta, GA)
- … and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures ... insights **Preferred Qualifications** + Master's Degree + HEDIS experience/knowledge + Medicare Stars experience **Additional Information** As part of our hiring… more
- Molina Healthcare (Columbus, GA)
- …and oversight of processes that track, evaluate, and submit encounter deletions for Medicare Advantage , ACA, and Medicaid lines of business. This role has ... in Director level role or above. + Extensive understanding of Medicare Advantage , ACA and Medicaid risk adjustment processes, including encounter data submission… more
- CVS Health (Atlanta, GA)
- …accountable for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC ... collaborating with others to meet/exceed expectations **Preferred Qualifications** + Experience in Medicare Advantage and/or Value Based Contracting + Ability to… more
- Datavant (Atlanta, GA)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage , HHS (ACA), and other markets. + Provide guidance and make ... inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. +… more
- NASCO (Atlanta, GA)
- …laws and regulations related to our products and services, including for our Medicare Advantage and ACA Exchanges business + Interacts with vendors and ... counsel on compliance issues, including related to HIPAA + Experience supporting Medicare Advantage and ACA Exchanges business **Required Training, Certification… more
- Humana (Atlanta, GA)
- …team and plays a critical part in forecasting risk scores and revenue for the Medicare Advantage Part D business. The successful candidate will lead efforts to ... FSA or plus relevant advanced degree + Experience with Medicare Part D + Familiarity with Risk Score Data...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more