- CVS Health (Albany, NY)
- …and lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans ... - Direct product enhancements **Required Qualifications** 7+ years of experience with Medicare Advantage , DSNP, HIDE and FIDE plans. **Preferred Qualifications**… more
- Molina Healthcare (Rochester, NY)
- …**Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will ... protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process + Ensures prospective members are… more
- Centene Corporation (Queens, NY)
- …in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). ... Act as a strategic advisor on contract structure and payment methodologies for Medicare Advantage and D-SNP providers, supporting new contract negotiations and… more
- Humana (Albany, NY)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... and genetics.** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid. + Utilization management experience in a medical… more
- Humana (Albany, NY)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations,… more
- Kelly Services (Fairport, NY)
- …line with established policies and procedures. + Maintaining current knowledge of Medicare Advantage regulations and corporate policies. + Skillfully resolving ... yes, please see this opportunity!** **Kelly(R) is seeking a Medicare Customer Satisfaction Advocate to work at a top...6 month project **What's a typical day as a Medicare Customer Service Representative? You'll be:** + Under the… more
- Centene Corporation (Bronx, NY)
- …+ Identify prospective enrollees and determine eligibility for participation in the Advantage Medicare product + Understand and apply all policies and ... procedures pertaining to: + Disclosures and provisions of the Advantage Medicare product + Enrollment and disenrollment + Develop a presence in the local… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …the guidance and plans they need for healthy living. Outreach and Retention Associate (ORA)- Medicare Advantage CPHL is a Medicare Advantage Prescription ... Medicare products *Licensed Agents Only. + Educate potential members about Medicare Advantage / Special Needs Plans and the benefits of enrolling in the CPHL… more
- Humana (Albany, NY)
- …internal teaching conferences, and other reference sources. 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, or other Medical management organizations,… more