- CVS Health (Columbus, OH)
- …Summary** Leads the strategy, design, development and life cycle management of Aetna Medicare products that serve Medicare Advantage populations, including ... Direct product enhancements **Required Qualifications** 7+ years of experience with Medicare Advantage plans, including C- SNP plans. **Preferred… more
- Molina Healthcare (Columbus, OH)
- …**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
- Humana (Columbus, OH)
- …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 (Columbus, OH)
- …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
- Humana (Columbus, OH)
- …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
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Supports ... Set (HEDIS) lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage , and Medicaid), including HEDIS audit submission, Consumer… more
- Humana (Columbus, OH)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare… more
- Humana (Columbus, OH)
- …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare … more
- Humana (Columbus, OH)
- …Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and Medicare Advantage value based programs. DVACO is a joint venture among ... areas including HR. DVACO's MSSP participation accounts for the region's largest Medicare ACO grouping, with more than 2,000 physicians and approximately 70,000 … more
- CVS Health (Cleveland, OH)
- …+ _4-year college degree or 1 to 2 years' experience of selling multiple Medicare products (ie, Medicare Advantage , Medicare Supplement)_ + ... and retain through the use of the Aetna IVL Medicare product portfolio.This role will deploy an operating model...shopper initiatives, and state, federal, and CMS requirements for Medicare sales agents and programs + 0-3 Years Experience… more