- Excellus BlueCross BlueShield (Rochester, NY)
- …pharmacist clinician is a program manager, who is responsible for all Medicare Part D formulary creation and submissions, which includes utilization management ... for the current and upcoming contract years. This individual creates and executes the Medicare Part D formulary, delivering value and quality to the Plan's Part D… more
- Insight Global (Pleasanton, CA)
- Job Description Insight Global is seeking a Medicare Billing Specialist to join their clients team. The Medicare Billing Specialist is responsible for the ... accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role ensures compliance with Medicare … more
- Walmart (Bentonville, AR)
- …claims on behalf of Walmart, Sam's Club, and Supply Chain. The Manager, Medicare Compliance Oversight, is responsible for supporting and optimizing the Medicare ... this role, you will serve as an expert in Medicare compliance, internal compliance protocols and impacts to claims...to claims handling. You will continually analyze the overall Medicare compliance program and its processes to ensure our… more
- Highmark Health (Buffalo, NY)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and...Medicaid Services (CMS) and company policies and regulations. The Medicare MAP advisor will develop a presence in the… more
- Prime Therapeutics (Salem, OR)
- …every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government ... Programs - Medicare & Managed Medicaid is responsible for the development,...of strategic plans that advance Prime's position in the Medicare space. This position has accountability for the … 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. This position is ... responsible for leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and … more
- Humana (Sanford, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...**Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental,… more
- CVS Health (Downers Grove, IL)
- …analytical and communication skills to support, manage and develop and execute Medicare and Medicaid compliance programs and processes that promote compliant and ... with internal senior level corporate compliance and business teams that operate Medicare Advantage in a highly complex regulatory environment and highly matrixed… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement ... and education programs to support improved Star Ratings. Responsible for Medicare Star projects and programs involving enterprise, department, cross-functional and… more