- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** Provides leadership to the Medicare Duals team and plays a critical role in advancing the Medicare Integrated Duals segment ... strategic priorities. Develops and executes Medicare strategies, including state-specific and product-specific growth initiatives. Leads high-priority projects… more
- Humana (Oviedo, FL)
- …to the development, implementation, and management of the company's Medicare /Medicaid Five-Star Quality Rating System. The Senior Stars Improvement, Clinical ... Organizations (MSOs) and organizational leaders to impact Centers for Medicare & Medicaid Services (CMS) Star Rating categories -...or Registered Nurse + 3 or more years of Medicare experience + 3 or more years of CMS… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare , (CM), Medicare ... private or public sector, to include: 1) Maintaining oversight processes of major Medicare healthcare programs, including the Medicare Drug Price Negotiation and… more
- Humana (Annapolis, MD)
- …management of Power BI dashboards and analytics initiatives to support Medicare /Medicaid care management programs. The role emphasizes project management, advanced ... productivity, quality outcomes, and other program KPIs for care management in Medicare /Medicaid. + Apply DAX to create complex calculated columns, measures, and… more
- Humana (Denver, CO)
- …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 ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Health Care Service Corporation (Chicago, IL)
- …the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network ... strategic network initiatives from inception to completion. This position will analyze Medicare network data using internal and external sources to support the… more
- Humana (Louisville, KY)
- …to develop forecasting and targeted improvement in healthcare quality with our Medicare population. This role will product development, lead execution of tactics, ... of programs and their impact to results on the Medicare CAHPS and Health Outcomes Survey. This role will...leadership to develop functional strategies that broadly impact the Medicare Stars program. This role will also develop partnerships… more
- Humana (Chicago, IL)
- …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan… more
- AdventHealth (Glendale Heights, IL)
- …patients + Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) + standards and communicates relevant coverage/eligibility ... gathers details (eg, insurer name, plan subscriber) + Performs Medicare compliance review on all applicable Medicare ...Performs Medicare compliance review on all applicable Medicare accounts in order to determine + coverage. Identifies… more
- Molina Healthcare (Kenosha, WI)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more