- Commonwealth Care Alliance (Boston, MA)
- …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider… more
- Fallon Health (Springfield, MA)
- …in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more
- Elevance Health (Nashville, TN)
- **Investigator II - Medicare ** **Locations:** + GA-ATLANTA, 740 W PEACHTREE ST NW + CO-DENVER, 700 BROADWAY + FL-MIAMI, 11430 NW 20TH ST, STE 300 + TN-NASHVILLE, 22 ... accommodation is granted as required by law._ The **Investigator II - Medicare ** is responsible for the identification, investigation and development of cases… more
- Adecco US, Inc. (Kansas City, MO)
- …outbound and follow-up calls to provide support with recently submitted Medicare applications. + Address client inquiries and concerns across various communication ... plan confidence. + Verify application details and assist clients in understanding Medicare Advantage and Supplement plan options. + Conduct Health Risk Assessments… more
- Humana (San Juan, PR)
- …caring community and help us put health first** The Provider Group Medicare Inbound Contacts Representative 2 represents the company by addressing incoming ... SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION The Provider Group Medicare Inbound Contact Representative 2 addresses customer needs which may include answering… more
- UCLA Health (Los Angeles, CA)
- Description Under the direction of the Assistant Director, the ICM Medicare Advantage Utilization Review Nurse performs utilization review of medical necessity and ... education and provider support, and data and quality reporting for referrals for Medicare Advantage population enrolled under UCLA Medical Group. The ICM Medicare… more
- CVS Health (Hartford, CT)
- …with heart, each and every day. **Position Summary** Aetna is one of the largest Medicare plan carriers in the United States and supports over 6 million members on ... platforms. The Lead Director, Technology Product Management for our Medicare Enrollment & Billing will lead the strategic roadmaps,...tech-ops, security, etc. to ensure overall cohesion for the Medicare claims platform. You will lead a team of… more
- CVS Health (WY)
- …we do it all with heart, each and every day. As the Senior Manager, Aetna Medicare Medical Pharmacist, you will play a key role in the development and execution of ... business strategies and programs within the Medicare Part B Pharmacy Team. You will act as...overseeing and problem-solving daily strategy and operations issues within Medicare Part B. Partners with key stakeholders to optimize… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for ... current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. + Carries out job… more
- CVS Health (UT)
- …the implementation of business projects and programs and managing operations within the Medicare Part B Pharmacy Team. You will act as a Subject Matter Expert ... functions. Responsible for overseeing and problem-solving daily operations issues within Medicare Part B. Partners with business owners to optimize the achievement… more