- Ochsner Health (New Orleans, LA)
- …in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies ... Notices of Grant Award, FDA letters to produce a Medicare Coverage Analysis within a CTMS system. + Creation,...+ Creation, revision, and management of documents related to Medicare coverage analysis and compliance with Medicare … more
- 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
- 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
- Humana (San Juan, PR)
- …represents Humana by addressing incoming telephone, digital, or written inquiries from Medicare members. The Call Center Representative 2 strives to provide the ... applying to other Humana opportunities outside of Individual or Group Medicare . **Required Qualifications** + **Must** **currently** **reside in Puerto Rico.** +… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …your true colors to blue. The Role The Clinical Pharmacist, Medicare Clinical Programs is responsible for providing comprehensive medication management services ... support care management with identifying and resolving drug-related problems for Medicare members. The Clinical Pharmacist will assist the Pharmacy Department in… more
- Humana (Concord, NH)
- …a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via ... annual pricing of Humana's largest segment of business, individual plan Medicare Advantage. The team consists of actuaries and business technology professionals… more
- Centene Corporation (Clayton, MO)
- …will provide Executive Assistant support to the Chief Executive Officer of Medicare leader. Responsible for leading and providing executive level support for the ... Chief Executive Officer of Medicare in partnership with multiple internal partners to ensure...and professional support to the Chief Executive Officer of Medicare with minimal or no supervision. + This position… more
- CVS Health (Scottsdale, AZ)
- …**Position Summary** The Clinical Pharmacist engages within the Medical Affairs - Medicare Formulary Administration team to support the creation and maintenance of ... the CVS Caremark's standard and client-modified Medicare formularies and utilization management edits. This role is...Managed Care residency - Demonstrated experience with formulary management, Medicare Part D, PBM and Managed Care, drug file… more
- Carle Health (Rantoul, IL)
- …of practice as defined by the Illinois Board of Nursing. Main focus of the Medicare Wellness nurse will be to complete Medicare Annual Wellness visits with ... Nursing (Required) **Other Knowledge/Skills:** Responsibilities Ensures understanding of CMS Medicare Annual Wellness Visit requirements/visit workflowsProvides and facilitates competent… more
- CVS Health (St. Louis Park, MN)
- …you will lead the market-wide strategy, performance improvement, and execution of the Medicare Stars quality program for Allina Health | Aetna Medicare ... improvement strategies. **Required Qualifications** + 7-10 years of experience with ** Medicare Stars** programs. + Strong analytical and project management skills. +… more