- Centene Corporation (Charleston, WV)
- …estimate outcomes. **In this Sr. Actuarial Analyst role, you will:** + Support ** Medicare Advantage bid development** , including preparing and reviewing PBP and bid ... **Why This Role Stands Out:** + **High-Impact Work** : Lead critical Medicare Advantage bid initiatives with visibility across senior leadership. + **Collaborative… 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
- Highmark Health (Harrisburg, PA)
- …Health Network **Job Description :** GENERAL OVERVIEW: Responsible for the Medicare Coverage Analysis (MCA) for sponsored projects within WPAHS, budget development ... the creation, revision and management of spreadsheets related to Medicare coverage analysis and compliance with Medicare ...to Medicare coverage analysis and compliance with Medicare rules and regulations. (60%) + Use MCA analysis… more
- Molina Healthcare (WI)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... restrictions to practice and free of sanctions from Medicaid or Medicare . **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare… more
- Centene Corporation (Austin, TX)
- …planning and delivery of strategic programs and complex, large-scale enterprise-wide Medicare designs to execute defined requirements and meet company strategic ... executive level discussion. + End-to-end development, filing and execution of the Medicare Supplemental dental, vision and hearing benefits. Program Manager will own… more
- Providence (OR)
- …we must empower them._** **Providence Health Plan is calling an Individual and Medicare Producer Support who will:** + Be accountable for and facilitates Providence ... Health Plan's detailed benefits management support of Medicare and Individual / family lines of business + Be responsible for supporting detailed benefits… more
- Molina Healthcare (Austin, TX)
- …Affairs to assess and provide analyses for proposed changes to Medicare , and other government-sponsored healthcare program contracts, governing regulations and new ... 10 years' experience in Managed Care, specifically government programs and/or Medicare /Duals Health Plan Operations or equivalent combination of education and… more
- Houston Methodist (Katy, TX)
- …HB Epic AR management experience + Strong working knowledge of Facility Medicare (Part A) guidelines. + Problem solving thought leader with proven execution ... to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Medicare Wellness Registered Nurse will schedule and conduct Medicare Annual Wellness visits in Primary Care Offices. Provides professional ... required by the time of appointment. Preferred Qualifications: Experience with Medicare wellness visits and collaborating with a multi-disciplinary team. EPIC… more
- Baylor Scott & White Health (Austin, TX)
- …environment independently and with cross functional groups.Knowledge of ACA, Medicare , Medicaid, MCO, TPA business requirements preferred.Experience with healthcare ... claims, enrollment and pharmacy data is preferred + Knowledge of ACA, Medicare , and TPA business requirements is a plus. **Skills/Abilities:** + Excellent data… more