- Providence (Beaverton, OR)
- …them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide care coordination, case management and ... care management services to Providence Health Plans(PHP) members + Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease + Case management services include: triage and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of CMS risk score methodology, risk score calculation, enrollment, premiums, medical and pharmacy claims, and provider data. Incumbent is… more
- Specialty Rx, Inc. (Ridgefield Park, NJ)
- Job Description SpecialtyRx is a full-service pharmacy. We need Medicare Part B- Billing Representative with Pharmacy experience in our Ridgefield Park, NJ location. ... Hours: 8:00am-4:00pm, 9-5 or 10-6pm Monday through Friday Must be able to train for 3 weeks onsite with the potential in going remote. Please apply here https://secure3.saashr.com/ta/s6337.careers?CareersSearch and we will be glad to reach out to you to… more
- BlueCross BlueShield of North Carolina (NC)
- …9 years of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + The opportunity ... to work at the cutting edge of health care delivery with a team that's deeply invested in the community. + Work-life balance, flexibility, and the autonomy to do great work. + Medical, dental, and vision coverage along with numerous health and wellness… more
- Amazon (FL)
- …Application deadline: Jan 8, 2026 As a Program Manager II on the One Medical At -Risk team, you will be the primary builder of new and existing capabilities and ... programs aimed at improving health outcomes for our at-risk patient populations. Working within Amazon's mission to be Earth's most customer-centric company, you will drive operational improvement and strategic initiatives from concept to implementation,… more
- Centene Corporation (Jefferson City, MO)
- …Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the ... Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement… more
- PruittHealth (Norcross, GA)
- …for all assigned locations. This position functions within a team environment and under general supervision. Successful individuals manage a volume of work as ... **JOB PURPOSE:** Supports the delivery of all Insurance billing services by final/higher level auditing, correcting, and submitting claims. Ensures that billing services are timely, accurate, and allow for appropriate reimbursement. Conducts all claims-related… more
- Queen's Health System (Honolulu, HI)
- …I. JOB SUMMARY/RESPONSIBILITIES: * Performs a variety of secretarial and administrative support duties. * Relieves the assigned Manager of routine duties and is ... required to make routine administrative decisions. II. TYPICAL PHYSICAL DEMANDS: * Essential: sitting, walking, stooping/bending, finger dexterity, seeing, hearing, speaking. * Frequent: standing, lifting usual weight up to 25 pounds; carrying usual weight of… more
- Sanford Health (MN)
- …The Product Manager will lead the ongoing analysis, planning, and management of their respective product line or Health Plan or Sanford Health System service and will ... **Careers With Purpose** **Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who… more
- Southeast Health (Dothan, AL)
- …Summary Job Description Shift DayShift Details FTE 1 Type Regular Join one of Forbes 500 best mid-sized employers in America. Equal Employment Employer Southeast ... Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or… more