- University Health Careers (San Antonio, TX)
- …efforts, and reviewing HCC quality indicators, and RAF scores to eligible Medicare Advantage beneficiary. Will monitor opportunities within the Medicare ... Will coordinate the transition of care and the interdisciplinary treatment for Medicare managed patients across the healthcare continuum. Facilitates the delivery of… more
- Abt Global Inc. (Rockville, MD)
- …least 5 years of experience working with Medicare , including Part D and Medicare Advantage , and Medicaid program and payment policy. + Deep familiarity with ... involving diverse government stakeholders. + Ensure alignment of project goals with Medicare and Medicaid program and payment policy frameworks. **What We Value** +… more
- Commonwealth Care Alliance (Boston, MA)
- …CAHPS, HOS) and value-based contract performance metrics + Experience with Medicare Advantage , Medicaid; and dually eligible populations **Desired Experience** ... to achieve high performance on CCA's Population Health goals; including Medicare Star measures, Medicaid- Medicare Plan withhold measures, quality performance… more
- Commonwealth Care Alliance (Boston, MA)
- …**Desired Experience (nice to have):** + Experience working in a health plan, with Medicare Advantage and/or dually eligible population + Experience with a care ... management platform (Guiding Care a plus) + Experience with Substance Use Disorders **Required Knowledge, Skills & Abilities (must have):** + Proven skills, knowledge base, and judgement necessary for independent clinical decision making in alignment with… more
- Caris Life Sciences (Irving, TX)
- …cross-functional initiatives and manage timelines, resources, and deliverables. + Experience with Medicare Advantage plans and familiarity with Xifin is a plus. ... + Demonstrated ability to lead teams, manage change, and drive performance in a fast-paced environment. + Proficiency in Microsoft Office Suite (Excel, Word, Outlook, Access) and healthcare billing systems. + Strong interpersonal, communication, and… more
- Highmark Health (Buffalo, NY)
- …are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs… more
- UCLA Health (Los Angeles, CA)
- …level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM ... coordinators and nurses. You'll work closely with Medicare Advantage leadership to plan, execute, and manage various initiatives related to UM administrative,… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. This position ... of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and Medicare Supplement products. Reporting directly to the Chief… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process + Ensures prospective members are… more
- Humana (Orange City, FL)
- …Based Role:** + **Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and ... Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help… more
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