• VP, Medicare Regional President- Central…

    Humana (Lincoln, NE)
    …This includes the following key responsibilities: + Develop product strategy for annual Medicare Advantage plan filings + Lead the expansion and support for ... and provider engagement activities for all lines of business + Medicare Advantage experience + Preferred location is Chicago. IL **Additional Information** This… more
    Humana (12/17/25)
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  • Medicare Sales Lead Sector Consultant…

    Henry Ford Health System (Traverse City, MI)
    …and planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for ... SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting...years of successful health insurance sales experience in the Medicare market. + Minimum of three (3) years of… more
    Henry Ford Health System (12/23/25)
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  • Product Development Partner - Medicare

    Intermountain Health (Murray, UT)
    …needed to develop a strong performing product. **Preferred Qualifications** + Knowledge of Medicare Advantage products, which could come from work experience in ... Partner leads the development and management of a portfolio of high-impact Medicare products within the government programs division at Select Health, overseeing… more
    Intermountain Health (12/02/25)
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  • Medicare Specialist I

    Southeast Health (Dothan, AL)
    …Using internal and external computer systems and payer portals, work traditional Medicare and Medicare Advantage /Replacement inventory to full resolution. ... to obtain accurate reimbursement; + Understands the use of and navigation of Medicare 's DDE system and other governmental and commercial payer websites for claim… more
    Southeast Health (11/05/25)
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  • Actuary - Medicare Part D

    CVS Health (Chicago, IL)
    …priorities and deadlines **Preferred Qualifications** + Prior Pharmacy, Part D, or Medicare Advantage experience + ASA **Education** + Bachelor's Degree ... is primarily responsible for modeling pharmacy network contracting arrangements for Aetna's Medicare Part D business and providing actuarial support to key business… more
    CVS Health (12/12/25)
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  • Eligibility & Revenue Operations Representative-…

    Fallon Health (Worcester, MA)
    …external SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage , Medicare Supplement, NaviCare, Summit Elder Care, ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
    Fallon Health (11/18/25)
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  • Senior Reimbursement Analyst

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does ... offices and/or conferences and exhibits. + Staff dedicated to supporting Medicare Advantage must have working knowledge of Medicare enrollment guidelines… more
    Blue Cross and Blue Shield of Louisiana (11/25/25)
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  • Senior Submissions Healthcare Data Analyst

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …assurance, and regulatory submissions with a focus on Risk Adjustment and Medicare Advantage (MA) data. You'll collaborate with business analysts, actuaries ... and Power BI. Encounter Data submissions experience focused on ACA, Medicaid, and/or Medicare Advantage is essential. Knowledge of CMS ACA EDGE, Medicare more
    Blue Cross and Blue Shield of Minnesota (12/22/25)
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  • Medical Director - Pharmacy Appeals

    Humana (Lincoln, NE)
    …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will ... Utilization management experience in a medical management review organization such as Medicare Advantage , managed Medicaid, or Commercial health insurance +… more
    Humana (12/03/25)
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  • Actuarial Analyst, Amazon One Medical Actuary,…

    Amazon (New York, NY)
    …will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and ... TME performance compared to plan expectations. Key job responsibilities -Analysis of Medicare Advantage and Accountable Care Organization data primarily -Medical… more
    Amazon (11/26/25)
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