• Associate Manager, Clinical Trial Reimbursement

    Abbott (Austin, TX)
    …(CTR). **What You'll Work On** + Review clinical investigative plan and payer policies ( Medicare , Medicare Advantage , Medicaid and Private Payer) to provide ... affect existing and future clinical trials. + Assist sites with Medicare , Medicare Advantage , Medicaid and Private Payor prior authorization,… more
    Abbott (10/25/25)
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  • Access Service Representative - Emergency…

    Sharp HealthCare (La Mesa, CA)
    …Rights. More fields may be added as regulations change.In cases where Tricare or Medicare / Medicare Advantage is primary or secondary, use scripting to review ... coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi-Cal.Use Coordination of Benefits (COB) standards to prioritize billing order… more
    Sharp HealthCare (01/02/26)
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  • Medical Director - Medicaid (remote)

    Humana (Washington, DC)
    …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (01/01/26)
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  • Senior Counsel

    University of Rochester (Brighton, NY)
    …Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS, Medicare Advantage and New York State Medicaid). + Manage disputes, risks ... and Compliance on relevant reimbursement and billing issues and requirements (including CMS, Medicare Advantage , and New York State Medicaid). Stays abreast of … more
    University of Rochester (12/25/25)
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  • Medical Director - IP Claims Management

    Humana (Raleigh, NC)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage , and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (12/11/25)
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  • Medical Director-Payment Integrity

    Humana (Carson City, NV)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (12/11/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Jefferson City, MO)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (11/15/25)
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  • Outreach and Retention Associate

    Centers Plan for Healthy Living (Staten Island, NY)
    …the guidance and plans they need for healthy living. Outreach and Retention Associate (ORA)- Medicare Advantage CPHL is a Medicare Advantage Prescription ... Medicare products *Licensed Agents Only. + Educate potential members about Medicare Advantage / Special Needs Plans and the benefits of enrolling in the CPHL… more
    Centers Plan for Healthy Living (10/14/25)
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  • Senior Program Manager, Supplemental Benefits…

    UCLA Health (Los Angeles, CA)
    …Benefits to lead the oversight and strategic management of key vendors supporting our Medicare Advantage product line. This role plays a critical part in ... experience. You will: + Oversee multiple complex vendors that support Medicare Advantage supplemental benefits, ensuring delivery against contractual,… more
    UCLA Health (12/23/25)
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  • Regulatory Lobbyist, Director I (Hybrid)

    American Medical Association (Washington, DC)
    …and coalitions involved with health-related programs. This position will focus on Medicare Advantage . Ensure AMA policies and positions are brought to ... advise on regulatory proposals; educate AMA colleagues and others about Medicare Advantage policies and other issues of interest to patients and physicians… more
    American Medical Association (12/12/25)
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