• 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 (07/15/25)
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  • Medical Director - Acute Rehab Team

    Humana (Baton Rouge, LA)
    …internal teaching conferences, and other reference sources. 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, or other Medical management organizations,… more
    Humana (09/11/25)
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  • Enrollment Specialist

    NTT DATA North America (Lincoln, NE)
    …future for NTT DATA and for the people who work here. NTT Data is hiring a Medicare Advantage Enrollment processor to join their team in Lincoln NE. Pay Rate is ... -Maintain current knowledge of CMS compliance requirements as they pertain to Medicare Advantage enrollment and member maintenance Requirements: + Minimum 1… more
    NTT DATA North America (09/05/25)
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  • HEDIS Analyst

    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. **Supports ... Set (HEDIS) lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage , and Medicaid), including HEDIS audit submission, Consumer… more
    Medical Mutual of Ohio (08/16/25)
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  • Appeals & Grievance Analyst (Hybrid - Troy, MI)…

    Henry Ford Health System (Troy, MI)
    …pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage , Medicare -Medicaid Program (MMP), and Medicaid ... by passing a writing assessment. + Demonstrated knowledge of the Medicare Advantage , Federal Government, Medicare benefits, all Commercial including… more
    Henry Ford Health System (09/11/25)
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  • Telephonic Call Center Specialist

    Humana (South Miami, FL)
    …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... based on business needs and hours could include weekends/holidays. + During the Medicare Annual Election Period, September to December, must be able to work Monday… more
    Humana (09/12/25)
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  • Medical Director - OneHome

    Humana (Austin, TX)
    …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare more
    Humana (08/25/25)
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  • Senior Clinical Reimbursement Analyst - RN - Long…

    Good Samaritan (WI)
    …with executive leadership, administrators, and facility staff in training/consulting on traditional Medicare A / Medicare Advantage coverage, documentation, ... and support to all operating segments across Sanford. Responsible to review Medicare /Medicaid documentation to assist nursing centers in completing minimum data set… more
    Good Samaritan (08/20/25)
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  • Data Engineer

    Humana (Cheyenne, WY)
    …member care, health outcomes, provider relationships, and financial sustainability for Medicare Advantage beneficiaries. We are seeking a technically skilled ... Data Engineer 2 to deliver integrated Medicare Advantage risk adjustment solutions that leverage data and technology to empower members, providers, and Humana.… more
    Humana (09/12/25)
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  • Insurance Strategy Consultant

    Humana (Indianapolis, IN)
    …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare more
    Humana (08/29/25)
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