- CenterWell (Orange Park, FL)
- …(EMR, email, etc.). **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid ... provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines.… more
- CenterWell (Stone Mountain, GA)
- …to make an impact** **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid ... provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines.… more
- CenterWell (Clarksville, TN)
- …years directly applicable experience. + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare ... /Medicaid provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers. + Familiarity with HEDIS quality indicators and Medicare … more
- Integra Partners (Troy, MI)
- …NCQA UM accreditation standards + Prior UM experience for MLTC, Medicaid, or Medicare Advantage plans Working Conditions and Additional Expectations: + Full-time ... The Medical Director ensures determinations are made in accordance with Medicare and Medicaid guidelines, health plan-specific criteria, internal policies, and… more
- CenterWell (Indianapolis, IN)
- …(EMR, email, etc.). **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid ... provider numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines.… more
- ChenMed (Orlando, FL)
- …+ Direct-to-patient sales and marketing experience preferred. + Experience within the Medicare Advantage population strongly preferred. Experience working for a ... as Salesforce, DASH, and Availity. + Eligibility criteria in terms of Medicare , Medicaid, Low-Income Subsidies, and Special Enrollment Periods. + Organizes MGC… more
- UNC Health Care (Morrisville, NC)
- …management of: commercial fee-for-service and value-based managed care payer contracts; Medicare Advantage and Managed Medicaid managed care fee-for-service and ... revenue that could cover any part of the managed care spectrum (commercial, Medicare Advantage , Medicaid Managed Care, specialty and carve-out services, direct… more
- BrightSpring Health Services (Bowling Green, KY)
- …of Business Abilis Health Plan, an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare ... Abilis Health Plan Overview * Abilis Health Plan was formerly Signature Advantage * Our Sales and Community Liaison is a relationship-driven field representative… more
- UCLA Health (Los Angeles, CA)
- …The NCQA and CMS Star Rating Program Manager will lead initiatives to drive the Medicare Advantage Plan's success in NCQA Health Plan Accreditation and CMS Star ... of NCQA survey process and IRT systems + Knowledge of Medicare Advantage operations, CMS regulations, and health services program requirements + Knowledge… more
- CommonSpirit Health (Phoenix, AZ)
- …systems architecture with organizational strategies related to value-based care, ACOs, Medicare Advantage , Medicaid, and commercial payer programs. Oversee ... with 5+ years in a leadership role. Experience with managed care models ( Medicare Advantage , ACO, Medicaid), HIE integration, and population health tools (eg,… more