- NTT DATA North America (Lincoln, NE)
- …-Maintain current knowledge of CMS compliance requirements as they pertain to Medicare Advantage enrollment and member maintenance **Required:** -High School ... team in Lincoln, NE (1 year of CMS - Medicare /Medicaid guideline experience required) Must be able to work...not just a method of gaining a one-time cost advantage , but an effective strategy for gaining and maintaining… more
- Humana (Lansing, MI)
- …+ Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... Information** + This role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside of bid season + The… more
- Humana (Tavares, FL)
- …preferably in the health care or insurance industry, and specifically in Medicare Advantage products + Proven experience in community outreach, grassroots ... role. **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional… more
- PruittHealth (Norcross, GA)
- …for health plans * Knowledge of CMS required contracting language for Medicare Advantage Plan agreements * Demonstrate compliance with CMS regulations ... regarding Medicare Advantage Plans and PruittHealth Code of Conduct. * Exceptional organizational skills; strong written and verbal communication and… more
- Adecco US, Inc. (Kansas City, MO)
- …2024. The Onboarding Specialist will be the first point of contact for our Medicare Advantage clients, helping them through the onboarding process with clarity ... accuracy. + Provide clear, helpful responses to inquiries about Medicare Supplement and Advantage plans. + Ensure clients are confident and satisfied with… more
- Gilead Sciences, Inc. (Foster City, CA)
- …and legislative developments impacting reimbursement for Gilead's therapies, with a focus on Medicare Advantage , Medicaid, Health Plans, and PBMs. + Develop and ... Medicare and Medicaid reimbursement systems, including Medicaid drug rebate policy, Medicare Advantage , and Commercial Health plan dynamics. + Exceptional… more
- BrightSpring Health Services (Louisville, KY)
- …a Medical Services company, Population Health Management services company, and a Medicare Advantage Institutional Special Needs Plan (I-SNP).Under the direction ... the primary focus of this position will be to support the Medicare Advantage Institutional Special Needs Plan (I-SNP), the Manager will work in collaboration… more
- Humana (Sacramento, CA)
- …interrelate across segments and/or enterprise-wide. **Regional VP of Health Services, Humana Medicare Advantage ** As the Regional VP of Health Services, you ... innovator, and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement &… more
- AdventHealth (Maitland, FL)
- …appeal processes. + Facilitate resolution to contract violations by leveraging knowledge of Medicare Advantage plans regulatory requirements and Medicare ... Senior Compliance Analyst will have expertise in Commercial and Governmental ( Medicare , Medicaid, Tricare) payer reimbursement language and methodologies. The Senior… more
- Commonwealth Care Alliance (Boston, MA)
- …or in team settings. + Prior experience working with EDPS data flows and Medicare Advantage programs is a strong advantage . **Required Language (must ... in SQL, data integration, and systems development are essential. Knowledge of Medicare risk adjustment methodologies is highly desirable. The ideal candidate is a… more
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