• Enrollment Specialist

    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
    NTT DATA North America (09/05/25)
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  • Associate Actuary

    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 (09/03/25)
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  • Field Marketing Executive - Bilingual…

    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
    Humana (09/03/25)
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  • Provider Relations Development Specialist…

    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
    PruittHealth (09/03/25)
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  • Onboarding Specialist Customer Service

    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
    Adecco US, Inc. (08/23/25)
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  • Director, US Reimbursement Policy

    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
    Gilead Sciences, Inc. (08/22/25)
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  • Manager, Financial Planning & Analysis-REMOTE

    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
    BrightSpring Health Services (08/13/25)
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  • Regional VP, Health Services Pacific Southwest…

    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
    Humana (08/08/25)
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  • Senior Compliance Analyst

    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
    AdventHealth (08/07/25)
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  • Database Developer (Healthcare / Risk Adjustment)

    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
    Commonwealth Care Alliance (06/25/25)
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