• Access Service Representative-Patient Focus…

    Sharp HealthCare (Chula Vista, 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 ... Coordination of Benefits (COB) standards to prioritize billing order of insurance plans. Medicare patients - Medicare Secondary Payer (MSP) questionnaire is… more
    Sharp HealthCare (09/24/25)
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  • Principal, Insurance Strategy

    Humana (Albany, NY)
    …new contracting models for value-based care providers, evolving key facets of the Medicare Advantage growth strategy, and identifying high level operating model ... of the largest health benefits organizations in the country. Role Overview The Insurance Strategy team supports Humana's Medicare and Medicaid business unit.… more
    Humana (09/18/25)
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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 ... is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of...lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage , and Medicaid), including HEDIS audit… more
    Medical Mutual of Ohio (08/16/25)
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  • Senior RN Stars Improvement Consultant

    Humana (Orlando, 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 ... to the development, implementation, and management of the company's Medicare /Medicaid Five-Star Quality Rating System. The Senior Stars Improvement, Clinical… more
    Humana (09/23/25)
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  • Telephonic Call Center Specialist

    Humana (Miami Beach, 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 (09/19/25)
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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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  • Transplant Financial Coordinator, Part Time

    Dartmouth Health (Lebanon, NH)
    …to best meet their individual needs, ie, COBRA, Medicare /Medicaid eligibility, Medicare Supplemental Plans, and Medicare Advantage Plans. * Provides ... in the application process for a wide range of Medicare , Medicaid and private insurance carriers. The...wide range of Medicare , Medicaid and private insurance carriers. The Transplant Financial Coordinator also has responsibilities… more
    Dartmouth Health (06/27/25)
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  • Supervisor Call Center Operations (Hybrid - Troy,…

    Henry Ford Health System (Troy, MI)
    Primary Objectives To supervise, organize and coordinate the HMO, Medicare Advantage and Federal Government call center operations associated with HAP's Customer ... two (2) years of experience in health care or insurance environment with focus on Medicare managed...of health care delivery systems. + Working knowledge of Medicare Advantage Programs. + Knowledge of CMS… more
    Henry Ford Health System (09/15/25)
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  • Account Administrator- Individual Broker

    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. **Responds to ... is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
    Medical Mutual of Ohio (09/24/25)
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  • Care Coordinator, RN Field Based

    Humana (Greenwood, IN)
    …other care team staff to address the member's identified needs + Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers ... for the people we so proudly serve. * Health Insurance begins on day one! * 23 days of...and benefits of members who are also eligible for Medicare . + Primary point of contact for the Interdisciplinary… more
    Humana (09/24/25)
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