- UPMC (Pittsburgh, PA)
- …of topics affecting the financial performance of the health plan; assist with reconciling Medicare Advantage Part C and Part D claims data to financials; analyze ... changes; develop assumptions, project costs and monitor emerging experience of Medicare Advantage Mandatory Supplemental Benefits including, but not limited… more
- CenterWell (Augusta, ME)
- …+ Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage / Medicare /Medicaid ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 09-30-2025 **About us**… more
- Humana (Santa Fe, NM)
- …benefits providers in the US. At the core of this evolution is Humana's Insurance Segment, which provides Medicare Advantage , Medicaid, and other health ... plans to millions. By integrating insurance with care delivery through CenterWell, Humana is improving...initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, and identifying improvement… more
- Humana (Tallahassee, FL)
- …productive. Our wholly owned affiliate, CarePlus, operates in 18 Florida counties, offering Medicare Advantage HMO plans that have been awarded 5-Star ratings by ... Vice President. **Key Responsibilities** + Initiate, negotiate, and execute value-based Medicare Advantage contracts and agreements with physicians and other… more
- Humana (Little Rock, AR)
- …and allows you to see the overall end to end bid process at a leading Medicare Advantage organization. This is a great role for a collaborative individual who is ... may include monitoring and researching laws and regulations applicable to Medicare Advantage and actuarial science. Advises certifying actuaries, executives… more
- Alight (TX)
- …Care) + Ability to pass AHIP and annual carrier certifications + Knowledge of Medicare Advantage , Medicare Supplement, and prescription drug plans + ... passion with purpose. Alight helps clients gain a benefits advantage while building a healthy and financially secure workforce...or high-volume environment + Aptitude for understanding details of Medicare insurance and complying with all CMS… more
- 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
- TEKsystems (Brookfield, WI)
- …of protecting the personal health information of our members. Skills insurance , EOB, Healthcare Customer Service, Metrics, Medicaid, Medicare , Call ... billing and/or authorizations. Proficient in one line of business, either Medicare or Group/Marketplace, translating health care related jargon into effective… more
- UPMC (Pittsburgh, PA)
- …the Medicare Annual Enrollment Period. The temporary sales agents will sell Medicare Advantage and Medicare Special Needs plans by handling inbound ... calls and making outbound calls to Medicare beneficiaries, offering Medicare education, benefit reviews,...be willing to get PA and OH Department of Insurance health and accident producer license with a month… more
- Humana (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