- Fallon Health (Worcester, MA)
- …accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. ... health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care...in a number of different key area's such as; Sales and Marketing, Provider Relations, Care Services, Pharmacy and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …exception requests from providers via phone and fax for the Retail Pharmacy, Medicare Advantage Part D, Home Infusion Therapy, and Medical Utilization Management ... compliance with all regulatory requirements. + Support product portfolio, including Medicare Part D which includes rotational weekend and holiday support for… more
- CVS Health (Chicago, IL)
- …+ Performs accurate analysis and risk assessment for new business group Medicare Advantage opportunities. + Produces timely and accurate customer specific ... documents for RFP responses. + Work closely with the sales team to provide strategic solutions which are affordable...which are affordable and satisfactory to the member and plan sponsor. + Drives for results by working across… more
- Capgemini (Cincinnati, OH)
- …of **Program Manager / Sr Project Manager** - Markets and Growth portfolio Medicare Advantage / DSNP/ Medicaid or Exchange program/ product build knowledge ... or many functions) E2E set of Pharmacy Benefits Experience in working with Plan and Pharmacy Benefits Manager Setting up Pharmacy call center Pharmacy member… more
- Providence (Portland, OR)
- …support the organization's objectives related to market expansion, particularly in Medicare Advantage , Commercial insured, and self-insured markets. + ... Role:** As the Chief Network Strategy & Management (CNSM) for Providence Health Plan , you will spearhead the vision, strategy, and management of our provider… more
- MVP Health Care (Kingston, NY)
- …Health Plus, Essential Plan , Qualified Health Plans (QHPs), HARP, Off-Exchange, Medicare Advantage (MA) products, and Dual Eligible Special Needs Plans ... **Qualifications you'll bring:** + Two or more years in a customer service or sales environment, with some experience in the health care industry such as a hospital,… more
- MVP Health Care (Albany, NY)
- …help eligible individuals enroll in plans including Medicaid, Child Health Plus, Essential Plan , QHPs, HARP, Off-Exchange, Medicare Advantage , and D-SNP. ... **Qualifications you'll bring:** + Two plus years of customer service or sales experience, ideally in health care (hospital, medical office, or insurance). +… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …areas within BCBSMA. + Responsible for reviewing Local Coverage Determinations (LCD) for Medicare Advantage and identifying any code changes that impact edits. ... education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs… more