• Manager, Provider Engagement - VBP…

    Centene Corporation (Queens, NY)
    …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special ... + Oversee Medicare -specific VBP contracts, focusing on implementation, performance management, and education of provider partners regarding CMS-aligned… more
    Centene Corporation (07/09/25)
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  • Senior Fraud Investigations Analyst…

    BlueCross BlueShield of North Carolina (NC)
    …of degree, 7+ years of experience in related field **Bonus Points** + Deep Medicare and/or Medicare Advantage regulatory experience + Extensive Medicare ... the business/organization. + In the course of investigation, may be required to provide deposition and/or testimony May also be required to conduct interviews of… more
    BlueCross BlueShield of North Carolina (07/25/25)
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  • Medicare Advantage Risk Adjustment…

    UCLA Health (Los Angeles, CA)
    Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... reports. + Write clear specifications and design data queries for healthcare performance measures. + Apply technical expertise to gather requirements and translate… more
    UCLA Health (06/11/25)
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  • Lead Director, Medicare Business Consulting

    CVS Health (Albany, NY)
    …do it all with heart, each and every day. **Position Summary** The Medicare Performance Management Lead Business Consultant will facilitate and support ... process and operating model. This role will assist the Medicare Advantage market facing General Manager most...for success. Role will report to the Head of Medicare Performance Management. **Fundamental Job Components:** +… more
    CVS Health (08/21/25)
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  • Behavioral Health Medical Director…

    Humana (Concord, NH)
    …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid products, or other Medical… more
    Humana (08/09/25)
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  • Un-Licensed Medicare Telesales Supervisor-…

    BroadPath Healthcare Solutions (Kapolei, HI)
    …lead a high-performing team of licensed sales agents who help consumers enroll in Medicare Advantage and Prescription Drug Plans. This is your chance to step ... levels are consistently met + Evaluate agent calls and provide coaching with clear performance documentation ....1+ year of recent **healthcare experience** , preferably in Medicare Advantage + Active **Health Producer License… more
    BroadPath Healthcare Solutions (08/14/25)
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  • Lead Sector Consultant Medicare Sales…

    Henry Ford Health System (Troy, MI)
    …and planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for ... GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 million in… more
    Henry Ford Health System (08/27/25)
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  • Director, Provider Contracting

    Humana (Miami, FL)
    …productive. Our wholly-owned affiliate, CarePlus, operates in 21 Florida counties, offering Medicare Advantage HMO plans that have been awarded 5-Star ratings ... office in Doral. **Key Responsibilities** + Initiate, negotiate, and execute value-based Medicare Advantage contracts and agreements with physicians and other… more
    Humana (08/23/25)
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  • Director, Provider Service Engagement

    Medical Mutual of Ohio (OH)
    …group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace of mind to more ... self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and... specific strategies to aimed at operational and administrative performance improvement. . Supports Provider Network Management… more
    Medical Mutual of Ohio (08/08/25)
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  • Regional Vice President (RVP) Provider

    Elevance Health (Norfolk, VA)
    …Virginia, positively impacting the affordability of respective Medicaid and Medicare Advantage health plan products. + Develops new provider networks that ... establish a competitive advantage , optimizing respective provider relationships to most effectively benefit health plan growth priorities. + Aligns contracting… more
    Elevance Health (07/25/25)
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