- Fallon Health (Webster, 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 creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with… more
- ChenMed (Houston, TX)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... be America's leading primary care provider , transforming care of the neediest population. Our mission...goals, and when leading their care team towards their performance goals. + **Leadership** : Lead center Super Huddle… more
- CenterWell (Port Orange, FL)
- …of two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... coordinated care environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality indicators .… more
- CenterWell (Austin, TX)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage / Medicare /Medicaid Experience a plus + Current nursing ... plan. This incentive opportunity is based upon company and/or individual performance . **Description of Benefits** Humana, Inc. and its affiliated subsidiaries… more
- CareFirst (Baltimore, MD)
- …strategy. The role serves as a dedicated resource within the organization for Medicare Advantage , Medicaid and ACA markets, coordinating and leading the end ... as HHS, CMS, States, BCBSA, etc. to drive necessary regulatory improvements. + Provide support, education and training to staff to build risk awareness within the… more
- TEKsystems (Chicago, IL)
- …Final rate may adjust slightly based on interview evaluation Training & Performance Expectations + 2‑week systems training (not underwriting fundamentals) + Must ... (80%+) to continue + First 90 days include high‑volume practice, QC scorecards, and performance feedback + Expected to underwrite a loan under 2 hours with 97%… more
- TEKsystems (Philadelphia, PA)
- …peak periods. + Breaks and lunches per state regulations. Training & Performance + Two-week training on proprietary platform (not underwriting training). + Exit ... exam required (80% or better). + Ongoing performance measured by loan quality and turnaround time. Education...accident, hospital indemnity, and/or critical illness supplement insurance * Medicare - free online resources for anyone who is… more
- TEKsystems (Boston, MA)
- …peak periods. + Breaks and lunches per state regulations. Training & Performance + Two-week training on proprietary platform (not underwriting training). + Exit ... exam required (80% or better). + Ongoing performance measured by loan quality and turnaround time. Education...accident, hospital indemnity, and/or critical illness supplement insurance * Medicare - free online resources for anyone who is… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …+ Legal Department: + Medical Directors + Member Appeals Grievance Programs (Commercial, Medicare Advantage , and InterPlan Program) + Physician Review Units + ... is responsible for monitoring the quality of the credentialed practitioner/ organizational provider networks ensuring our members receive the highest quality of care… more
- Caris Life Sciences (Irving, TX)
- …Billing to support a seamless patient and provider experience. + Provide regular reporting and analysis of eligibility performance , including KPIs, denial ... cross-functional initiatives and manage timelines, resources, and deliverables. + Experience with Medicare Advantage plans and familiarity with Xifin is a plus.… more