- CareFirst (Baltimore, MD)
- …government programs including Maryland Medicaid, Dual Prime Special Needs Plan (DSNP), and Medicare Advantage products. This role has oversight of pharmacy staff ... and CMS. Oversee the creation and maintenance of the website contents, member/ provider /internal communications in accordance with NCQA, Medicare , and MDH… more
- Humana (Washington, DC)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Raleigh, NC)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage , and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Jefferson City, MO)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
- Humana (Frankfort, KY)
- … and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures ... and advancing the care experience of our members and provider partners through quality solutions. HQS is committed to...+ Bachelor's Degree + 8+ years of experience in Medicare Advantage quality, Stars and/or member experience… more
- Humana (Washington, DC)
- …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 ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, and identifying improvement opportunities for a key… more
- Humana (Washington, DC)
- … and Medicaid's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Manager, you will deconstruct issues ... Humana's businesses. The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana's largest, which comprises over 80% of the… more
- CenterWell (Las Vegas, NV)
- …to be screened for TB **Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of ... two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in… more
- Highmark Health (Pittsburgh, PA)
- …Federal Segments - Individual, ACA and Senior Markets, Group and Direct Pay Medicare Advantage , Direct Pay Medicare Supplemental and Prescription Drug ... in multiple geographic regions, partnering closely with Market Executives to develop provider partner strategies and provide leadership and vision in the… more
- Humana (Charleston, WV)
- …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