- CenterWell (Nashville, TN)
- …Direct experience working with Homecare Homebase strongly preferred. * Experience supporting Medicare , Medicare Advantage , Medicaid, and commercial payers. * ... large-scale transformation initiatives including centralization, workflow redesign, automation, and performance standardization. * Establish governance, escalation paths, and … more
- Bluestone Physician Services (Stillwater, MN)
- …Knowledge/Skills/Abilities + Demonstrated experience working across: + Health plans (especially Medicare Advantage ) + Providers and provider organizations ... social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone… more
- Humana (Greenwood, IN)
- …other care team staff to address the member's identified needs + Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers ... and benefits of members who are also eligible for Medicare . + Primary point of contact for the Interdisciplinary...used only if approved by leadership. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …data analysis. This roleleveragesdeepexpertiseinRiskAdjustment and healthcare data-primarily Medicare Advantage , Medicaid, and ACA Commercial-identifyingtrends ... have experience inRiskAdjustment methodologies, clinical coding, and healthcare programs ( Medicare Advantage , Medicaid, ACA Commercial), as well asproficiencyin… more
- CVS Health (Hartford, CT)
- …Sponsor Liaison [PSL] will serve as the Single Point of Contact for Aetna Medicare Advantage servicing to our Plan Sponsors human resources personnel [their ... administration matters as the single point of contact to provide swift resolution. + Develops complex customer service account...of Hartford, Connecticut** + 3 years experience in Group Medicare Business and Medicare Advantage … more
- CenterWell (Clarksville, IN)
- …administrators. Nearly 250,000 total patients served in 2022, including those in Medicare Advantage , value-based arrangements or other Medicare programs. ... health and pharmacy. Launched in spring 2021, CenterWell creates experiences that provide patients with ease, comprehensive care and a personal approach. By placing… more
- WTW (Philadelphia, PA)
- …health plans; and (ii) assist retirees in enrolling in individual health products, such as Medicare Advantage , Medicare Supplement, Medicare Part D and ... to join the WTW legal team. The candidate will provide general legal advice and contracting support, primarily to...may also have knowledge of ERISA, state insurance laws, Medicare , and/or experience in the employee benefits or health… more
- Presbyterian Homes and Services (Roseville, MN)
- …knowledge of regulatory compliance in the field. * Knowledge of reimbursement under Medicare , Medicare Advantage , commercial payers, and private duty. * ... for all operations, licensure compliance, survey readiness, and regulatory reporting. * Provide direct oversight of daily operations for Home Health, outpatient, and… more
- CenterWell (Anderson, SC)
- …be required to be screened for TB. **Preferred Qualifications** + Experience managing Medicare Advantage panels of patients with understanding of best practice ... moderate to substantial. **Overview:** We are a value-based care provider focused on quality of care for the patients...our team-based care environment. Our approach allows us to provide an unmatched experience for seniors. Our model is… more
- Integra Partners (Troy, MI)
- …plan medical director + Experience with DMEPOS UM programs, MLTC, Medicaid, or Medicare Advantage + Experience chairing or participating in UM, Credentialing, or ... include but are not limited to: Clinical Leadership & Oversight + Provide day-to-day clinical leadership and oversight to the Utilization Review Medical Director(s)… more