• Director of Home Health Authorizations,…

    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
    CenterWell (01/08/26)
    - Related Jobs
  • Director, Growth Strategy - Value Based Care

    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
    Bluestone Physician Services (12/24/25)
    - Related Jobs
  • Care Coordinator, RN Field Based

    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
    Humana (12/12/25)
    - Related Jobs
  • Principal Risk Adjustment Healthcare Analyst

    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
    Blue Cross and Blue Shield of Minnesota (12/22/25)
    - Related Jobs
  • Senior Analyst, Plan Sponsor

    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
    CVS Health (12/06/25)
    - Related Jobs
  • Medical Assistant

    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
    CenterWell (11/25/25)
    - Related Jobs
  • Counsel

    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
    WTW (01/03/26)
    - Related Jobs
  • Home Health Operations Director

    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
    Presbyterian Homes and Services (12/30/25)
    - Related Jobs
  • Paneled Nurse Practitioner

    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
    CenterWell (12/31/25)
    - Related Jobs
  • Senior Utilization Review Medical Director

    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
    Integra Partners (12/03/25)
    - Related Jobs