• Senior Manager, MarketPoint Sales

    Humana (Chicago, IL)
    …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/29/25)
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  • AVP, Clinical Stars & Quality Improvement (Remote)

    Molina Healthcare (Spokane, WA)
    …and compliance to SVP, Clinical Operations and CMO, Enterprise Medicare Unit, + Develops strategic direction for Star Rating improvement through ongoing ... existing healthcare quality improvement initiatives and education programs supporting Medicare Star Ratings improvement for Clinical HEDIS measures. Responsible for… more
    Molina Healthcare (08/28/25)
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  • Medical Director-Payment Integrity

    Humana (Washington, DC)
    …at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will understand… more
    Humana (09/26/25)
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  • Medical Director - Claims Management

    Humana (Denver, CO)
    …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage, and Medicaid requirements and will understand… more
    Humana (09/17/25)
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  • Licensed Practical Nurse, Home Care

    Eastern Connecticut Health Network (Vernon, CT)
    …Provides intermittent skilled nursing service to patients and their families in compliance with state and Medicare regulations, incorporating the following: a) ... appropriate supervision. e) Projects professional image through attitude and compliance with dress code. f) Functions as a team...g) Maintains CPR certification. h) Adheres to Agency Corporate Compliance Plan and HIPAA Privacy Plan as per written… more
    Eastern Connecticut Health Network (09/18/25)
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  • Master Data Management Configurator

    Medical Mutual of Ohio (Brooklyn, OH)
    …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Master ... with the established polices & procedures of the Data Governance Office (DGO), Compliance , Legal and Security departments to meet business needs. The MDM Analyst… more
    Medical Mutual of Ohio (08/02/25)
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  • Admission RN Hospice

    Tufts Medicine (Lowell, MA)
    …indicatean appropriate hospice referral. Presents the advantage of the hospice Medicare /Medicaid benefits to referral sources. + Thoroughly understands the ... Medicare /Medicaid hospice benefit, the Medicare home health...services. Includes activities during National Hospice Month. + Reports Compliance concerns to the CEO or Chief Compliance more
    Tufts Medicine (09/27/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Supports corporate and ... lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment… more
    Medical Mutual of Ohio (08/16/25)
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  • Product Management Senior Advisor - Express…

    The Cigna Group (St. Louis, MO)
    **Product Management Senior Advisor - Medicare Solutions, Express Scripts** **Description of Position:** + The Product Management Senior Advisor provides leadership ... will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide… more
    The Cigna Group (07/23/25)
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  • Program Delivery Lead: Stars Quality Provider…

    Humana (Lansing, MI)
    …performance improvement for healthcare outcomes and patient experience within our Medicare population. This role will lead execution of tactics, collaborative ... of programs and their impact to results on the Medicare Health Outcomes Survey and patient experience. This role...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (09/27/25)
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