- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements: The physical requirements described ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and... MAP Advisor- Will promote and sale MAP and Medicare Line of Business, maintains relationships, services our existing… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will manage the ... and regulatory changes, market dynamic forces, and new competitive threats around Medicare revenue and risk adjustment + Assess new proposals or regulatory positions… more
- Molina Healthcare (Des Moines, IA)
- …Summary** Responsible for leading, organizing and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with ... the standards and requirements established by the Centers for Medicare and Medicaid. **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of… more
- Molina Healthcare (St. Petersburg, FL)
- …Summary** Responsible for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible for reviewing and ... accordance with the standards and requirements established by the Centers for Medicare and Medicaid. This position will provide direct support to the implementation… more
- Molina Healthcare (Albany, NY)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (NY)
- …experience of 5 years or more + 5 years of experience in Medicare , DSNP and CSNP population, Enrollment, A&G, Claims, Compliance, or other Operations experience ... To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …healthcare? Bring your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics, the Associate Director ... for developing and executing the analytic plan for the Medicare and Merged Market segments. The Associate Director... Medicare and Merged Market segments. The Associate Director of Risk Adjustment Data and Analytics will oversee… more
- Humana (Little Rock, AR)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Centene Corporation (Raleigh, NC)
- …management of department overseeing compliance with regulations and laws related to Medicare line of business, which includes implementation of elements of an ... process for overseeing compliance with regulations and laws related to Medicare requirements + Provides guidance to various business departments regarding compliance… more
- AdventHealth (Hendersonville, NC)
- …compliance with external accreditation standards, state and federal laws and Medicare conditions of Participation. The Director ensures administrative interface ... shops, art galleries and unique restaurants The role you'll contribute: The Director manages the functions required to support the market-wide medical staff… more