- US Tech Solutions (May, OK)
- …or Pharmacy Benefits Manager (PBM) **Skills:** + MUST HAVE MANAGED CARE exp and Medicare / Medicaid knowledge. + MUST HAVE 6 months of experienced with Prior ... Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. **Education:** + Pharm D. required… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The ... Responsibilities: + Educate prospects on CPHL MAP product designed for Full Medicaid and Medicare recipients that need in home care and Long-term care services,… more
- Medical Mutual of Ohio (OH)
- …and submits compliance reports to regulatory agencies including the Centers for Medicare and Medicaid Services + Plans, coordinates, and/or oversees auditing, ... and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. This position is responsible for… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …years of healthcare experience, with at least 2 years working on Center for Medicare and Medicaid (CMS) Stars programs, National Committee for Quality Assurance ... member of the Government Programs Star Performance team, the Medicare Stars Analyst provides ongoing analytic support to the...in class 5-star strategy. In collaboration with the VP, Medicare Stars, this person will work with key stakeholders… more
- Molina Healthcare (Dayton, OH)
- …documents. + Lead regularly scheduled business meetings. + Interpret and analyze Medicare and Medicaid communications. + Review and interpret internal dashboards ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a… more
- McLaren Health Care (Flint, MI)
- …our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy ... We are looking for a Quality Administrator Medicare , to join us in leading our organization...strategizing, and improving quality performance with a focus on Medicare Star ratings. This position supports the design, development,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and ... benefit plans and strong knowledge of government program contracts ( Medicare and Medicaid ) and benefits, preferred. + Strong written and verbal communication… more
- Erickson Living (Tinton Falls, NJ)
- …residents of our communities, has earned 5 out of 5 stars from the Centers for Medicare and Medicaid Services, for 6 consecutive years. This role is 32 hours per ... Village by Erickson Senior Living We are hiring a Medicare Sales Agent, also known as our Health Insurance...of all applicable CMS regulations and guidelines of specific Medicare Advantage Plans. + Create sales events intended to… more
- Elevance Health (Indianapolis, IN)
- …and Experiences** : + Experience in the HMO/healthcare field, working knowledge of Medicaid and/or Medicare programs; specific Medicaid experience preferred. ... ** Medicaid Contract Implementation Management Director** **Location** : Indianapolis,...an accommodation is granted as required by law._ The ** Medicaid Contract Implementation Management Director** is responsible for managing… more
- Accura Healthcare (Omaha, NE)
- …laws and regulations pertaining to the position. QUALIFICATIONS: + Knowledge of Medicaid , Medicare , and insurance reimbursement systems, including billing forms ... and Nebraska will be considered. Accura HealthCare has an opportunity to invite a Medicaid Billing Specialist - Lead to join our growing accounting and finance team!… more