- UCLA Health (Los Angeles, CA)
- Description We're seeking a strategic Senior Product Manager to lead the design, development, and implementation of our Medicare Advantage products. In this ... role, you'll partner with the Director of Medicare Product Development and Bids to guide the annual...meet CMS requirements and organizational goals. + Collaborate with actuarial , compliance, operations, and other key teams. + Translate… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does not ... manage people + This role reports to this job: MANAGER , PROVIDER REIMBURSEMENT + Necessary Contacts: In order to effectively fulfill this position the incumbent must… more
- Point32Health (Canton, MA)
- …Medicaid, Duals and or Commercial small and individual group market membership. The Manager will collaborate with Actuarial and analytical teams within the ... complete and accurate capture of risk adjustment data. To be successful, the Manager will need to rely on strong analytic, consultative and communication skills to… more
- Travelers Insurance Company (Irvine, CA)
- …Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where Wage ... to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions.… more
- Point32Health (Canton, MA)
- …products serving under and over 65 members in Massachusetts ("One Care", and " Senior Care Options"). The Performance Manager leads Duals Products performance key ... are at Point32Health (https://www.point32health.org/) . **Job Summary** The Performance Manager (Product Strategy) is responsible for supporting product strategy… more
- Banner Health (Phoenix, AZ)
- **Primary City/State:** Phoenix, Arizona **Department Name:** Actuarial -BHN Cntr **Work Shift:** Day **Job Category:** General Operations Help lead health care into ... Insurance Operations CFO and is responsible for overseeing all healthcare related actuarial and healthcare economics needs. This role will partner with other… more
- Travelers Insurance Company (Richmond, VA)
- …Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where Wage ... to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions.… more
- AbbVie (Mettawa, IL)
- …channels of pharmaceutical businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. This role requires collaboration with stakeholders ... pipeline products. Key Job Responsibilities Responsible for working with hiring manager to perform payer contract analysis, communicate results/ recommendations from… more
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