- Henry Ford Health System (Rochester Hills, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... Join Henry Ford Health Pharmacy Advantage team as a...+ Excellent computer skills including Microsoft Office and database management . + Excellent written/verbal communication, networking, and interpersonal skills.… more
- CVS Health (Blue Bell, PA)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...serve as the subject matter expert for Aetna's Medicare Advantage Special Needs Plans (SNP) business. Includes Dual Eligible,… more
- Highmark Health (Buffalo, NY)
- …Six Sigma, TQI, TQC or other quality management certification + Experience in health plan provider network performance management , population health ... Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant...of user interfaces, predicative analytic tools, and other population health management tools endorsed by Highmark. +… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Behavioral Health Case Manager - Medicare Advantage Location: Remote Career Area: ... an Equal Opportunity Employer and maintains an Affirmative Action plan , as required by Minnesota law applicable to state...* 1+ years of managed care experience; eg case management / health coach, utilization management and/or… more
- Humana (Concord, NH)
- **Become a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app ... t-SQL), which generates annual pricing of Humana's largest segment of business, individual plan Medicare Advantage . The team consists of actuaries and business… more
- Martin's Point Health Care (Portland, ME)
- …improvement tools + Experience in Health Plan utilization management + Experience in Medicare Advantage and/or TriCare preferred Required License(s) ... other plan functions that interface with Medical Management such as Health Management ,...management and strategic deployment. + Provides support to Health Plan risk adjustment activities as needed.… more
- UCLA Health (Los Angeles, CA)
- Description Step into a vital role at New Century Health Plan and coordinate the care for our Medicare Advantage members. As a Clinical Social Worker, you ... safety risks and prioritize interventions + Proficiency in electronic health records (EHR) and care management software...one year of experience in a managed care or health plan setting, preferred + Minimum of… more
- Sanford Health (Sioux Falls, SD)
- …related field required. Master's degree preferred. Minimum of 7 years of experience in health plan appeals and grievances, regulatory oversight, or health ... a drug screen and pre-employment background screening as a condition of employment. **Req Number:** R-0237044 **Job Function:** Health Plan **Featured:** No more
- Highmark Health (Pittsburgh, PA)
- …Medicare Advantage bids * Experience managing vendor relationships for health -related services * Experience analyzing Medicare Advantage insurance product ... and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan , organize, staff, direct and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... vs manual processing + Providing information to the quality management leadership team regarding need for group and/or individual...General Knowledge of HIPAA Confidentiality Laws About At Brighton Health Plan Solutions, LLC, our people are… more
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