• Medicare Compliance Manager

    Molina Healthcare (ID)
    **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
    Molina Healthcare (07/25/25)
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  • Senior Manager , Medicare Sales…

    Humana (Des Plaines, IL)
    …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales motivates and drives a team of Medicare ... and train a team of sales individuals. The Senior Manager , Medicare Sales must have a solid...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (07/31/25)
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  • Quality Program Manager - Medicare

    Providence (WA)
    **Description** **Quality Program Manager - Medicare Advantage Stars** **The Quality Program Manager - Medicare Advantage Stars is tasked with serving as ... strategies that result in improved Star ratings.** **The Stars Quality Program Manager will:** + Develop and implement strategies to improve Medicare more
    Providence (07/19/25)
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  • Medicare Broker Relations Manager

    AmeriHealth Caritas (Philadelphia, PA)
    …services. Discover more about us at www.amerihealthcaritas.com. **Role Overview:** The Medicare Broker Relations Manager drives broker channel growth and ... with independent brokers and general agencies, while ensuring full compliance with Centers for Medicare & Medicaid...while ensuring full compliance with Centers for Medicare & Medicaid Services (CMS), state, and internal regulations.… more
    AmeriHealth Caritas (07/31/25)
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  • Medicare Product Development Manager

    Molina Healthcare (Layton, UT)
    …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… more
    Molina Healthcare (07/25/25)
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  • Actuary - Medicare Part D - Evernorth…

    The Cigna Group (Bloomfield, CT)
    This position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This ... Drug or Part D bid development consulting experience preferred + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager (PBM) / Healthcare /… more
    The Cigna Group (08/04/25)
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  • Medicare MAP Advisor

    Centers Plan for Healthy Living (Staten Island, NY)
    …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
    Centers Plan for Healthy Living (07/15/25)
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  • Care Manager Social Worker…

    Beth Israel Lahey Health (Exeter, NH)
    …standards of social work case management practice and reports to the Manager of Care Management **Job Description:** Essential Duties & Responsibilities (including ... -Demonstrates ability to fulfill role in supporting the ACO in regulatory compliance as appropriate. -Practices in accordance with applicable state and federal… more
    Beth Israel Lahey Health (05/30/25)
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  • Senior Medicaid & Medicare Reimbursement…

    OhioHealth (Columbus, OH)
    …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
    OhioHealth (06/07/25)
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  • Regulatory Analyst, Medicare

    Healthfirst (NY)
    …and ad hoc material reviews including assisting the Regulatory Affairs Manager by reviewing, finalizing, submitting, and tracking approvals of material reviews ... in HPMS. + Actively participates in the annual Medicare Go to Market process, including working with internal...review of the website with business owners and ensures compliance with regulatory requirements specific to annual Go to… more
    Healthfirst (06/27/25)
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