• VP Government Programs - Medicare & Managed…

    Prime Therapeutics (Frankfort, KY)
    …every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government ... Programs - Medicare & Managed Medicaid is responsible for the development,...of strategic plans that advance Prime's position in the Medicare space. This position has accountability for the … more
    Prime Therapeutics (01/07/26)
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  • Manager, Medicare Compliance

    Medical Mutual of Ohio (OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. This position is ... responsible for leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and … more
    Medical Mutual of Ohio (12/23/25)
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  • Sr. Medicare (PPS) Provider Hospital…

    Humana (Boise, ID)
    …a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer ... Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team continue to… more
    Humana (12/19/25)
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  • Medicare Part D Formulary Manager…

    Excellus BlueCross BlueShield (Rochester, NY)
    …pharmacist clinician is a program manager, who is responsible for all Medicare Part D formulary creation and submissions, which includes utilization management ... for the current and upcoming contract years. This individual creates and executes the Medicare Part D formulary, delivering value and quality to the Plan's Part D… more
    Excellus BlueCross BlueShield (12/09/25)
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  • Medicare Advantage Quality Consultant

    Highmark Health (Buffalo, NY)
    …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
    Highmark Health (11/06/25)
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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, ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and...Medicaid Services (CMS) and company policies and regulations. The Medicare MAP advisor will develop a presence in the… more
    Centers Plan for Healthy Living (10/14/25)
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  • Medicare Sales Field Agent…

    Humana (South Miami, FL)
    …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...**Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental,… more
    Humana (01/02/26)
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  • Senior Manager, Medicare Sales - Chicago…

    Humana (Chicago, IL)
    …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan… more
    Humana (12/30/25)
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  • Medicare Coverage Analyst

    Actalent (New Haven, CT)
    Job Title: Medicare Coverage Analyst Job Description We are seeking a knowledgeable Medicare Coverage Analyst with expertise in a broad range of trials, ... Analysis or managing assignments to third-party vendors, ensuring that all relevant Medicare policies are adhered to and that thorough evaluations are conducted to… more
    Actalent (01/10/26)
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  • AVP, General Manager - Medicare - New…

    CVS Health (Concord, NH)
    …every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in their market, supporting ... of medical costs management, compliance, and revenue integrity efforts for all Medicare Advantage products (inclusive of collaborating with the Employer Group team… more
    CVS Health (12/04/25)
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