• Medicare Advantage Quality…

    Highmark Health (Charleston, WV)
    …are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess the needs… more
    Highmark Health (09/22/25)
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  • Lead Director; Actuarial - Medicare

    CVS Health (Blue Bell, PA)
    …in this role will serve as the subject matter expert for Aetna's Medicare Advantage Special Needs Plans (SNP) business. Includes Dual Eligible, HIDE/FIDE ... Chronic plans. The SNP population presents a huge growth opportunity for Medicare Advantage plans, and Aetna is aggressively expanding into this market. This… more
    CVS Health (10/22/25)
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  • Manager, Healthcare Partnerships - Medicare

    Mom's Meals (Ankeny, IA)
    Position SummaryThe Manager of Healthcare Partnerships will drive Medicare Advantage channel growth through continued development of relationships at Medicare ... home health, home care, hospital or medical equipment + Knowledge of Medicaid/ Medicare benefit programs + Demonstrated experience consulting and presenting to care… more
    Mom's Meals (10/23/25)
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  • Senior Fraud Investigations Analyst…

    BlueCross BlueShield of North Carolina (NC)
    …of degree, 7+ years of experience in related field **Bonus Points** + Deep Medicare and/or Medicare Advantage regulatory experience + Extensive Medicare ... / Medicare Advantage investigative experience **What You'll Get​** + The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community + Work-life balance, flexibility, and the autonomy to do great… more
    BlueCross BlueShield of North Carolina (10/14/25)
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  • Behavioral Health Case Manager - Medicare

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …and Blue Shield of Minnesota Position Title: Behavioral Health Case Manager - Medicare Advantage Location: Remote Career Area: Health Services About Blue Cross ... and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare.… more
    Blue Cross and Blue Shield of Minnesota (09/30/25)
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  • Medicare Advantage Risk Adjustment…

    UCLA Health (Los Angeles, CA)
    Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... department measurements used in both internal and external reporting. You will: + Ensure data quality and accuracy through rigorous assurance checks. + Develop and maintain reports, from ad hoc requests to scheduled production reports. + Write clear… more
    UCLA Health (09/10/25)
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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 ... of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and Medicare Supplement products. Reporting directly to the Chief… more
    Medical Mutual of Ohio (09/23/25)
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  • Medicare MAP Advisor

    Centers Plan for Healthy Living (Staten Island, NY)
    …throughout the five (5) boroughs. Territory Management + Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple ... equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan. Enrollment application process + Ensures prospective members are… more
    Centers Plan for Healthy Living (10/14/25)
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  • Medicare Sales Account Representative

    BrightSpring Health Services (Lexington, KY)
    …Business Signature Advantage , an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare ... Our Company Signature Advantage Overview *Signature Advantage is becoming...and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and… more
    BrightSpring Health Services (10/01/25)
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  • Account Representative, Medicare

    Molina Healthcare (Manhattan, NY)
    …for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved ... product features and differences. + Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment… more
    Molina Healthcare (10/18/25)
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