- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... and CPT (II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications, required + Six or more… more
- 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
- Trinity Health (Farmington Hills, MI)
- …**POSITION PURPOSE** Work Remote Position (Pay Range: $18.8367-$28.2551) Performs the day-to-day billing and follow-up activities within the revenue operations for an ... assigned Patient Business Services (PBS) location. Serves as a member of the billing and follow-up team assigned to a PBS location responsible for billing and follow-up of government and non-government accounts. Provides training and guidance to lower level… more
- 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
- BrightSpring Health Services (Louisville, 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 Seeking a Sales Account Representative/Executive for...and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and… more
- Centene Corporation (Queens, NY)
- …in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). ... Act as a strategic advisor on contract structure and payment methodologies for Medicare Advantage and D-SNP providers, supporting new contract negotiations and… more
- CVS Health (Boston, MA)
- …The ideal candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a ... + Lead the development and execution of actuarial analytics strategies for Medicare Advantage and Part D programs. + Inform and enhance the end-to-end bid… more
- TEKsystems (Rochester, NY)
- …the job - Responsible for maintaining accurate and up-to-date knowledge of all Medicare Advantage regulations and possess the ability to communicate to members ... corporate performance guidelines and standards set forth by the Medicare Division and the Centers for Medicare ...We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …create monthly business review report that displays the key metrics of BCBSMA's Medicare Advantage business + Design and develop metrics, reports, and dashboards ... network analysis We're Looking for : + Experience in Government Programs, Medicare Advantage Preferred + Ability to develop strong working relationships and to… more
- CVS Health (Hartford, CT)
- …FP&A role will be responsible for financial forecasting and analysis within the Medicare Advantage segment. This role will require strong financial modeling ... detail. The Manager will own forecast models, assumptions, and analytics for Medicare Advantage products. They will work cross-functionally with actuarial,… more
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