• Medicare Risk Adjustment Strategy Program…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …or equivalent work experience. + 6-8 years of relevant experience, preferably in health insurance + Medicare Advantage and Prescription Drug Plan experience ... considerations and recommendations We're Looking for : + Excellent knowledge of Medicare Advantage risk adjustment programs and industry trends + Knowledge… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Medical Director - National Medicare

    Humana (Olympia, WA)
    …experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance . + Experience with ... internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand… more
    Humana (07/21/25)
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  • Sex Therapist - Baptist Women's Wellness Clinic…

    Ochsner Health (New Orleans, LA)
    …managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Proficiency in using ... public programs such as those funded by Medicare , Medicaid, Medicare Advantage and commercial insurance plans. + Excellent psychotherapeutic skills. +… more
    Ochsner Health (07/30/25)
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  • Account Representative Medicare

    CNO Financial Group (Carmel, IN)
    …and location. This position is bonus eligible.** The Account Representative - Medicare Advantage Account Representatives is responsible for working with internal ... and external team members in managing our Medicare Advantage carrier relationships and distribution of...+ 3 years of experience in account management. + Insurance Industry Certification desired and will be required. **What… more
    CNO Financial Group (07/29/25)
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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 ... Quality Program Manager will:** + Develop and implement strategies to improve Medicare Advantage Star Ratings, driving clinical quality indicators (HEDIS Star… more
    Providence (07/19/25)
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  • Clinical Coordinator

    WMCHealth (Warwick, NY)
    …+ Obtain Pre-Admission Authorizations and continued stay authorizations with Medicare , Medicare Advantage , Medicaid, and Insurance Programs. + Maintain ... other providers, regulatory agencies, billing agencies, and auditing agencies including Medicare , Medicaid, and third-party billers. + Scans, uploads, and files… more
    WMCHealth (06/30/25)
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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 ... care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We're committed to better health and better health… more
    BlueCross BlueShield of North Carolina (07/25/25)
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  • Billing and Follow-Up Representative-II (Hospital…

    Trinity Health (Farmington Hills, MI)
    …clarify billing discrepancies, and obtain demographic, clinical, financial, and insurance information. Performs all follow-up functions which includes the ... and systems working within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting,… more
    Trinity Health (07/18/25)
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  • Customer Service Performance Manager

    WTW (Charlotte, NC)
    …direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage , Medicare Supplement and Life & Supplemental ... telemarketing or call center settings. + Knowledge of Medicare Advantage , Medicare Supplement, Life Insurance , Prescription Drug Products and Services.… more
    WTW (07/09/25)
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  • Social Worker LMSW - Ochsner Medical Center West…

    Ochsner Health (Gretna, LA)
    …systems and public programs such as those funded by Medicare , Medicaid, Medicare Advantage , and commercial insurance plans. + Strong interpersonal skills ... necessary to deal effectively and courteously with patients, families, multidisciplinary team members, departmental peers, and community agency personnel. **Job Duties** + Conducts patient assessment interviews, provides referrals and coordinates discharge… more
    Ochsner Health (07/30/25)
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