• Manager, Provider Engagement - VBP…

    Centene Corporation (Queens, NY)
    …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special ... + Oversee Medicare -specific VBP contracts, focusing on implementation, performance management, and education of provider partners regarding CMS-aligned… more
    Centene Corporation (07/09/25)
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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 ... reports. + Write clear specifications and design data queries for healthcare performance measures. + Apply technical expertise to gather requirements and translate… more
    UCLA Health (06/11/25)
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  • Senior Medicare Markets Pricing Consultant…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …+ Solid understanding of Medicare and its related financial models, including Medicare FFS, Medicare Advantage , Medicare Part D, and ... work collaboratively with both technical and non-technical staff including Underwriting, Medicare Product Development, Provider Contracting, Sales, and others… more
    Blue Cross Blue Shield of Massachusetts (09/05/25)
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  • Behavioral Health Medical Director…

    Humana (Concord, NH)
    …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid products, or other Medical… more
    Humana (08/09/25)
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  • Medical Director - National Medicare

    Humana (Carson City, NV)
    …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... radiology, and genetics.** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid. + Utilization management experience in… more
    Humana (09/04/25)
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  • Medicare Seasonal Associate - Processor

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …us transform healthcare? Bring your true colors to blue. Job Title: Medicare Advantage Enrollment Seasonal Associate Department: Medicare ... any other characteristics protected by law. Position Summary: The Medicare Advantage Enrollment Seasonal Associate will be...and willingness to adapt to changing business needs + Provide outstanding level of service to both internal and… more
    Blue Cross Blue Shield of Massachusetts (09/05/25)
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  • Un-Licensed Medicare Telesales Supervisor-…

    BroadPath Healthcare Solutions (Kapolei, HI)
    …lead a high-performing team of licensed sales agents who help consumers enroll in Medicare Advantage and Prescription Drug Plans. This is your chance to step ... levels are consistently met + Evaluate agent calls and provide coaching with clear performance documentation ....1+ year of recent **healthcare experience** , preferably in Medicare Advantage + Active **Health Producer License… more
    BroadPath Healthcare Solutions (08/14/25)
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  • Lead Sector Consultant Medicare Sales…

    Henry Ford Health System (Troy, MI)
    …and planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for ... GENERAL SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting for more than $400 million in… more
    Henry Ford Health System (08/27/25)
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  • Consulting Actuary - Medicare Risk…

    BlueCross BlueShield of North Carolina (NC)
    …at least 9 years of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + The ... lead initiatives that directly impact patient outcomes and business performance -whether it's designing innovative insurance products, optimizing pricing strategies,… more
    BlueCross BlueShield of North Carolina (09/05/25)
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  • Provider Engagement Professional

    Humana (Indianapolis, IN)
    performance , operational improvements and other areas as they relate to provider performance , member experience, market growth, provider experience and ... Medicare policies, processes and procedures + DSNP experience inclusive of Medicare Advantage + Long-term support services; experience working with or… more
    Humana (08/22/25)
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