• Medicare Advantage Quality

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

    Health Care Service Corporation (Tulsa, OK)
    …invest in your professional development. **Job Summary** The Medicare Advantage Bid Optimization Principal Divisional Strategy Consultant will support MA ... This position is responsible for assisting with leading the team with all Medicare Advantage short-term and multi-year planning, assisting the leadership team on… more
    Health Care Service Corporation (10/16/25)
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  • Senior Nurse STARS Improvement Consultant

    Humana (Oviedo, FL)
    …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... contributes to the development, implementation, and management of the company's Medicare /Medicaid Five-Star Quality Rating System. The Senior Stars Improvement,… more
    Humana (10/03/25)
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  • Quality & Risk Adjustment Provider…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00 ... Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location:...Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer… more
    Blue Cross and Blue Shield of Minnesota (09/30/25)
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  • Prin Div Strategy Consultant

    Health Care Service Corporation (Chicago, IL)
    …**Preferred Job Qualifications:** + Health insurance or healthcare industry experience supporting Medicare Advantage + Knowledge of Medicare Advantage ... the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network… more
    Health Care Service Corporation (10/08/25)
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  • Risk Adjustment QA Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment. * Certified Risk Adjustment Coder (CRC) ... The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll...certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Market CMO, Centerwell Senior Primary Care…

    CenterWell (Phoenix, AZ)
    …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
    CenterWell (10/24/25)
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  • Primary Care Physician Lead

    CenterWell (Atlanta, GA)
    …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
    CenterWell (10/22/25)
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  • Primary Care Physician

    ChenMed (Louisville, KY)
    …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
    ChenMed (10/24/25)
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  • Primary Care Physician - Miami Dade County Various…

    ChenMed (Miami, FL)
    …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
    ChenMed (09/26/25)
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