- Humana (Albuquerque, NM)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and… more
- Health Care Service Corporation (Albuquerque, NM)
- …on schedule + Healthcare acumen, Managed Care Organization, Pharmacy Benefit Manager , Medicare experience + Advanced analytical skills, databases ... driving delivery, contingency planning, business results, and strategic planning for Medicare Part D Pharmacy consisting of multiple programs, complex projects, and… more
- Molina Healthcare (NM)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key… more
- CenterWell (Santa Fe, NM)
- …part of our caring community and help us put health first** The Manager of Pre-Bill Audit provides strategic leadership and operational oversight for the ... in unbilled rates, revenue cycle performance, and compliance. The Manager leads a team of Pre-Bill Specialists, partners with... leads a team of Pre-Bill Specialists, partners with senior leadership, and champions initiatives that enable scale and… more
- CenterWell (Santa Fe, NM)
- …from 7am-3:30pm EST.** + **Required to work every other holiday.** The **Care Manager , Telephonic Nurse** helps to ensure optimal continuity of care for patients ... appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a… more
- CenterWell (Santa Fe, NM)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CenterWell (Santa Fe, NM)
- …CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group will provide ... , a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group...the state. . Graduate of accredited MD or DO program of accredited university . Board certification or eligible… more
- CenterWell (Santa Fe, NM)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel:… more
- CenterWell (Santa Fe, NM)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more
- Datavant (Santa Fe, NM)
- …to improve productivity and quality.** + Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and return on ... for analysis and assumptions to provide data-driven insights into program performance and partnerships + Create clear and concise...train other junior analysts in support of their direct manager What you will bring to the table: +… more
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- OhioHealth (Columbus, OH)