- Molina Healthcare (ID)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- Humana (Des Plaines, IL)
- …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales motivates and drives a team of Medicare ... and train a team of sales individuals. The Senior Manager , Medicare Sales must have a solid...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- The Cigna Group (Bloomfield, CT)
- This position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This ... Drug or Part D bid development consulting experience preferred + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager (PBM) / Healthcare /… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Providence (WA)
- **Description** **Quality Program Manager - Medicare Advantage Stars** **The Quality Program Manager - Medicare Advantage Stars is tasked with serving as ... strategies that result in improved Star ratings.** **The Stars Quality Program Manager will:** + Develop and implement strategies to improve Medicare … more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Molina Healthcare (Layton, UT)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… more
- Healthfirst (NY)
- …and ad hoc material reviews including assisting the Regulatory Affairs Manager by reviewing, finalizing, submitting, and tracking approvals of material reviews ... in HPMS. + Actively participates in the annual Medicare Go to Market process, including working with internal...review of the website with business owners and ensures compliance with regulatory requirements specific to annual Go to… more
- Fallon Health (Springfield, MA)
- …in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more
- RVO Health (New York, NY)
- **AT A GLANCE** RVO Health is looking for a Senior Product Manager - Medicare to play a key role in shaping innovative multi-channel customer journeys and ... and agent experiences while meeting business goals. + Collaborate with business, compliance , data, and design teams to ensure alignment on voice experiences strategy… more
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