• Specialist , Medicare Member

    Molina Healthcare (Bellevue, WA)
    …issues or questions. + Log all contacts in a database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being ... **Job Description** **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member more
    Molina Healthcare (09/28/25)
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  • Medicare /Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider … more
    Commonwealth Care Alliance (08/31/25)
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  • Member Engagement Specialist

    Wider Circle (Southmont, NC)
    …and disadvantaged communities. Job Overview: Wider Circle is seeking a passionate and dedicated Member Engagement Lead to play a vital role in our groundbreaking ... group events, home visits, and telephone outreach. As a Member Engagement Lead, they will be seen...video conferencing. + A genuine interest in working with Medicare /DSNP/Medicaid populations and a commitment to building strong, supportive… more
    Wider Circle (09/22/25)
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  • Provider Engagement Specialist

    Lumeris (NH)
    …its people and empowers you to make an impact. **Position:** Provider Engagement Specialist **Position Summary:** Responsible for improving Accountable Care Team ... (Provider) engagement . Establishes significant "mindshare" within our Accountable Care Team...subject matter expertise in any of the following areas: Medicare advantage, Medicare Shared Savings Program (MSSP),… more
    Lumeris (09/25/25)
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  • CISC Member , Caregiver and Stakeholder…

    Magellan Health Services (Albuquerque, NM)
    …Presents the program and offerings in group settings. Consistently achieves member engagement strategies while meeting quality performance standards. + ... with individuals with adverse childhood experiences. General Job Information Title CISC Member , Caregiver and Stakeholder Engagement Manager Grade 23 Work… more
    Magellan Health Services (09/18/25)
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  • Community Resource Center Specialist III

    LA Care Health Plan (Los Angeles, CA)
    …data to inform management with an integrated approach to outreach activities and targeted member engagement . Plan, develop, analyze and implement member and ... Community Resource Center Specialist III Job Category: Customer Service Department: Community...instructors. The role leads community and provider outreach and engagement initiatives to increase member traffic at… more
    LA Care Health Plan (09/09/25)
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  • Sr Utilization Review Specialist Nurse

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating appropriate length of… more
    Houston Methodist (08/26/25)
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  • Care Management Specialist II

    LA Care Health Plan (Los Angeles, CA)
    Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12405 ... safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of… more
    LA Care Health Plan (09/06/25)
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  • US Payer Advocacy and Market Access Principal…

    Medtronic (Minneapolis, MN)
    …supports engagement with commercial payers, managed care organizations, and Medicare Advantage plans. Additionally, this role requires experience and skill in ... seeking a US Payer Advocacy and Market Access Principal Specialist , a role responsible for driving patient and market...is responsible for executing our market access strategies through engagement and support of clinical stakeholders and other key… more
    Medtronic (09/27/25)
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  • ENT Specialist

    Novant Health (Salisbury, NC)
    …+ Our team members are part of an environment that fosters team work, team member engagement and community involvement. + The successful team member has ... cost of Medicare and Medicaid). In 2022, Novant Health community engagement contributed more than $1.9 million in charitable contributions to community partners… more
    Novant Health (07/19/25)
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