- CVS Health (Boston, MA)
- …convenient and affordable. **Job Description Summary** The primary responsibility of the Medicare Part B Operations Coordinator is to support activities related ... claims to Third Party Insurers. **Position Summary:** As a Medicare Part B Operations Coordinator, you will...**Required Qualifications:** + 1+ years (retail pharmacy, PBM, account management ) + 1+ years of professional MS Office experience… more
- The Cigna Group (Bloomfield, CT)
- …+ Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for ... regular trainings and other collaborative meetings as appropriate. + Works with management team to achieve operational objectives and financial goals. + Supports… more
- Medical Mutual of Ohio (OH)
- …I** Working under general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and ... II** Working under general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and… more
- Highmark Health (Harrisburg, PA)
- …set by the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and...management **Preferred** + 7 years in a government program setting, managed care, primary care management … more
- Centene Corporation (Cheyenne, WY)
- …experience. Master's degree preferred. + 5+ years project implementation, product or program management experience. + Medicare Supplement Benefits (Dental, ... objectives + Provide functional and technical knowledge regarding overall program requirements and operations **Education/Experience:** + Bachelor's degree… more
- USAA (Tampa, FL)
- …that will support Medicare Supplement Claims for USAA Life Company Claims Operations . This employee will report to the Life Company Chief Claims & Fraud Officer ... implementation of business processes. This role will involve execution of any Issue Management matters for Medicare Supplement claim issues. As business process… more
- Providence (OR)
- …Registered Nurse License in Washington State + Medicare : Insurance business operations experience + Case Management Experience (EX. Triage and Referral, ... empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare who will:** +...and or chronic conditions + Provide care coordination, case management and care management services to Providence… more
- Elevance Health (Atlanta, GA)
- …required. **Preferred Skills, Capabilities and Experiences** + Knowledge and understanding of Medicare rules and regulations for program areas including but not ... design, develop and lead activities to ensure an effective Compliance program . + Oversees programs for multiple departments/functions with numerous stakeholders and… more
- The Cigna Group (Bloomfield, CT)
- …the analytics strategy for Cigna Healthcare, performing research and analysis within the Medicare Stars program with a focus on HEDIS Stars measures. This ... reporting and dashboards focusing on HEDIS measures within the Medicare Stars program using a broad array...accuracy + Work experience as a Data Analyst in Medicare Stars, specifically in operations and reporting… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- … Part D and/or EGWP programs.** **Scope of Responsibilities:** Provides oversight and management of Medicare Part D/EGWP program . **Job Summary:** The ... and payment, reconciliation, and quality control. Coordination with Plan Sponsor to ensure program is compliant with Medicare Part D standards and consistent… more