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The Medicare Sales Representative ensures that Communicare Medicare Advantage products are the choice for Medicare eligible individuals in their assigned territory. CommuniCare Advantage , a member of CommuniCare Health Services , is currently recruiting an experienced Sales Representative for our Medicare Advantage plan.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. – Senior Care Plus is a Medicare Advantage organization and a stand-alone Prescription Drug Plan with a Medicare contract.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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A demonstrated working knowledge of Local, State & Federal laws and regulations pertaining to health insurance, investigations & legal processes (Commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.
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Must have 3+ years of experience in Medicare/Medicare Advantage along with value based care. Analysis of Medicare Advantage and Accountable Care Organization data primarily.
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Experience in the annual Medicare Advantage bid development process is a plus. Analyze and develop new to market assessments and modeling which includes future Medicare geographic expansion and enhancements / changes to other market segments (Commercial potentially.
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Medicare Risk score projections and Premium estimation. Credit towards emergency childcare. Strong technical programming skills; SQL, R, SAS, Python, Snowflake, Tableau/Looker, Demonstrated data visualization experience; Tableau/Looker, Power BI.
RemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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One Medical is seeking our Head Actuary to join its Actuarial & Strategic Finance Team. This. The Actuarial & Strategic Finance team has exposure to all facets of the business and plays a critical role in shaping the future and strategy of the company through forecasting and analysis of key business drivers.
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Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years.
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Value based care contracting support and ongoing financial and risk analysis. You will help design new processes that provide critical and timely evaluation of our financial risks to the strategic finance team.
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Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage. Review provider documentation of diagnostic data from medical record to verify that all Medicare Advantage and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company.
$25 - $35 an hourFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Risk Adjustment Coder (CRC) & Certified Coding Specialist (CCS-P), CCS, CPC. Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines.
$25 - $35 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Sage Health builds enriching neighborhood health centers that are easy to access, provide or arrange for all of our patients' healthcare needs, and partner with Medicare Advantage plans that fully cover primary care.
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SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada.
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The programs the AVP will have oversight for include but are not limited to: MACRA/MIPS, 21st Century CURES, Centers for Medicare and Medicaid Innovation (CMMI) projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models (AAPM); Medicare Advantage; and commercial payer value programs.
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Identify, understand and communicate plan details to patients with HMO, PPO, EPO, Medicare Advantage and. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties.
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medicare advantage jobs Title: emergency room registered nurse
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