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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.
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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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Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. PALS: Children Services, Cardiovascular Lab, Emergency Department, GI Lab, Interventional Radiology, Surgical Services Pre-Op and Recovery Room.
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Supports the Medicare Patient Helpline, providing high-level education to patients on Medicare and Medicare Advantage plans. Promotes and manages up organization benefits such as our online portal (MyChart), ReadyMed urgent care locations, virtual care, geriatric primary care, and the APCC Advanced Practitioner Clinician Collaborative program.
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Experience in health care, health plans, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
$30.72 - $39.94 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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In cases where Tricare or Medicare/Medicare Advantage is primary or secondary, use scripting to review and deliver appropriate regulatory form (Tricare Rights, Tricare Third Party Liability, and Important Message from Medicare (IMM) form.
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HEDIS experience requiredStrategy SummaryOur team is an Mfocused group that provides direct and matrixed technology support for Cigna's Medicare Advantage and CareAllies business units. As needed, represent Medicare Technology for HEDIS matters to various enterprise, shared service, and Government segment working committees.
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Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services' self-funded employee health benefit plan.
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This role works closely with numerous payors and insurance products, including but not limited to Commercial, Workman's Compensation, Medicare Advantage, Medicare, and Medicaid (AHCCCS.
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We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
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Advanced knowledge of medical insurance plans: Managed Care Organizations, Commercial, Medicare Advantage, Self-Funded, TPAs and providers at financial risk (hospital/health systems, medical group/IPA.
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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 285,000 members in California, Arizona, Nevada, and Texas.
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Coordinate Pre-certification sand recertification in accordance with facility policies for Medicare Advantage andcommercial insurance payers. Coordinate with the scheduler to ensure a Registered Nurse (RN) is on duty at least 8 hours a day/7 day a week and a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) is on duty 24 hours a day.
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About Our Company Capital Health Plan (CHP) is a not-for-profit mixed model health maintenance organization (HMO) offering employer group and Medicare Advantage plans. Tallahassee has been ranked among the top livable cities in Florida, in part thanks to a cost of living 5.5% below the national average and an excellent school system.
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HCC Risk Adjustment Coders will be involved with activities of code abstraction for the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation.
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