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Preferred Location: Hanover, MD.The Medicare Risk Adjustment Advanced Analytic Senior Is responsible for creating statistical models to predict, classify, quantify, and/or forecast business metrics.
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Job Description :Audit & Reimbursement III - Medicare Cost Report AuditLocations: This is a virtual position; the ideal candidate will live within 50 miles of an Elevance Health PulsePoint location.
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This role is likely to be focused on either Medicaid Managed care data used for compliance and oversight, or on the Medicare Quality Review Program. Applicable languages and platforms include Python, SQL, R, Git for version control, Snowflake, Databricks, and AWS.
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Job Description :Medicare Risk Adjustment Advanced Analytic SeniorLocation: This position will work a hybrid model (remote and office). Medicare Advantage and Medicaid (Dual Members) risk adjustment experience preferred.
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Minimum Requirements:Requires MS, MA, or PhD with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research, a minimum of 3 years direct experience programming large, multi-source datasets with SAS required, and a minimum of 3 years in health care setting; or any combination of education and experience which would provide an equivalent backgroundPreferred Skills, Capabilities, and Experiences:PhD preferred.
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The Program Manager is a key member of the Medicare Advantage Claims, Configuration and Appeals and Grievance Operations team. Assists in planning, developing, implementing, and managing the Medicare Advantage Claims, Appeals and Grievance program requirements, operational initiatives and policies.
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Intermediate to Advanced expertise with software such as SAS Stat, SAS ETS, SAS Enterprise Miner or equivalents strongly preferred. Experience with ACA Risk adjustment, Star, and Medicaid quality incentives preferred.
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The Segment Marketing Senior Manager will oversee direct-to-consumer (DTC) marketing for the Cigna Medicare Part D (PDP) business, reporting to the VP of Marketing. DTC Marketing Senior Manager - Medicare - Hybrid.
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Along with the Assistant Director, Medicare Advantage Operations, the Program Manager is responsible for program management activities impacting the functional areas within the span of control of the Assistant Director including but not limited to initiation, planning, development, and monitoring of program implementations and day to day operations performance monitoring in order to ensure timeliness and compliance.
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Great Place to Work®Most Loved Workplace® Forbes Best-in-State EmployerMedicare Specialist (Remote)PRIMARY PURPOSE: To coordinate, analyze and facilitate Medicare Compliance and Medicare Set-Aside (MSA) functions within the assigned team.
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Communicates and advises appropriate internal and external stakeholders on Medicare Compliance and Medicare Set-Aside (MSA) matters including, but not limited to, lien negotiation efforts, MSA submissions and/or general information.
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Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. About Cigna Healthcare. This role will be responsible for developing and executing a multi-channel DTC marketing strategy focused on driving smart and measurable growth across the PDP product portfolio.
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The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other relevant study-related documents to create a coverage analysis/billing guide.
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Significant marketing strategy, direct marketing, and multi-channel marketing experience is required. Manage multi-channel advertising budget and strategic initiatives including brand and direct response media across the MA product footprint.
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Compiles and organizes medical records; distributes to Medicare Compliance nurses for analysis; and provides guidance and advice on processing claims based on nurses’ analysis. Maintains thorough understanding of service and products offered by Medicare Compliance department.
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Title: medicare Company: Village Center For Care
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