MANAGER, MEDICARE PROGRAMS

Job Title: Managing Actuary - Medicare Part DCompany: Leading Blue PlanLocation: Remote from Several StatesPosition Overview: My client is seeking a highly skilled and experienced Actuarial Manager to lead our Medicare Part D division. As the Actuarial Manager, you will play a crucial role in providing strategic direction, overseeing actuarial analysis, and...

Description: Scheduler Medicare Home Health Full timeLake WorthJob Summary: Provides clerical support to the Clinical Manager in managing the day-to-day team operations through assigned workflow processes driven primarily by cross-matrix EMR reports. Supports the home health team by anticipating and responding to team processes related to scheduling and...

Job Title: Managing Actuary - Medicare Part DCompany: Leading Blue PlanLocation: Remote from Several StatesPosition Overview: My client is seeking a highly skilled and experienced Actuarial Manager to lead our Medicare Part D division. As the Actuarial Manager, you will play a crucial role in providing strategic direction, overseeing actuarial analysis, and...

* Enter admission and claims information into system.* Review Medicare accounts for necessary information required.* Respond to technical help letters.* Review and make all necessary corrections and adjustment to claims.* Review Medicaid admissions daily for eligibility and third party payer information.* Review Medicaid Pending Report on a regular basis and...

Employment TypeFull-timeExempt or Non-ExemptExemptJob Summary**Hybrid Work Environment - Must reside in Oahu**Pay Range: $81,931 - $135,801Note: Individuals typically begin between the minimum to middle of the pay range Administers HMSA's provider contracting for value-based programs.Design, develop and operationalize new clinical integration...

Your Role The Care Management Department, which oversees all outpatient care management for the Commercial and Medicare lines of business, is seeking a Clinical Program Manager, Principal to join our team.   In this role, the candidate will provide comprehensive support and collaborate effectively with stakeholders across various departments. The ideal...

Your Role The Care Management Department, which oversees all outpatient care management for the Commercial and Medicare lines of business, is seeking a Clinical Program Manager, Principal to join our team.   In this role, the candidate will provide comprehensive support and collaborate effectively with stakeholders across various departments. The ideal...

Job Title: Senior Manager Actuary - Medicare AdvantageLocation: Flexible (Remote or Hybrid)About: This company is a global leader in management consulting, with a dedicated focus on helping clients solve their toughest problems and seize opportunities. With a commitment to delivering transformative solutions, we operate across various industries, including...

Utilization Management Coordinator (RN)Under the general supervision of the Director of Health Services, the position is responsible for appropriately and successfully executing clinical and administrative health plan denials in accordance with regulatory guidelines and plan policies. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Is responsible for managing all...

What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care...

Requisition #:195468 Location:Worcester, MA 01606 Category:Nursing Salary:$85,000 - $100,000 per year Position Details Position Overview: The RN Clinical Manager - Home Health works under the direction and guidance of the Branch Administrator to provide supervision of all clinical staff working with high medical acuity clients and/or clients receiving...

Under the general supervision of the Director of Health Services, the position is responsible for appropriately and successfully executing clinical and administrative health plan denials in accordance with regulatory guidelines and plan policies. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Is responsible for managing all denials by conducting a comprehensive...

Home Health RN Clinical Manager ApplyRefer a FriendBack Job Details Requisition #: 195468 Location: Worcester, MA 01606 Category: Nursing Salary: $85,000 - $100,000 per year Position Details Position Overview: TheRN Clinical Manager - Home Healthworks under the direction and guidance of the Branch Administrator to provide supervision of all...

Job Description Founded in 1921, Straub Medical Center includes a 159-bed hospital in Honolulu, a network of neighborhood clinics and a visiting specialist program that reaches throughout the state of Hawai'i. With over 200 physicians who are leaders in their fields, Straub provides its patients with diagnoses and treatments for more than 32 different...

Job Description With 118 beds and more than 400 physicians on its medical staff, Pali Momi Medical Center offers a full range of services for the communities of Central and West O'ahu. The hospital has delivered many medical firsts for the community, including Central and West O'ahu's only interventional cardiac catheterization unit to detect and treat...

*\*$10K-$15K Sign-on bonus for eligible new employees!!!\***Notre Dame Hospice-New Orleans* is seeking a *Case Manager - RN!*Are you ready to join an organization that has a reputation for outstanding leadership, innovation, and industry expertise. Our employees use their creativity and talent to invent new solutions, meet demands, and offer the most...

Program ManagerDepartment: EngineeringReports To: Mechanical Engineering ManagerFLSA Status: ExemptLocation: Hudson, NHUpdated: 02.02.2024THE COMPANYInvio Automation is an Industry 4.0 automation leader that serves a variety of high-growth end-markets including medical devices & life science, renewable energy, mobility, logistics & fulfillment, and heavy...

Position Overview:The RN Clinical Manager – Home Health works under the direction and guidance of the Branch Administrator to provide supervision of all clinical staff working with high medical acuity clients and/or clients receiving extended non‐licensed support services. This leader is responsible to provide staff orientation and ensure competence as a...

Requisition #:195408 Location:Des Moines, IA 50311 Category:Nursing Salary:$70,000 - $90,000 per year Position Details This position is salaried and comes with a 10% bonus incentive plan Position Overview The RN Clinical Manager - Home Health works under the direction and guidance of the Branch Administrator to provide supervision of all clinical...

The Program Manager, Natural Environment Programs plays a critical role in leading a small team of experts who provide environmental assessment advice into statutory planning processes, primarily related to managing biodiversity risk. Assessment types include large scale infrastructure, subdivisions, renewable energy facilities and agricultural and...