Average salary: $234,000 /yearly
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- ...Join the revolution and make a meaningful difference in the lives of patients and families every day. HHH As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required...SuggestedFull timeLocal area
- ...healthcare company is seeking a Strategy Consultant to support high-priority projects within its Insurance business unit, focusing on Medicare Advantage strategy development. The role demands someone with management consulting experience and analytical skills to drive...Suggested
Humana
Dover, DE3 days ago $86.3k - $118.7k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...SuggestedFull timeTemporary workApprenticeshipRemote workHumana
Dover, DE3 days ago$97.9k - $133.5k
...organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, dynamic environment to support our Medicare Stars and Medicaid programs through engaging in the transformation of clinical data to inform operational and strategic decision...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeHumana
Dover, DE8 days ago$129.3k - $177.8k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork experience placementWork at officeRemote workWork from homeHome officeFlexible hoursHumana
Dover, DE6 days ago$223.8k - $313.1k
A healthcare services company is seeking a Medical Director to oversee clinical case evaluations and ensure compliance with CMS guidelines. Applicants must hold an MD or DO degree, current board certification, and have 10 years of direct clinical patient care experience...SuggestedRemote workHumana
Dover, DE3 days ago$78.4k - $107.8k
...Professional researches and analyzes rules, regulations, and sub-regulatory guidance. These apply to Insurance Products, such as Medicare Advantage, Part D, Group Specialty, and Individual Specialty. You will also assess risk and consult on licensure or corporate structure...SuggestedFull timeTemporary workApprenticeshipWork at officeRemote workHumana
Dover, DE5 days ago$115.2k - $158.4k
...Innovation Portfolio Strategy Advisor is responsible for advancing Humana's behavioral health network quality and access across both Medicare Advantage (MA) and Medicaid (MCD) LOBs. This position will focus on developing and executing strategies to enhance provider...SuggestedFull timeTemporary workFor contractorsApprenticeshipRemote workWork from homeHome officeHumana
Dover, DE8 days ago$115.2k - $158.4k
...Qualifications Experience supporting Quality Focused Visits (QFV) or similar quality‑driven in‑home programs Familiarity with Medicare Advantage, Stars measures, and member eligibility requirements Experience designing or managing daily eligibility file...SuggestedBi-weekly payFull timeContract workTemporary workRemote workWork from homeHome officeHumana
Dover, DE5 days ago$126.3k - $173.7k
...Pharmacoeconomics and Health Outcomes training Pharmacy practice residency or similar pharmacy practice experience Knowledge of Medicare as it relates to pharmacy Six Sigma and/or Project Management Professional certification Travel: While this is a remote...SuggestedFull timeTemporary workApprenticeshipRemote workHome officeHumana
Dover, DE3 days ago$104k - $143k
...of residence Pharmacy degree from an accredited college of pharmacy Ability to participate in Federal prescription programs (Medicare/Medicaid reviews) Self-directed, but also able to work well in a group Ability to solve problems and encourage others in...SuggestedDaily paidFull timeContract workApprenticeshipRemote workMonday to FridayFlexible hoursShift workWeekend workHumana
Dover, DE4 days ago$33 - $36 per hour
...Aveanna isn't just a provider of compassionate homecare to children and adults. We are a national leader. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required...SuggestedHourly payWeekly payDaily paidFull timePart timeReliefLocal areaFlexible hoursShift workNight shiftWeekend workDay shiftAveanna Healthcare LLC
Middletown, DE3 days ago$126.3k - $173.7k
...to functional team(s). The Supplemental Benefits Operations (SBO) team within Humana's Enterprise Growth organization manages Medicare Mandatory Supplemental Benefits (MSBs) that shape member experience, operational performance, and regulatory outcomes. You will be...SuggestedFull timeContract workTemporary workApprenticeshipRemote workHumana, Inc.
Dover, DE11 days ago$129.3k - $177.8k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeShift workNight shiftHumana
Dover, DE7 days ago- ...integrating and overseeing all Outpatient and Inpatient based MDs and RNs and non-clinical support for UM functions in Medicaid and Medicare, with a focus on streamlining processes, ensuring consistent clinical practices, driving trend savings, improving Star Ratings,...SuggestedApprenticeshipRemote work
Humana
Dover, DE4 days ago $71.1k - $97.8k
...success in introducing new processes and/or process improvements in operational environments Preferred Qualifications: Group Medicare knowledge Self-starter who takes initiative, ownership and anticipates future trends accurately Additional Information...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeHumana
Dover, DE4 days ago$106.9k - $147k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeHumana
Dover, DE5 days ago$104k - $143k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...Full timeTemporary workFor contractorsApprenticeshipRemote workWork from homeHome officeMonday to FridayWeekend workHumana
Dover, DE6 days ago$117.6k - $161.7k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeHumana
Dover, DE4 days ago$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health, SNF, DME, dual Medicare/Medicaid requests. The Medical Director reviews and determines whether healthcare services provided...Full timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayHumana, Inc.
Dover, DE3 days ago$104k - $143k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...Bi-weekly payFull timeTemporary workWork at officeRemote workWork from homeHome officeHumana
Dover, DE3 days ago$168k - $231k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?...Full timeTemporary workApprenticeshipRemote workHumana
Dover, DE4 days ago$71.1k - $97.8k
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at...Bi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayHumana
Dover, DE5 days ago- ...systems. Have an interest in working in the managed care industry. Preferred Qualifications: Bachelor's degree Previous Medicare/Medicaid experience. Previous experience in prior authorization, utilization management. Experience working with MCG or...Full timeFor contractorsApprenticeshipWork experience placementInternshipRemote workWork from homeHome officeWeekday work
Humana
Dover, DE8 days ago $71.1k - $97.8k
...PowerPoint, Excel, Word, Outlook, Teams) or equivalent tools. Preferred Qualifications At least 3 years of experience in Medicaid, Medicare, provider products, contact center, or healthcare or insurance environments. Minimum of 4 years of experience designing...Full timeTemporary workApprenticeshipRemote workHumana
Dover, DE3 days ago$298k - $409.8k
...and experience at scale. What Makes This Role Different 1. Influence Care at Scale Impact care decisions for millions of Medicare Advantage members Shape how care is delivered across the entire post-acute continuum, not just one silo Operate in a payer-provider...Full timeTemporary workRemote workShift workHumana
Dover, DE7 days ago$223.8k - $313.1k
...(hospitalist-level acuity, ED, ICU, or hospital-based FP/IM). Prior experience in utilization management or inpatient review (Medicare Advantage, Managed Medicaid, or Commercial lines of business). Familiarity with MCG® or InterQual® guidelines. Experience providing...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend workHumana
Dover, DE6 days ago$71.1k - $97.8k
...metrics-focused role Experience as an MDS Coordinator or discharge planner in an acute care setting Experience as an RN for a Medicare Certified Home Health agency Health Plan or Medicare / Medicaid Experience Call center or triage experience BSN or...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome officeHumana
Dover, DE4 days ago$15 - $22 per hour
...placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required...Hourly payWeekly payDaily paidFull timePart timeReliefLocal areaFlexible hoursShift workNight shiftWeekend workDay shiftAveanna Healthcare LLC
Milford, DE7 days ago$15 - $22 per hour
...compensation, and training. CCPA Notice for Job Applicants, Contractors, and Employees Residing in California As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required...Hourly payFull timeTemporary workPart timeFor contractorsLocal areaNight shiftAfternoon shiftAveanna Healthcare LLC
Newark, DE5 days ago
