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- ...• Working in healthcare with retirees and retiree populations • Knowledge of healthcare industry and Commercial and Medicare Advantage health plans Required Skills/Experience – The rest of the required skills/experience. Include: • Proficient in Microsoft Suite...SuggestedWork at officeLocal areaRemote work2 days per week1 day per week
KYYBA
Detroit, MI13 days ago $117.9k - $152.57k
...to confronting the largest public health challenges of our day and improving the lives of patients for generations to come. As a Sr PRC Specialist, at Gilead you will ... Create Inclusion - knowing the business value of diverse teams, modeling inclusion, and embedding...SuggestedFull timeFor contractorsLocal area- Nurse Case Manager (PRC) - Fort Peck Service Unit Apply for the Nurse Case Manager (PRC) role at SHR (Spectrum Healthcare Resources). Location: Chief Redstone Health Center, Wolf Point, MT. Schedule: Monday - Friday, 8:00 a.m. - 4:30 p.m. (Federal holidays off). Spectrum...SuggestedFull timeMonday to FridayWeekday work
- ...research and analysis underpinned by deep expertise and thought leadership. What You’ll Do Demonstrate deep expertise in Medicare Advantage, with strong functional knowledge across key domains including Risk Adjustment, Quality (Stars), Provider Engagement, and Cost of...SuggestedLocal areaWork from homeWorldwideFlexible hours
$60k - $80k
...SALES REPRESENTATIVE - PRICE ADVANTAGE RESPONSIBILITIES: ~ Understand the customer need and establish company's product as the best solution that addresses that need ~ Build and present solution demos ~ Provide outstanding leadership through trial, implementation...SuggestedPermanent employmentFull timeTemporary work- ...which encompass the core functions of case management including; assessment, planning, implementation, monitoring and reassessment. Advantage Case Management Certification preferred Licenses/Certifications: RN/LPN Experience: RN/LPN with one year paid professional...SuggestedRelocation package
- ...for Leadership Level communication (both internal and external). Communicate effectively with POD /Category leadership as well as ADvantage Support Center. Deliver in-depth category and vendor analysis with process improvement recommendations to drive category improvement...SuggestedWork experience placement
- A tribal healthcare organization in Kenai, Alaska, is seeking a Purchased Referred Care (PRC) Eligibility Technician. The role involves reviewing referrals for eligibility according to guidelines, assisting with urgent care claims, and ensuring compliance with health policies...SuggestedFull timeWork at office
$151k - $208k
Director, Marketing Operations - PRC/MLR page is loaded## Director, Marketing Operations - PRC/MLRremote type: Hybridlocations: Cambridge, MAtime type: Full timeposted on: Posted Todayjob requisition id: REQ22139**About This Role:**As Director, Marketing Operations - MLR...SuggestedTemporary workLocal area$34.01 - $65 per hour
A health services company is seeking a Registered Nurse (RN) - Case Manager to provide specialized case management and care coordination for patients with special health care needs. This role requires at least three years of nursing experience, including case management...SuggestedHourly pay- A healthcare organization located in Chicago, IL, seeks a Nursing Manager to oversee the Purchased Referred Care program. This role requires a Bachelor's degree in Nursing, along with nursing management experience and strong clinical oversight skills. The successful candidate...Suggested
$118.45k - $260.59k
...development, validation, and delivery of key medical cost assumptions used in annual pricing and bid development for Individual Medicare Advantage. This role ensures all assumption models are completed accurately and delivered on time to the actuarial pricing team. The leader...SuggestedHourly payFull timeTemporary workLocal areaFlexible hours- Trade-Up Advantage Specialist Now Hiring in LONGVIEW Do you love connecting with people, asking the right questions, and helping them make confident decisions? If so, this might be the perfect role for you. We’re looking for a Trade-Up Advantage Specialist to join our...SuggestedFull timeImmediate start
$86.3k - $118.7k
...in Raleigh, NC. This role involves leading high-impact strategy projects and collaborating with senior leaders to enhance Medicare Advantage strategies. Candidates should have a bachelor's degree and at least two years of management consulting experience. Remarkable...SuggestedFull time- Competitive Advantage Benefits Account Manager Join to apply for the Competitive Advantage Benefits Account Manager role at The Competitive Advantage Companies Competitive Advantage Benefits Account Manager 18 hours ago Be among the first 25 applicants Join to apply for...SuggestedFull timeWork at officeRemote workMonday to Friday
$86.3k - $118.7k
...analyses for executive management, conducting market and competitor research, and managing strategic projects focused on Medicare Advantage. The ideal candidate has strong consulting skills, problem-solving abilities, and at least 2 years of consulting experience. This...Full time- ...Professional in Austin, TX. This role involves delivering high-quality analyses and managing key strategic projects, focusing on Medicare Advantage strategy development. Candidates should have a Bachelor’s degree along with relevant consulting experience. Strong problem-solving...Remote work
$70k - $97.75k
Inside Sales Manager - Medicare Advantage Base salary of $70,000 to $97,750 per year, with annual bonus opportunities. Base Pay Range $70,000.00/yr - $97,750.00/yr Additional Compensation Types Annual Bonus About GetScale GetScale offers clients end-to-end customer acquisition...Full timeWork at office$62.4k - $90.75k
...data preparation, modeling, analysis, and/or visualization techniques. Essential Functions -Collects, monitors and analyzes Medicare Advantage and D-SNP Claims reporting to ensure timeliness, accuracy and compliance internally to support decisions on day-to-day operations,...Work at officeRemote workShift work$112.9k - $256.9k
...exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you’ll provide direct management to a team of UM coordinators and nurses. You’ll work closely with...- Position Information Purchased Referred Care (PRC) Eligibility Technician Department: Health Systems Management Program: Health Systems Reports To: Medical Social Worker Supervisor Employment Status: Full-Time FLSA Status: Non-Exempt Schedule: 40 Hours/52 Weeks Preference...Full timeWork at officeLocal area
- A leading healthcare company is seeking a Senior Strategy Advancement Professional in Columbus, Ohio, to support high-priority projects within their Insurance segment. The role demands prior management consulting experience and involves delivering strategic analysis, managing...
$22 - $23.5 per hour
Visiting Professor - Cyber (Advantage Academy) Chicago, IL, USA Job Description Posted Monday, November 25, 2024 at 6:00 AM DeVry University strives to close our society’s opportunity gap and address emerging talent needs by preparing learners to thrive in careers shaped...Hourly payFull timeTemporary workPart timeRemote workFlexible hours$34.01 - $65 per hour
A healthcare services provider is seeking a Registered Nurse (RN) - Case Manager to support Indian Health Services in Wolf Point and Poplar, MT. The ideal candidate will have at least 3 years of nursing experience, a valid RN license, and the ability to obtain an IHS clearance...Hourly pay- A leading biotechnology company in Cambridge is seeking a Director of Marketing Operations. This role involves leading the Promotional Review Committees and ensuring compliance in promotional content. The successful candidate will manage a team and work closely with various...
- A prominent healthcare provider in Los Angeles is seeking a Claims Processor responsible for precise data entry and the review of medical claims. The ideal candidate will have extensive experience in medical claims payment within an HMO setting, with strong skills in adjudication...
$36k - $54k
Overview Are you passionate about being part of a team at a Fortune 100 company with nearly $70 billion in annual sales that delivers extraordinary care to help individuals and businesses prepare for and protect their future? NationWide Financial could be the place for ...Full timeTemporary workPart timeWork experience placementCasual workWork at officeRemote work$75.04k - $112.56k
...range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more. Overview ADvantage POD analyst - Responsible for providing category specific insights for medium complexity categories in terms of scope/value (process...Full timeWork experience placementRemote workFlexible hours- Join Henry Ford Health Pharmacy Advantage as a Pharmacy Intern and get hands-on experience in a dynamic closed door pharmacy setting. General Summary Schedule: Contingent, Rotating Shifts Location: Pharmacy Advantage, Rochester Hills The pharmacy intern actively...InternshipRotating shift
Henry Ford Health
Rochester Hills, MI9 days ago - A major energy provider in North Palm Beach is looking for a Substation Engineering Compliance Manager. The role entails leading a team to ensure compliance with NERC Reliability Standards for all renewable energy projects. Candidates should have a Bachelor's degree in ...Full time
