-
Prime Therapeutics
-
Richmond, Virginia
...
**
Clinical Program Manager Remote
Job Description
This Clinical Program Manager opening is ... utility player/SME of the department.
The Clinical Program Manager is responsible for the management
...
-
CVS Health
-
Richmond, Virginia
...
, analytic, and consultative skills to join our team of Medicare Advantage Manager, Business Consultants (MANAGER, BUSINESS CONSULTANT) who offer clinical insights and solutions to help improve health plan
...
-
Takeda Pharmaceuticals
-
Richmond, Virginia
...
Manager of Payer Contracting. Where you will lead the development and implementation of assigned Payer and PBM contracts with an emphasis on drafting and editing complex agreements for Commercial and Medicare
...
-
Humana
-
Richmond, Virginia
...
Senior Data Manager acquires, cleans and develops datasets from internal and external sources to support ... other teams to ensure all aspects of data needs are taken into account.
Coordinate the completion
...
-
HealthEdge Software Inc
-
Richmond, Virginia
...
Overview
Position Overview:
As a Senior Product Manager, within theclaimsvalue ... key stakeholders including Customers, Account Executives, Sales, Professional Services, Support and
...
-
Travelers Insurance Company
-
Richmond, Virginia
...
a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where ... strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare
...
-
Merck
-
Richmond, Virginia
...
collaborating with the in-scope customer team: Customer Team Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more.
**Position Qualifications
...
-
Elevance Health
-
Richmond, Virginia
...
government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.
The Audit and Reimbursement Lead will support our Medicare
...
-
Elevance Health
-
Richmond, Virginia
...
Audit & Reimbursement III- Medicare Cost Report Audit
Locations: _This is a ... Elevance Health’s family of brands. We administer government contracts for Medicare and partner with the
...
-
CommuniCare Health Services Corporate
-
Richmond, Virginia
...
term care setting
Must possess a thorough understanding of Medicare. Medicaid, Private
...
-
Prime Therapeutics
-
Richmond, Virginia
...
problems and issues.
If supporting Medicare Part D, will be responsible for implementing CMS ... Structure**
Reports to Manager or Sr Director in the Finance department
Responsibilities
3
...
-
Elevance Health
-
Richmond, Virginia
...
Audit & Reimbursement Senior - Medicare Cost Report Audit
Locations: _This ... member of Elevance Health’s family of brands. We administer government contracts for Medicare and partner
...
-
Elevance Health
-
Richmond, Virginia
...
Audit & Reimbursement II Medicare Cost Report Appeals
Location : This is a virtual ... of brands. We administer government contracts for Medicare and partner with the Centers for Medicare
...
-
Elevance Health
-
Richmond, Virginia
...
Audit & Reimbursement III- Medicare Cost Report Audit
_This is a United States based ... of brands. We administer government contracts for Medicare and partner with the Centers for Medicare
...
-
Humana
-
Richmond, Virginia
...
Become a part of our caring community and help us put health first
The Group Medicare ... proposals (RFPs)/request for renewals (RFRs).
The Group Medicare Proposal Development/Contract Review
...
-
Elevance Health
-
Richmond, Virginia
...
government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to ... Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid
...
-
Humana
-
Richmond, Virginia
...
need, when they need it. These efforts are leading to a better quality of life for people with Medicare
...
-
Humana
-
Richmond, Virginia
...
(typically 10+ years) in the insurance brokerage industry, with a significant focus on Medicare products and ... qualifications and personal attributes are also sought:
In-depth knowledge of Medicare regulations, market
...
-
Bon Secours Mercy Health
-
Richmond, Virginia
...
governmental/third party agencies (Medicare & Medicaid) and/or third-party payers.
Adheres to the ... laws and regulations, and reporting to designated Manager (or employer hotline) any suspected unethical
...
-
Cardinal Health
-
Richmond, Virginia
...
professional communication
Clear knowledge of Medicare (A, B, C, D)
1-2 years of Pharmacy and/or ... -being.
Medical, dental and vision coverage
Paid time off plan
Health savings account (HSA
...
-
Highmark Health
-
Richmond, Virginia
...
), Pennsylvania Department of Health, Department of Labor, the Center for Medicare and Medicaid Services (CMS) and
...
-
Bon Secours Mercy Health
-
Richmond, Virginia
...
, standards and directives regarding governmental/third party agencies (Medicare & Medicaid) and/or third ... party agencies (Medicare & Medicaid) and/or third-party payers.
Adheres to the standards and
...
-
Public Consulting Group
-
Richmond, Virginia
...
Responsibilities**
Provide strong leadership on all Medicare/Medicaid cost settlement and supplemental payment ... relevant Medicare or other government program regulations.
Develop a comprehensive understanding of
...
-
CVS Health
-
Richmond, Virginia
...
consultative clinical support to Account Management in support of Key Clients as assigned.
The Medical ... commercial clients, governmental (Medicare/Medicaid) programs and individual client requested coverage
...
-
Highmark Health
-
Richmond, Virginia
...
, locations and departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage across ... Organization are met and to optimize outcomes. Collaborates with the company's Medicare Advantage matrixed
...
-
Deloitte
-
Richmond, Virginia
...
a career in Deloitte's Human Capital practice.
The wage range for this role takes into account ... Medicare products, including Medicare Advantage or Medicare Supplement products for various enrollee types
...
-
Deloitte
-
Richmond, Virginia
...
Experience with Medicare products, including Medicare Advantage or Medicare Supplement products for various ... into account the wide range of factors that are considered in making compensation decisions including
...
-
Humana
-
Richmond, Virginia
...
they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid
...
-
Humana
-
Richmond, Virginia
...
(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and Medicare Advantage value based
...
-
CVS Health
-
Richmond, Virginia
...
aligned plan's members.
Position Description:
Aetna Medicare Duals Center of Excellence is ...
Independently motivated and capable of researching and adjudicating Medicare and Medicaid benefit and coverage
...
