- Highmark Health (Harrisburg, PA)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Humana (Annapolis, MD)
- …highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Insurance Strategy Consultant , you will ... initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Elevance Health (Denver, CO)
- … Sr.** for **Provider Success** is responsible for consulting with providers (Commercial, Medicare Advantage and Medicaid Lines of Business) to assess and deploy ... each assigned provider to identify key opportunity areas and provider needs. + Consultant support model consists of a continuous process of assessment, root cause… more
- Highmark Health (Annapolis, MD)
- …gain share and risk share models and will be implemented for the Organization's Medicare Advantage , Medicaid, ACA, and commercial populations with the goal of ... maximizing quality while reducing healthcare costs. + Work with reimbursement,...+ Collaborate with and support the senior Strategic Partners Consultant role as needed + Other duties as assigned… more
- Banner Health (AZ)
- …Networks. BPN has over 1 million members who are part of Commercial, Medicare Advantage , and Medicaid population. These members receive care from multiple ... information systems. Responsible for establishing system documentation standards and quality assurance methodologies for systems and applications, overseeing planning,… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Medical Mutual of Ohio (Dublin, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... mind to more than 1.6 million Ohioans through our high- quality health, life, disability, dental, vision and indemnity plans....self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- CenterWell (Dallas, TX)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- The County of Los Angeles (Los Angeles, CA)
- …Facilities Inspection Division and are responsible for either survey services, consultant services, or licensing, enforcement and training services. These positions ... hospitals and other health care facilities to evaluate the quality of care provided with respect to State, Federal...and the coordination of work with other Sections. + Consultant Services: Directs a staff of consultants who provide… more
- ChenMed (Philadelphia, PA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... demonstrates 1) success in developing providers to deliver high quality , cost-effective care; 2) effective dyad partnership with the...Act as a health coach, rather than just a consultant for sickness, by helping patients set short and… more