Senior Manager, Medicare Advantage Operations in Los Angeles, CA for UCLA

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Utilization Management Manager, Medicare Advantage - RN

UCLA

Los Angeles, California

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CARDIAC ANESTHESIA OPPORTUNITY with IU HEALTH in the HOME OF PURDUE UNIVERSITY

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Registered Nurse RN Home Health Care Manager Weekend

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Physician (Home Based Primary Care Medical Director) with Recruitment/Relocation Incentive

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Emergency Department Care Manager - Care Management

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Lenexa City Center, Social Worker - MSW

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Care Manager II - Case Management - Full Time

CHRISTUS Health

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Health Plan Representative - Denver Health Medical Plan (*Colorado State Applicants Only*)

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Clinical Pharmacist

University of Maryland Medical System

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Pharmacist Resident - Medical Network

Cedars Sinai

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Financial Clearance Specialist, Evenings Labor and Delivery

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Case Management Registered Nurse

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Senior Manager, Medicare Advantage Operations

DescriptionAs a key leader within Medicare Advantage Operations, the Senior Manager will be responsible for overseeing the strategic management and operational execution of Appeals and Grievances, Claims Processing, and Payment Integrity functions. In this role, you will ensure the efficient and compliant operation of all Medicare Advantage activities, aligning with CMS regulations and internal organizational standards. You will: • Ensure timely, accurate, and compliant operations in accordance with CMS, DMHC, and internal standards. • Collaborate with cross-functional teams to identify opportunities for operational improveme

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