Remote Medicare Advantage Jobs

…demands deep, battle-tested expertise in Medicare Advantage bid preparation, rate cell modeling, CMS regulations, and risk adjustment mechanics.

…business with a focus on Medicare Advantage.

…or healthcare technology environment ( Medicare Advantage health plan and/or startup a plus)

…mastery of CMS regulations governing Medicare Advantage disputes, organization determinations, and auditing protocols

Experience expanding solutions across Medicare Advantage, Medicaid, Commercial, or dual-eligible populations.

Advantage populations and value-based care economics Experience with peri-operative optimization, post-acute recovery, or falls and fracture

Advantage populations in closing STARS/HEDIS preventive care gaps (A1c, Colorectal Cancer, Diabetic Retinopathy, Mammography, KED and Blood Pressure).

Advantage directory accuracy expectations, or other healthcare data and network regulations Salary Range: $73,000-$115,000

…of key value-based concepts like Medicare Advantage, risk scores, shared savings

Advantage populations in closing STARS/HEDIS preventive care gaps (A1c, Colorectal Cancer, Diabetic Retinopathy, Mammography, KED and Blood Pressure).

Advantage directory accuracy and verification requirements, online directory obligations.

Ensure adherence to CMS regulations, Medicare Advantage requirements, and internal compliance standards.

Experience in health insurance (Medicare Advantage a plus) Experience in geriatrics Salary

…health insurance claims processing, particularly Medicare

We partner with Medicare and Medicare Advantage so they give us a fixed budget per patient per year based on expected medical spending.