- Medical Mutual of Ohio (Brooklyn, OH)
- …as Medicare Advantage, Medicare Supplement, and individual plans. The Medicare Advantage Products Analyst plays an integral role in the product ... execution of Medicare Advantage product strategy and corresponding benefits. The Analyst will be instrumental in the building of plan benefit packages (PBPs),… more
- AdventHealth (Altamonte Springs, FL)
- …+ Create core reporting dashboards summarizing and trending all aspects of Medicare business , CMS Revenue, Enrollment, Risk Adjustment, cost trend, and ... **Senior Medicare Data & Finance Analyst ** **Location:**...claims, and payer reports by means of SQL queries, business intelligence solutions, and analytics software (such as Lightbeam)… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …location for this position is full remote with occasional time onsite.** The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research ... to patient insurance and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a… more
- Providence (WA)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare Advantage… more
- Vanderbilt University Medical Center (Nashville, TN)
- …**Organization:** Finance Reimb/Acct **Job Summary:** The primary purpose of the financial analyst is to support and perform analyses of financial matters related to ... reimbursement, net revenue and Medicare cost reporting. The work performed by this role...various processes associated with revenue cycle in a complex business environment. + Experience with business intelligence… more
- Cleveland Clinic (Independence, OH)
- Financial Analyst III - Medicare /Medicaid Reimbursement Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide ... one of the most respected healthcare organizations in the world. The Financial Analyst III provides Financial or Revenue Cycle Management (RCM) data, metrics and… more
- The Cigna Group (Sunrise, FL)
- …primary conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst 's responsibilities ... **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market...members contribute to the growth and profitability of the Medicare Advantage business in their market in… more
- CareFirst (Washington, DC)
- …regarding federal and state public policy issues in support of the company's business objectives and requirements. The Analyst has key responsibility for ... **Resp & Qualifications** **PURPOSE:** The Senior Public Policy Analyst monitors, evaluates, and provides recommendations on strategy and communications… more
- Centene Corporation (Jefferson City, MO)
- …be responsible for delivering fully compliant products to the market, while supporting business goals and objectives. + Support the Medicare product development ... offering quality, competitive product solutions for growth and retention of our Medicare members. Support the development and execution of product changes within the… more
- Elevance Health (St. Louis, MO)
- …Elevance Health PulsePoint locations. **Preferred Location: Indianapolis, IN.** The **Actuarial Analyst III** will complete very diverse and complicated projects and ... studies. **How you will make an impact:** + Insources Medicare Advantage Risk Adjustment Analytics from vendors. + Analyzes...They are how we achieve our strategy, power our business outcomes and drive our shared success - for… more
- The Cigna Group (Philadelphia, PA)
- Performs actuarial analyses for Medicare Advantage business , including, but not limited to: medical expense analyses and projections, financial forecasts, ... Medicare Part C bid development, regulatory (CMS) filings, actuarial...to management and associates. **Responsibilities:** Primary focus areas are Medicare pricing and CMS bid and supporting documentation development,… more
- Molina Healthcare (WI)
- …claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed ... on databases and ensure adherence to business and system requirements of customers as it pertains...existing health plans. + Must have experience working on QNXT/ Medicare /NetworX + Must have experience working on SQL. +… more
- The Cigna Group (Bloomfield, CT)
- This position, the Nurse Case Manager Senior Analyst , through the case management process, will promote the improvement of health outcomes to members and assist ... needs within case load assignments of a defined population based on business perspectives. The Case Manager will promote quality cost-effective outcomes managing… more
- UCLA Health (Los Angeles, CA)
- …this and more at UCLA Health. As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running processes/jobs ... for claim encounter data submissions and the coordination of business transactions for all HIPPA/CMS standard sets. You will...more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5… more
- Elevance Health (Norfolk, VA)
- **Risk Adjustment Advanced Analyst Senior** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of ... locations.** **Preferred Location: Norfolk, VA.** The **Risk Adjustment Advanced Analyst Senior** is responsible for creating statistical models to predict,… more
- Healthfirst (NY)
- …and oral and written communication skills with the ability to translate data to business insights (in other words, you are an analytic storyteller) + Team player who ... want to go above and beyond to understand the business context. **Preferred Qualifications:** + Experience working in a...system or a health insurance company + Knowledge of Medicare and Medicaid programs, health care, and managed care… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Science, business or related field. + 2 year's experience as a business analyst . Technical Skills and Knowledge: + Advanced understanding of system design ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....or related field. + 5 year's experience as a business analyst . + 1 year of experience… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Computer Science, business or related field. + 5 year's experience as a business analyst . + 1 year of experience in project management. Technical Skills and ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....or related field. + 6 year's experience as a business analyst . + 2 year's experience in… more
- TEKsystems (Honolulu, HI)
- ALOHA, Seeking a Medicare Analyst with a Data and Business Analyst experience | Full-time, contract to hire | Monday to Friday, 8:00 am- 5:00 pm HST | ... and data analysis skills, focusing on healthcare and Medicare / Medicare claims. The ability to present information...manipulation (nice to have). Qualifications: - Experience as a Business /Data Analyst in the healthcare industry. -… more
- Ventura County (Ventura, CA)
- …in the business administration field, AND Experience (by level) Finance Analyst I- Four (4) years of progressively responsible experience as an accountant, ... Behavioral Health Finance Analyst I/II/Senior Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4617164) Apply Behavioral Health Finance … more