- The Cigna Group (Denver, CO)
- **Summary** The Business Analytics Lead Analyst will be responsible for performing reporting and analysis within the Clinical & Data Science Analytics team for ... Medicare Strategic Analytics. Reporting to the Manager of Care...reporting, dashboards, and collaboration with our internal partners. The Business Analytics Lead Analyst will interface across… more
- The Cigna Group (Plano, TX)
- **Summary** The Business Analytics Lead Analyst will be an individual contributor responsible for supporting the analytics strategy for Medicare Health ... steps; ensure analytic approach and results are clearly understood and communicated to business partners + Exhibit full understanding of data and leverage data in an… more
- The Cigna Group (Nashville, TN)
- **Summary** The Business Analytics Lead will be an individual contributor responsible for providing analytics supporting value-based care capabilities for ... trends + Deliver monthly analytics packages to Network Operations, Finance and other business partners + Create reports and other tools to help provider facing… more
- G-TECH Services, Inc. (Detroit, MI)
- Reporting Analyst for Medicare Business Performance - Business Process Management Top 3 required skills/experience: * Proven ability to translate ... and reporting. Required skills/experience: * Five (5) years of relevant technical or business work experience required. * Must have the aptitude and desire to learn… more
- 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
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Implements and manages ... the implementation and daily operation of the Medicare Advantage Compliance Program and all compliance-related activities for the Company's Medicare Advantage… 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
- The Cigna Group (Seattle, WA)
- …Components:** All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: + ... Growing the MA Business : The Provider Performance Lead Analyst is...HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage required + Ability to apply an enterprise… 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
- 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
- The Cigna Group (Franklin, TN)
- **Summary** The Data Scientist Lead Analyst will contribute to the Medicare Clinical and Customer strategy, performing research and analysis within the Clinical, ... insights, and collaboration with our internal partners. The Data Scientist Lead analyst will interface across multiple business areas, including, but not… 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
- 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
- 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
- The Cigna Group (Bloomfield, CT)
- …Summary:** Responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and ... goals, and service levels * Proficient knowledge of policies and procedures, Medicare , HIPPA and NCQA standards; * Professional demeanor and the ability to… more
- The Cigna Group (Bloomfield, CT)
- …Summary:** Responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and ... goals, and service levels + Proficient knowledge of policies and procedures, Medicare , HIPPA and NCQA standards; + Professional demeanor and the ability to… more
- CVS Health (Denver, CO)
- …or customer service oriented. * Additional responsibilities assigned based on business need, including staffing an online chat platform. **Required Qualifications** ... - 1+ year(s) of experience educating individuals/families on various community resources, and locating and referring to community resources (ie, elder care resources, food assistance, transportation, housing, rental assistance, support groups, human services… more