- NORC (Washington, DC)
- … Medicaid , and commercial payer administrative data. In addition to providing subject matter and methodological leadership to projects, the Program Area ... Area Director should have familiarity and experience leading Medicare and Medicaid demonstration evaluations that use experimental or quasi-experimental design. The… more
- Stanford Health Care (Palo Alto, CA)
- …the Office of Compliance and Privacy in organizational meetings; serves as compliance subject - matter expert . + Participate in Office of Compliance and ... collaborates with Stanford Medicine leadership and stakeholders to serve as a subject matter consultant to clinical and operational teams in collaboration… more
- Stanford Health Care (Palo Alto, CA)
- …related to third-party liabilities and balance sheet reserves. + Serve as the subject matter expert on regulatory compliance reporting, including Medicare ... the Workday customer management model. + Serve as the subject matter expert for the...Medicare Auditor Contractor and strong familiarity with Medicare and Medicaid regulations. **Required Knowledge, Skills and Abilities** + Advanced… more
- Lundbeck (Dallas, TX)
- …access via medical and pharmacy benefit reimbursement process + Serve as a deep subject matter expert on the local market access expertise including ... boundaries with access to a major airport. Territory boundaries include: Texas ( subject to change)** **SUMMARY:** The Lundbeck Field Access Specialist is a… more
- Lyric (Newtown Square, PA)
- …+ Mentor and development Medical Content Analysts to achieve departmental KPIs + Serve as subject matter expert on CPT, HCPCS, ICD10CM coding and claims edit ... logic (including NCCI, LCDs, State Medicaid , MUEs, Lyric edits and payer medical policies) +...be initiative-taking and self-directed + Effective communication skills including expert at presenting extraordinarily complex material via all mediums… more
- Commonwealth Care Alliance (Boston, MA)
- …liaison with external vendors + Facilitate Communications Team in content creation as the subject matter expert for provider network + Maintain inventory of ... foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This role ensures providers are well-informed, engaged,… more
- DESC (Seattle, WA)
- …works, and work with end-users to ensure usage and usability. + Serves as a subject matter expert for department managers on documentation standards that ... Senior Manager of Policy and Program Analytics to ensure programs leveraging Medicaid Waiver dollars are complying with all applicable laws, regulations and contract… more
- Stanford Health Care (Palo Alto, CA)
- …Medical Association (AMA) CPT Assistant. The SPC Coding Specialist II serves as a subject matter expert in hospital and professional coding, and interacts ... skills + Remain abreast of current Centers for Medicare and Medicaid Services (CMS) requirements, NCCI edits, National Coverage Determinations (NCDs), Local… more
- Commonwealth Care Alliance (Boston, MA)
- …**Required Knowledge, Skills & Abilities (must have):** + Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience ... (preferably Medicare/ Medicaid ) + Experience in health plan provider relations + Experience with behavioral health providers preferred + Understanding of provider… more
- DATAMAXIS (Springfield, IL)
- …distance (3 - 5 Hours) of Springfield, IL. Functional Description: This position is a Medicaid Subject Matter Expert for the Illinois Enterprise Data ... Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations. * With the specialized… more
- State of Colorado (CO)
- …are aligned with the Medicaid & CHP+ regulatory and programmatic rules. + Subject matter expert in the technical aspects of Decision Support Systems ... CO Medicaid Enterprise Solution (CMES) Integration Business Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5148793) Apply CO … more
- Commonwealth Care Alliance (Boston, MA)
- …overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment ... - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid billing-related certifications **Required Experience (must have):** + 3+ years in healthcare… more
- Molina Healthcare (Mesa, AZ)
- **JOB DESCRIPTION** **Job Summary** Responsible for being the SME ( Subject Matter Expert ) for Medicaid risk adjustment programs in multiple states. ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
- Elevance Health (Indianapolis, IN)
- …with developing program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day-to-day external client-facing ... **Process Expert II ( Medicaid Rx)** **Hybrid 1:** This...business issues. + Researches applicable subject matter practices and remains aware of industry… more
- TEKsystems (Montgomery, AL)
- …approve * Interact professionally with a diverse group of executives, managers, and subject matter experts. * Perform standard project functions such as creating ... Description Position Description The Alabama Medicaid Agency (AMA) is preparing for a major...* 2 years of experience with multi-vendor project * Expert /Advance experience in using Visio, MS Project, Office 365,… more
- State of Indiana (Indianapolis, IN)
- DFR Subject Matter Expert Date Posted: Dec 10, 2025 Requisition ID: 468034 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career ... by emphasizing self-sufficiency and personal responsibility. Role Overview: This role, Subject Matter Expert , provides specialized knowledge regarding… more
- RELX INC (Annapolis, MD)
- …sales leadership, and sales executives to implement strategic initiatives. + Serving as the Subject Matter Expert and thought leader for LNRS as Head ... risk. About the Job: The Head of CMS and Medicaid Solutions will oversee all aspects of the CMS...50% of the time. + Present themselves as a subject matter expert / thought… more
- OhioHealth (Columbus, OH)
- …analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject matter expert in the following areas, S-10, Wage Index, ... is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This...reimbursement functions. Knowledge in the following areas: Reimbursement functions: Subject matter expert on CMS… more
- Molina Healthcare (ID)
- …to ad-hoc data analyses, development, and presentation of financial reports + Serve as subject matter expert on developing financial models to evaluate the ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans +… more
- AmeriHealth Caritas (Charleston, SC)
- …are validated, researched and resolved within established SLA timeframes. + Serves as the subject matter expert in State specific health reimbursement rules ... 1 to 2 years managed care or related experience preferred. + 1 to 2 years Medicaid experience preferred. + 2 to 5 years of claims analysis experience in a healthcare… more
