- 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 ... development of the Medicare Advantage. This role supports Medicare product...Medicare Advantage product strategy and corresponding benefits. The Analyst will be instrumental in the building of plan… 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 ... and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying Clinical… 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
- 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 ... to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of... Advantage plans + Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong… more
- AdventHealth (Altamonte Springs, FL)
- …Wednesday and Thursday onsite **The role you'll contribute:** The Reimbursement Analyst is responsible for assisting the Reimbursement Manager with the preparation ... of work papers for the filing of the annual Medicare , Medicaid, and Champus/Tricare cost reports, audit preparation and...of accurate and timely cost reports as required by Medicare , Medicaid and other State or Federal agencies for… more
- Actalent (Phoenix, AZ)
- Job Title: Clinical Trial Coverage Analyst Job Description We are seeking a Clinical Trial Coverage Analyst to join our pre-award team. The primary ... items to insurance, based on federal and state billing regulations, including Medicare 's National Coverage Decision (NCD) 310.1. This role requires a keen… more
- 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...to the Manager of Care Management Analytics, the lead analyst will analyze healthcare claims and clinical outcomes associated… more
- The Cigna Group (Nashville, TN)
- **Job Description** Medicare Technology Operations - Data Measurement and Reporting Lead Analyst **Overview** Guides the team to deliver tasks in the Data ... through sustainable means. **Responsibilities** The Data Measurement and Reporting Lead Analyst will play an important role in the development and support… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Senior Public Policy Analyst monitors, evaluates, and provides recommendations on strategy and communications regarding ... issues in support of the company's business objectives and requirements. The Analyst has key responsibility for supporting policy development on key issues, ensuring… 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, ... to improve clinical programs, customer value, growth, and retention for Cigna Medicare . This role will help us accomplish this through data science, strategic… 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
- Waystar (Duluth, GA)
- **ABOUT THIS POSITION** The Technical Support Analyst is responsible for providing superior support to our clients with the highest degree of care and client ... hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values:… 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 Services, ... performing research and analysis within the Clinical Analytics team. This role will help us accomplish this through data-driven analytics, strategic insights, and collaboration with our internal partners. In addition, this person will be responsible to… 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 ... required * Five or more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5 years of experience with Encounter… more
- The Cigna Group (Bloomfield, CT)
- …goals, and service levels * Proficient knowledge of policies and procedures, Medicare , HIPPA and NCQA standards; * Professional demeanor and the ability to ... work effectively within a team or independently; * Flexible with the ability to shift priorities when required * Other duties as required **Qualifications:** * Current Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN. Must have active unrestricted… more
- The Cigna Group (Bloomfield, CT)
- …goals, and service levels + Proficient knowledge of policies and procedures, Medicare , HIPPA and NCQA standards; + Professional demeanor and the ability to ... work effectively within a team or independently; + Flexible with the ability to shift priorities when required + Other duties as required **Qualifications:** + Current Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN. + Active unrestricted license… more
- The Cigna Group (Nashville, TN)
- …in healthcare analytics; value-based care experience preferred + Experience with government medicare data highly desired + Data extraction and analysis skills using ... SQL required + Strong Excel skills and experience building and maintaining Excel models + Tableau and Alteryx experience is highly desired + Ability to communicate to technical and non-technical matrix partners including leadership is essential If you will be… more
- Healthfirst (NY)
- …a health care delivery system or a health insurance company + Knowledge of Medicare and Medicaid programs, health care, and managed care + Python skills with ability ... to create automated data pulls and manipulations WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity,… more
- CVS Health (Denver, CO)
- …Position Summary Fully Remote ANYWHERE within the continental US Training Hours 9- 5:30 EST or CST Normal work Hours 11:45 - 8:15 EST The WorkLife Consultant (WLC) is ... part of the WorkLife Team and provides education about community resources, resource needs assessment, and community and/or national referrals to a variety of customers for a variety of needs including childcare, elder/adult care, and basic/everyday needs. The… more
- CVS Health (Phoenix, AZ)
- …Fully Remote ANYWHERE within the continental US **Training hours 9 - 5:30 EST or CST** **Work hours after training 10 - 6:30 pm EST** **The WorkLife Consultant (WLC) ... is part of the WorkLife Team and provides education about community resources, resource needs assessment, and community and/or national referrals to a variety of customers for a variety of needs including childcare, elder/adult care, and basic/everyday needs.… more