- 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
- Medical Mutual of Ohio (Brooklyn, OH)
- …finance experience . Certified Public Accounting (CPA) preferred Sr . Financial Analyst . Bachelor's degree in Business , Accounting, Finance, or a ... departments, ensuring financial processes are efficient and aligned with company goals. Sr Financial Analyst Responsible for analyzing financial trends, creating… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Competitive Intelligence Analyst Sr .-Lead_ **Location:** _OH-Brooklyn_ **Requisition ID:** ... and help our members achieve their best possible health and quality of life. ** Sr . Competitive Intelligence Analyst ** **Plays a pivotal role in driving our… more
- CommonSpirit Health (Englewood, CO)
- …happen both inside our hospitals and out in the community. **Responsibilities** The ** Senior Reimbursement Analyst i** s responsible for providing cost report ... , Medicaid and other State and Federal regulations. The Sr . Reimbursement Analyst interacts with customers and...Analyst also assists in the improvement of internal business processes and meeting future reimbursement service needs. The… more
- Commonwealth Care Alliance (Boston, MA)
- …. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing prospective claims auditing ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- AdventHealth (Altamonte Springs, FL)
- ** Senior Medicare Data & Finance Analyst ** **Location:** Virtual **All the benefits and perks you need for you and your family:** + Benefits from Day One + ... Full-Time, Monday - Friday **The role you'll contribute:** The Senior Medicare Data & Finance Analyst...core reporting dashboards summarizing and trending all aspects of Medicare business , CMS Revenue, Enrollment, Risk Adjustment,… more
- Kepro (Albany, NY)
- …a vital partner for health solutions in the public sector. Acentra is looking for a Senior Business Analyst to join our growing team. Job Summary: Senior ... Business Analyst is responsible for analyzing business problems, identify gaps, and develop technical solutions involving...large complex projects. + You have a Medicaid / Medicare (healthcare) background. + You have Business … more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is ... processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid, and Health Insurance Marketplace for the assigned department.… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Sr . Compliance Analyst (Regulatory Intelligence and Assessment) - Remote **Job ... Description** The Senior Compliance Analyst assists in the implementation...organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory… more
- Providence (WA)
- …retain the best people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible ... and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare Advantage… more
- Point32Health (Boston, MA)
- …Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** This Senior Actuarial Analyst will support the Medicare Part C Pricing work. The ... key responsibilities for this role are pricing, rate filing ( Medicare Advantage Bid) development, strategic analysis, and other ad hoc projects. This role will also… 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
- Evolent Health (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a ... Senior Analyst , Performance Analytics to join our Performance Suite business unit. Our mission is to improve and innovate Evolent's capabilities driving… more
- Molina Healthcare (MI)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... key business issues related to cost, utilization and revenue for...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Senior Public Policy Analyst monitors, evaluates, and provides recommendations on strategy and communications ... regarding federal and state public policy issues in support of the company's business objectives and requirements. The Analyst has key responsibility for… more
- Point32Health (Canton, MA)
- …will support the operations and analysis of risk adjustment strategy across Point32Health business lines. The Data Analyst will assist in managing vendor ... data and external analytics vendors to independently perform opportunity analyses across business divisions, product lines and provider groups + Support the program… more
- Evolent Health (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** Evolent is seeking a Senior Analyst , Primary Care Performance Analytics to join our Primary Care ... business , Evolent Care Partners. Evolent Care Partners' mission is...Care Organizations (ACOs) is preferred + Working knowledge of Medicare claims, episode and condition groupers, case/episode and risk… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: The Transplant Senior Finance Manager directs and plans the financial activity for the Transplant Institute. Develops annual operating and capital ... the evaluation phase through the post-transplant phase. Participates in the Medicare cost-report process to ensure appropriate hospital reimbursement for all… 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
- 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