- Molina Healthcare (AZ)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Providence (OR)
- …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
- TEKsystems (Honolulu, HI)
- …working closely with a local healthcare company that is looking to become an Analyst . This position will play a crucial role in analyzing data, developing insights, ... and supporting the decision-making process with a focus on Medicare and Medicare claims. This is a...tools. + Collaborate with stakeholders to gather and document business requirements. + Conduct data validation and ensure data… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** Are you an experienced actuarial professional with a passion for Medicare Advantage? Join our dynamic team as a Senior Actuarial Analyst , ... you'll leverage your expertise in mathematics, probability, statistics, and business principles to support our rating/pricing, valuation, healthcare economics, and… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …of benefits information and proactively resolving COB issues. **Job Title: Medicare Benefits Validation Analyst ** **Location: Pearland Administrative Office** ... experience, certifications, etc.)** **Qualifications** **Education** Required: Bachelor's degree in business or healthcare administration Preferred: N/A **Experience** Required: 5… more
- G-TECH Services, Inc. (Detroit, MI)
- …activities with varying timelines. . Familiarity with Chapter 2 - Medicare Advantage Enrollment and Disenrollment guidance . . **Required Skills/Experience - ... reports and presentations to display operational data and proposed business changes. **Preferred Skills/Experience** - Optional but preferred skills/experience.… more
- AmeriHealth Caritas (Philadelphia, PA)
- …Discover more about us at www.amerihealthcaritas.com . **Responsibilities:** Support Medicare by managing various workflows essential to effectively executing ... + Monitor and troubleshoot ongoing processes to ensure continuity of critical business functions.; + Generating and distributing daily, weekly, and monthly reports… 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 ... of our Elevance Health PulsePoint locations.** The **Risk Adjustment Advanced Analyst Senior** is responsible for creating statistical models to predict, classify,… 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
- CVS Health (Austin, TX)
- …needs, elder/adult care, basic/everyday needs, and mental health. Due to expanded business , elder care is the top requested need. Additional Responsibilities: + The ... or customer service oriented. Additional responsibilities assigned based on business need. **Required Qualifications** - 1+ year(s) of experience **locating… more
- CVS Health (Austin, TX)
- …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
- 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
- BeneLynk (Detroit, MI)
- …conjunction with BeneLynk's Manager of Business Analysis, Quality Assurance, the Sr. Business Analyst - Quality Assurance, and the Engineering (ENG) team to ... they deserve. Currently BeneLynk serves clients representing 12 million Medicare /Medicaid lives in every state in the USA. The... Business Analysis, Quality Assurance and the Sr. Business Analyst - Quality Assurance regarding QA/UAT… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Medicare Advantage, Medicare Supplement, and individual plans. The Business Intelligence Programmer Analyst is responsible for transforming business ... support analytic deliverables and capabilities. The Sr. BI Programmer Analyst will have heavy interaction with our Business... Analyst will have heavy interaction with our Business Analysts to ensure all requirements are covered and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …improve care and health plan quality ratings across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid).** **Collaborates with ... care and health plan quality ratings across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid).** **Promotes collaboration… more
- Advanced Systems Design (Montgomery, AL)
- Advanced Systems Design is seeking a Business Analyst for our client located in Montgomery, AL. This position is onsite in Montgomery, AL, and requires in-person ... 1. Job Overview: + Our client requires a Senior Business Analyst (SBA) to support their operations....years of experience in MMIS or domain knowledge of Medicare , Medicaid or with a major health care payer… more
- BeneLynk (Sunrise, FL)
- …environment for our employees to thrive in their ability to assist others. BUSINESS ANALYST POSITION SUMMARY BeneLynk, a leading national provider in identifying ... to lead healthier lives, is seeking to hire a Business Analyst to join the Product Management...Medicare /Medicaid lives in every state in the USA. Business analysts are the drivers of our continued growth… more
- Medical Mutual of Ohio (OH)
- …of business lines and functional areas and interacts with the respective business partners. The analyst 's work assignments are directed by the Manager of ... Strategy Analyst ** Education and Experience + Bachelor's degree in Business Administration, Healthcare, Finance, Economics, or a related field with 5 years… more
- Medical Mutual of Ohio (OH)
- … Supplement, and individual plans.** **Responsibilities** **Provider Reimbursement Analyst II** Under general supervision, supports assigned provider network ... rate loading. . Performs other duties as assigned. **Qualifications** **Provider Reimbursement Analyst II** . Bachelor's degree in business or healthcare… more
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