- Humana (Albany, NY)
- …of our caring community and help us put health first Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results.… more
- Humana (Richmond, VA)
- …Senior Market Finance Professional supports more than half of Humana's Medicaid business, providing technical financial analysis and data -driven insights to ... in Medicaid claims and premiums. Deliver project-based and ad-hoc reporting for Medicaid markets; provide insights into membership analysis, provider… more
- Allied Universal (Mission Viejo, CA)
- …Desktop Inspectors and other PEO SVS operational staff for the execution and reporting of site visit inspection performance. Professional attire, demeanor, and ... inspector will perform site visit inspection services for Medicare and Medicaid providers/suppliers in accordance with established requirements. The Inspector works… more
- Humana (Indianapolis, IN)
- …your skills to make an impact Required Qualifications Minimum of 2 years' professional experience in Medicaid data management, healthcare operations Ability ... Encounter Data Management Lead supports the Encounter Data Management team within the Healthcare Quality Reporting...for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare, and DSNP states,… more
- Humana (Oklahoma City, OK)
- …waste and abuse within the healthcare industry Knowledge of the Medicare and Medicaid programs Experience in data analysis Must be passionate about contributing ... and help us put health first The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring… more
- Abt Global Inc. (Rockville, MD)
- …+ Translate CMS research and policy needs into IT solutions that enable data -driven decision-making. + Develop dashboards and reporting tools to monitor payment ... is what we do every day at Abt. Advancing data -driven innovations is no small task, but we are...you will support a large-scale Center for Medicare & Medicaid Services (CMS) project. This role will be contracted… more
- NORC (Washington, DC)
- …of health care payment and delivery interventions on outcomes and cost using data files derived from Medicare, Medicaid , and commercial payer administrative ... input and direction to staff on research design, methodology, data analysis, and interpretation for Medicare and Medicaid...motivate, inspire, and build high-performing teams. + Experience in reporting on research to a wide range of both… more
- Commonwealth Care Alliance (Boston, MA)
- …strategic objectives. The Manager leads performance evaluation and improvement efforts, including reporting and data analysis, to ensure delegated entities meet ... full management responsibility for all performance measure components, including end-to-end data collection, evaluation, and timely dissemination of reports to both… more
- University Health (Pleasanton, TX)
- …led by Population Health Management (PHM). Duties include developing, reviewing, and validating data reports, as well as presenting findings in a clear and concise ... manner to improve reporting and documentation practices. Oversees information management related to...and information sciences to identify, collect, process, and manage data and information. Conducts workflow analysis and integrates multiple… more
- Commonwealth Care Alliance (Boston, MA)
- …management, (c) coordination of onboarding and training of related CBO staff, (d) data review, reporting and analysis, and (e)assistance to these external ... in meetings/calls with ASAPs and LTSC Agencies - Performance reporting / data management support o Link with CCA's...that CCA implements. - Working knowledge of Medicare and Medicaid (MassHealth) - Familiarity with and full support of… more
- Commonwealth Care Alliance (Boston, MA)
- …inquiries and facilitating collaborative discussions on improvement opportunities. Performance Reporting & Data Management Partner with Quality Analytics ... on CCA's Population Health goals; including Medicare Star measures, Medicaid -Medicare Plan withhold measures, quality performance metrics incorporated into other… more
- Commonwealth Care Alliance (Boston, MA)
- …and outcomes, and leads performance evaluation and improvement efforts. Through reporting , data analysis, and partnership management, the LTSS Program ... and data accuracy, including roster reconciliation, payment processes, and reporting . + Manage special projects related to program development, process redesign,… more
- Commonwealth Care Alliance (Boston, MA)
- …inquiries and facilitating collaborative discussions on improvement opportunities. **Performance Reporting & Data Management** + Partner with Quality ... on CCA's Population Health goals; including Medicare Star measures, Medicaid -Medicare Plan withhold measures, quality performance metrics incorporated into other… more
- Molina Healthcare (Louisville, KY)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... abuse, and over utilization by providers and recipients. The position will review claims data , medical records, and billing data from all types of healthcare… more
- Commonwealth Care Alliance (Boston, MA)
- …strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This role ensures providers are well-informed, engaged, ... facing staff apprised of messaging and timelines. + Present reporting and trends to the committee + Develop and...standards, and provider-friendly + Work with provider network and data management to influence how provider contact information is… more
- Humana (Annapolis, MD)
- …programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. The Primary Care CFO will lead a team ... and key market benchmarks. Leads all aspects of Primary Care financial reporting and projections Forecasts, compiles, and analyzes financial, economic and other … more
- Houston Methodist (Katy, TX)
- …meetings, resources and equipment, to ensure staff competency and professional pathway progression. Communicates updates/changes to processes, managed care ... systems to enhance operations; supports entity-specific performance improvement and data management/analysis functions. Employs a proactive approach in the… more
- CVS Health (Frankfort, KY)
- …for compliance-related challenges. Experience with Microsoft Excel with advanced proficiency for data analysis and reporting to strengthen internal controls and ... data management platforms. Education Bachelor's degree preferred/specialized training/relevant professional qualification. Anticipated Weekly Hours 40 Time Type Full… more
- Commonwealth Care Alliance (Boston, MA)
- …in a matrixed environment. - Proficiency in Microsoft Office Suite; experience with data reporting tools preferred. - Ability to function independently and ... relationships with behavioral health providers and driving performance improvement through data insights, education, and partnership. This individual will serve as… more
- Commonwealth Care Alliance (Boston, MA)
- …- Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word) and comfort with data dashboards or reporting tools. - Ability to lead and facilitate ... and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. - Lead initiatives to streamline provider… more
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