- Lundbeck (Dallas, TX)
- …navigating 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 field-based… 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
- 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
- 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
- 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
- Insight Global (Eden Prairie, MN)
- …Skills and Requirements *Expertise in Medicaid and DSNP Claims Domain ( Subject Matter Expert ). *Experience in capturing requirements in a ... healthcare setting. *Knowledge of CSP Facets *Claim Processing Experience more
- Highmark Health (Buffalo, NY)
- …improvement models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides ... HEDIS, risk revenue). + Function as the Organization's representative subject matter expert in government...as the clinical subject matter expert for PCP Medicare STARS, Medicaid HEDIS,… more
- Huntington Ingalls Industries (Woodlawn, MD)
- …and potential impact on business operations. + Collaborate with security teams and agency subject matter experts: Work closely with subject matter ... vital role in supporting our Centers for Medicare and Medicaid and Health and Human Services (HHS) efforts. What...security strategies based on threat intelligence insights. + Provide subject matter expertise and training: Educate internal… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …Coordinator-2\_R-001870-1?q=R-001870) to apply. + Serves as the subject matter expert in ... escalated matters. + Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid ...of Medicaid and Eligibility policy to interpret Medicaid claims. + Participates in the development and implementation… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …Coordinator-2\_R-001881?q=R-001881) to apply. + Serves as a subject matter expert (SME) ... and accuracy of the Buy-In System as it interfaces with the Louisiana Medicaid Eligibility Data System (LaMEDS), Medicaid Management Information System (MMIS)… more
- State of Georgia (Cobb, GA)
- …Assists with troubleshooting Medicaid problems, training staff, conducting audits and is subject matter expert on PE Pregnancy Medicaid policy. ... Management (PCM), Babies Born Healthy (BBH), PE Pregnant Woman Medicaid (PEMD). Responsibilities include, but not limited to: screen...Pay Grade F Current state employees' salary will be subject to State Personnel Board rule provisions. If you… more
- MyFlorida (Tallahassee, FL)
- …Also, the candidate will support the work of other analysts by serving as a subject matter expert if necessary. MPI's Practitioner Care Unit, is seeking ... entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000...intermittent tasks. OPS employees are at-will employees and are subject to actions such as pay changes, changes to… more
- Molina Healthcare (Fremont, NE)
- …to refer clients who may be eligible for other Molina products. + Viewed as a " subject matter expert " (SME) by community and influencers on the health care ... Responsibilities:** + Drive membership growth and retention for Molina Healthcare Medicaid . + Build and maintain relationships with community-based organizations and… more
