- Dana-Farber Cancer Institute (Brookline, MA)
- The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other ... and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying Clinical… 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 ... 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
- Kelsey-Seybold Clinic (Pearland, TX)
- …of benefits information and proactively resolving COB issues. **Job Title: Medicare Benefits Validation Analyst ** **Location: Pearland Administrative Office** ... customer service, and third-party coverage Preferred: Prior experience with Medicare Advantage including knowledge of regulations, products, and processes. Prior… 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 full time opportunity and must come on-site on the first day… more
- G-TECH Services, Inc. (Detroit, MI)
- …activities with varying timelines. . Familiarity with Chapter 2 - Medicare Advantage Enrollment and Disenrollment guidance . . **Required Skills/Experience - ... . Experience with reconciliation processes. Familiarity with Chapter 2 - Medicare Advantage Enrollment and Disenrollment guidance Proficient in Microsoft Office… 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
- AmeriHealth Caritas (Philadelphia, PA)
- …Discover more about us at www.amerihealthcaritas.com . **Responsibilities:** Support Medicare by managing various workflows essential to effectively executing ... data analytics, research, project management, or process improvement. + Familiarity with Medicare , Medicaid, and Affordable Care Act (ACA), or the health insurance… 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 , ... required). + Minimum of 4 years of experience in Medicare Advantage. + Completion of at least 5 actuarial...Join us and make a significant impact on our Medicare Advantage programs. Apply today to be part of… 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
- 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 (Austin, TX)
- …Fully Remote ANYWHERE within the continental US **The schedule is Monday through Friday, 11:45am to 8:15pm Eastern Time.** 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 WLC is… more
- CVS Health (Austin, TX)
- …Fully Remote ANYWHERE within the continental US **The schedule is Monday through Friday, 11:00am to 7:30 pm Eastern Time.** Training hours may differ from the shift ... you are hired for. The WorkLife Consultant (WLC) is part of the WorkLife Team and provides consultation, assessment, and resource referrals to a variety of customers for a variety of needs including child care, elder/adult care, and basic/everyday needs. The… 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
- Library of Congress (Washington, DC)
- …The Congressional Research Service (CRS), Domestic Social Policy (DSP) Division seeks an Analyst in Health Policy ( Medicare ) to provide expertise on Medicare ... ideal candidate will have academic and professional skills/training in Medicare and public health policy (eg, Part B premiums,...analyst to work primarily on issues related to Medicare , including Part B premiums, financing, end stage renal… more
- Molina Healthcare (Columbus, OH)
- …**Job Summary** Under supervision, applies software engineering methods and techniques to the design, development, integration, qualification and/or support of ... Microsoft Reporting Services, SQL stored procedures and developing areas of expertise. **KNOWLEDGE/SKILLS/ABILITIES** + Creates reports to meet user requirements using Microsoft SQL Reporting Services. + Writes and maintains database stored procedures. +… more
- R1 RCM (Houston, TX)
- …Accounting systems to deliver quality work products to R1' s clients. The Medicare Advantage Analyst is primarily responsible for researching underpayments as ... you will leverage your experience and expertise in complex Medicare Advantage payor methodology, payment screenings and experience maneuvering...they relate to Medicare Advantage payor population and researching processing issues, examining… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s ... best possible health and quality of life. **Responsibilities** **Clinical Quality Data Analyst I** **Supports the design, execution and delivery of analyses and… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... achieve their best possible health and quality of life. **Corporate Strategy Analyst III** The Corporate Strategy team works closely with senior leaders across… more
- Medical Mutual of Ohio (OH)
- … Supplement, and individual plans.** **Responsibilities** **Provider Reimbursement Analyst II** Under general supervision, supports assigned provider network ... payment models. . Performs other duties as assigned. **Provider Reimbursement Analyst III** Under general to limited supervision, supports assigned provider network… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... best possible health and quality of life. Business Systems Analyst II Provides the interface between the business and...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.… more
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