- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... business process and technical workflow documents. + Understand Medicaid risk score methodology, including risk score calculation, financial risk receivable… more
- General Dynamics Information Technology (Fairfax, VA)
- …experience **Job Description:** At GDIT, people are our differentiators. As Data Analyst /Statistician you will lay the groundwork for program integrity to be ... government programs grow. Our work depends on a Data Analyst /Statistician joining our team to support the Centers for...our team to support the Centers for Medicare and Medicaid Services. You will support a diverse and multi-disciplinary… more
- Queen's Health System (Honolulu, HI)
- …B. EXPERIENCE: * In addition to the educational requirement, three (3) years pharmacy operations, business operations or finance experience, preferably in a ... monitoring and routine auditing of virtual inventory accumulation, purchasing procedures, Medicaid billing procedures, patient eligibility, new areas of service, and… more
- Humana (Louisville, KY)
- …caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical ... effectiveness within the Medicaid segment. This function integrates Medical Economics, Clinical Insights, and Quality to deliver improved health outcomes, optimized… more
- State of Colorado (CO)
- …Job WHAT YOU'LL BE DOING AS ESI WORK REQUIREMENTS INTEGRATION BUSINESS ANALYST : + Department's Staff Authority for Colorado Medicaid Enterprise System (CMES) ... Enterprise Solutions Integration (ESI) Work Requirements Integration Business Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5178627) Apply … more
- Prime Therapeutics (Rancho Cordova, CA)
- …Come build the future of pharmacy with us. **Job Posting Title** Consulting Business Analyst , Principal - Remote - Must be Located in CA **Job Description** ... The Consulting Business Analyst Principal provides strategic analytical leadership...Experience using the SDLC process + Experience working in Medicaid Every employee must understand, comply with and attest… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... operational requirements for Medicare Advantage(MA), Affordable Care Act (ACA) & Medicaid Lines of Business (LOB). Additional responsibilities include… more
- Henry Ford Health System (Troy, MI)
- …Alliance Plan's (HAP's): Commercial, Medicare Advantage, Medicare- Medicaid Program (MMP), and Medicaid lines of business . Analyst must identify trending ... on an ongoing basis and provide root/cause analysis when required. The Analyst will work with HAP's medical directors, nurses, pharmacists, Legal department, and… more
- Prime Therapeutics (Boise, ID)
- …we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Compliance Analyst (Regulatory Change Management) ... - Remote **Job Description** The Compliance Analyst assists in the implementation of Prime's compliance programs within their designated areas and partners with key… more
- Mount Sinai Health System (New York, NY)
- … Analyst has responsibilities that include: analyzing medical and pharmacy trends, researching all facility amendments, procuring all financial data necessary ... of patients. We are accelerating a transition to a business model focused on population health management - our...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Prime Therapeutics (Columbia, SC)
- …future of pharmacy with us. **Job Posting Title** Senior Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs...to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The Compliance ... launch and beyond, focusing on balancing customer needs with business goals. + Consults with business areas...legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated… more
- Prime Therapeutics (Little Rock, AR)
- …the future of pharmacy with us. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior Compliance Analyst assists in the ... across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance. +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Supply Chain Analyst (Data Science Analyst I) collaborates with stakeholders from across the organization to develop sophisticated ... analytics to provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning, decision-making, goal setting, and… more
- Molina Healthcare (Columbus, OH)
- …Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid , Marketplace and Medicare/MMP. + 3+ Years of experience ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...as well as Reporting modules related to Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. + Analysis and reporting related… more
- Option Care Health (Bannockburn, IL)
- …best and brightest talent in healthcare. **Job Description Summary:** The Analyst , Compliance Auditing, Monitoring and Analytics is responsible for supporting the ... local regulations. + Always respect and maintain the confidentiality of sensitive business and patient information. + Always maintain files and work papers… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …core member of the Government Programs Star Performance team, the Medicare Stars Analyst provides ongoing analytic support to the development and execution of the ... company, eg performance measurement and improvement, clinical quality, operations, and pharmacy , to identify opportunities for improvement and measures of success in… more
- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial and even clinical… more
- Molina Healthcare (NM)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial and even clinical… more
- CVS Health (Tallahassee, FL)
- …all with heart, each and every day. **Position Summary** The **Revenue Cycle Analyst ** reports directly to the Senior Manager, Reimbursements Concepts, Inc ( _RCI_ ... 3+ years of experience in healthcare. + Working knowledge of Medicare, Medicaid and Third-Party Insurance payers and reimbursement guidelines. + Strong competency… more