- Mathematica (Columbus, OH)
- …in multidisciplinary teams, drawing on your knowledge and past experience with Medicaid programs * Help conduct research and technical assistance projects ... to the growth, expertise, and institutional knowledge of staff working in the Medicaid area Position Requirements: * Researcher candidates should have 5/+ years… more
- American Institutes for Research (Chapel Hill, NC)
- …to avoid scams at ftc.gov/scams . \#LI-DC1 #LI- Remote Submit an interest application (https://jobs-airdc.icims.com/jobs/13170/ researcher ... **Overview** Join AIR as a ** Researcher - Quality Measures** with ourHealth (https://www.air.org/our-work/health) team.AIR's Health Division specializes in … more
- Molina Healthcare (WI)
- **Job Description** **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects. Provides… more
- Molina Healthcare (AZ)
- …negotiating strategies, modeling current and future contract rate proposals. + Research , analyze, and consult Medicaid and Medicare reimbursement methodologies, ... **JOB DESCRIPTION** **Job Summary** Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- Molina Healthcare (ID)
- …Effectively uses current and emerging technologies. **Job Functions** * Leverage analytics and quantitative methods to inform and influence decision making * ... with internal, external and enterprise individuals as needed to research , develop and document new standard reports or processes...tracking for at least one line of business among Medicaid , Marketplace and Medicare/MMP. + 5+ Years of experience… more
- Staffing Solutions Organization (Albany, NY)
- …reflection of our clients and the people they serve. **Data Scientist-Healthcare Analytics : Item 1292 Remote position** **Summary:** This individual will assist ... Data Scientist-Healthcare Analytics Corning Tower, Albany, 100 S Mall Arterial,...the NYSDOH (Quality Reporting Requirements, VBP Reporting Requirements, and Medicaid claims and encounters) and other state and federal… more
- Kepro (Raleigh, NC)
- …crafting testing strategies and software quality assurance methodologies specific to Medicaid MES systems. + Develop customized test strategies during the proposal ... phase, ensuring test plans meet RFP requirements and address state-specific Medicaid needs. + Lead technical presentations to prospective clients, showcasing the… more
- Humana (Columbus, OH)
- …put health first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( Remote ). Healthcare is rapidly changing, and our members are living ... longer, often with more chronic conditions. The Clinical Analytics team identifies opportunities and build solutions to improve clinical outcomes and lower costs for… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** Although this position is REMOTE , candidates are preferred to live in the MD, DC, VA, PA area in order to travel into the offices on ... occasion. **PURPOSE:** Supports the Maryland Medicaid pharmacy program by performing pharmacy benefit related activities and operational support. Helps drive… more
- Molina Healthcare (MA)
- …Ohioans seeking care. **KNOWLEDGE, SKILLS & ABILITIES** Quality Improvement (QI) - Ohio Medicaid + Learn how healthcare quality impacts the Medicaid ... Study Act) to enable enhanced health outcomes for the Medicaid population + Work closely with our QI Provider...with our QI Provider Engagement team, QI specialists, Quality Analytics team and their leadership + Lead and assist… more
- Mathematica (Columbus, OH)
- …innovation within Mathematica and with our clients, fostering a culture of innovation * Analytics & Product Development o Lead the design of products from concept to ... inclusion lens across job responsibilities o Engage with our research team during usability testing and user research...of 7-10 years of experience in data science and analytics , with a strong focus on healthcare * Advanced… more
- Prime Therapeutics (Columbus, OH)
- …identification opportunities for improved management of Medical benefit drugs through clinical research and analytics that improve medical cost savings and ... **Job Posting Title** Director, Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary** Responsible for support and development of… more
- Huron Consulting Group (Chicago, IL)
- …are now and create your future. **Position Summary** Your passion and expertise in clinical research will make you a key member of Huron's Research Office Team. ... Clinical Research Administrative Specialist II, you will assist Huron's Research Office team in developing coverage analysis, drafting and negotiating study… more
- Children's Mercy Kansas City (Kansas City, MO)
- …beyond the walls of our hospital. Overview Reporting to the Director of Medicaid OPS and Provider Relations, (or ICS Population Health Facilitation Manager) the ICS ... input from provider and staff, care team members, and continued research on clinical guidelines, and clinical recommendations. Implements changes as necessary… more
- SSM Health (MO)
- **It's more than a career, it's a calling** MO- REMOTE **Worker Type:** Regular **Job Highlights:** **_Named 150 Top Places to Work in Healthcare 2023 - Becker's ... fellow colleague, please contact: Jon Dirksen Executive Talent Partner ###@ssmhealth.com \#LI- Remote SSM Health is committed to equal employment opportunity based on… more
- The Cigna Group (Bloomfield, CT)
- …or new standards of practice. * Contributes to strategy for outcome measurement and research ; works with Evernorth analytics and operations in the preparation of ... privacy standards, regulatory compliance (OSHA, CDC, Centers for Medicare and Medicaid , HIPAA, and management of reputational issues. * Represents Occupational… more
- CareFirst (Baltimore, MD)
- …**PURPOSE:** The Payment Integrity Analyst is responsible for conducting research and analysis and reviewing billing requirements, provider manuals, medical ... on their findings. **This role will be focused on Medicare and Medicaid lines of business.** **ESSENTIAL FUNCTIONS:** + Identifies, develops, and implements new… more
- American Institutes for Research (Chapel Hill, NC)
- …science and technology tools. The selected candidate will collaborate in research , technical assistance, and operations projects funded by Federal Agencies (such ... as Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control...nonpartisan, not-for-profit institution that conducts behavioral and social science research and delivers technical assistance to solve some of… more
- Commonwealth Care Alliance (Boston, MA)
- …that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and ... research , as necessary on all new and revised coding...necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance… more
- CVS Health (Sacramento, CA)
- …Double Board Certified Oncologist/Internal Medicine for this opportunity. This is a remote based from from home role. The Medical Affairs department provides ... departments (eg, specialty pharmacy services, clinical product development, Enterprise Analytics , Compliance, Legal, Accreditation) and clients. The Medical Director… more