- USAA (Tampa, FL)
- …special! **The Opportunity** We are currently seeking a dedicated **Business Process Owner Senior ** that will support Medicare Supplement Claims for USAA Life ... Chief Claims & Fraud Officer and will work on Medicare Supplement Claims activities and ensure a flawless execution...the process. Supports alignment of process to overall experience strategy and vision. We offer a flexible work environment… more
- The Cigna Group (Bloomfield, CT)
- …Business Analytics Senior Advisor will be responsible for leading the analytics strategy for Cigna Healthcare within the Medicare Stars program with a focus ... operational and analytical support to internal and external partners to improve Cigna's Medicare Star Ratings. The Business Analytics Senior Advisor will lead… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Prepares data for inclusion in presentations on strategic requirements to senior leadership related to implementations of systematic and procedural changes to ... the assembly of documentation and data to support analytical reporting to senior business operational leaders and physician leadership regarding: + Audit results to… more
- Elevance Health (Atlanta, GA)
- …designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. ... **Preferred Skills, Capabilities and Experiences** + Knowledge and understanding of Medicare rules and regulations for program areas including but not limited… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Senior Risk Management Professional identifies and analyzes potential sources of loss to ... minimize risk. The Senior Risk Management Professional work assignments involve...and development of applicable monitoring of threats to clinical/UM strategy ** . Responsibilities include: + Research new or emerging… more
- Elevance Health (Columbus, OH)
- …Services to transform federal health programs. The **Audit and Reimbursement Senior -Appeals** will support our Medicare Administrative Contract (MAC) with ... of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare...strategy but will also lead to personal and professional growth for our associates. Our values and behaviors… more
- Humana (Louisville, KY)
- …part of our caring community and help us put health first** The Senior Compliance Professional develops and implements compliance policies and procedures. ... Maintains relationships with government agencies. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues regarding… more
- Humana (Columbus, OH)
- …one of the largest health benefits organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Insurance… more
- Humana (Little Rock, AR)
- …part of our caring community and help us put health first** The Senior Stars Improvement Professional is responsible for development, implementation, and ... engagement, quality improvement programs, NP team engagement and initiatives. The Senior Stars Improvement Professional work assignments involve coordinating,… more
- Humana (Oklahoma City, OK)
- …a part of our caring community and help us put health first** The Senior Quality Compliance Professional uses quality compliance and improvement tools and ... close gaps in care for Oklahoma Medicaid enrollees. The Senior Quality Compliance Professional has proven data...analyze and interpret healthcare data/information in order to develop strategy and build interventions to close gaps in care.… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Senior Financial Planning and Analysis Professional analyzes and forecasts financial, economic, ... provide accurate and timely information for strategic and operational decisions. The Senior Financial Planning and Analysis Professional work assignments involve… more
- Point32Health (Canton, MA)
- …Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Compliance Senior Manager will report to the Government Programs Compliance Officer. ... laws and regulations related to the Government Programs Compliance Programs for Medicare and Duals products. This role involves guiding teams and processes while… more
- Humana (Louisville, KY)
- …financial reporting, and provide actionable insights that drive business performance. The Senior Financial Analytics Professional manages data to support and ... operations, strategic planning and specific business performance issues. The Senior Financial Analytics Professional work assignments involve moderately… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Senior Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to ... transform high volumes of complex data into advanced analytic solutions. The Senior Data Scientist work assignments involve moderately complex to complex issues… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Senior Market Finance Professional collects, analyzes and reports on various market data ... to connect financial outcomes with operational effectiveness. The Senior Market Finance Professional work assignments involve moderately complex to complex… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures ... accuracy for pharmacy point of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional work assignments involve moderately… more
- Humana (Louisville, KY)
- …statements of work. Apply today, we would love to talk to you. The Senior IT Vendor Management Professional investigates available IT contingent labor suppliers; ... to develop cost effective strategies aligned with business objectives. Drives the strategy and selection of vendors. Coordinates the negotiation and execution of… more
- Humana (Nashville, TN)
- …health first** The RN Senior Stars Improvement, Clinical Consultant / Professional executes the overall Medicare Stars Improvement Program within the market, ... performance within the contracted working relationship with the health plan. The RN Senior Stars Improvement Consultant / Professional : + Builds and maintains… more
- University of Michigan (Ann Arbor, MI)
- …Apply Now **Job Summary** The Senior Corporate Compliance Director (? Senior Director?) is responsible for leading the strategy , development, implementation, ... Medicine?s (?MM?) statewide Corporate HIPAA Compliance Program (?Program?). The Senior Director?s responsibilities include, but are not limited to, developing,… more
- Humana (Louisville, KY)
- …unit strategy , and/or business analysis experience + Balance Scorecard Professional Certification (BSPC) + .OKR Certification **Use your skills to make an ... a part of our caring community and help us put health first** Humana's Strategy Management Office partners with executives across the enterprise to further Humana's … more