- General Dynamics Information Technology (Fairfax, VA)
- …equivalent combination of education and experience) + 5+ years of experience in quality assurance + Previous experience in Medicare , Medicaid, or Marketplace + ... Able to Obtain:** None **Public Trust/Other Required:** None **Job Family:** Quality Assurance **Skills:** Quality Assurance Processes, Quality … more
- Molina Healthcare (Georgetown, KY)
- …improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application upgrades and ... existing health plans. + Must have experience working on QNXT/ Medicare /NetworX + Must have experience working on SQL. +.../NetworX + Must have experience working on SQL. + Medicare claims experience is a huge plus + … more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr . Supervisor, Sr . Manager, Director, ... interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of...key program performance metrics, such as utilization, coding, and STARs/ quality performance + Assist in the STARS and clinical… more
- The Cigna Group (Bloomfield, CT)
- **The job profile for this position is Nurse Case Management Senior Analyst , which is a Band 3 Senior Contributor Career Track Role.** **For this position, ... Nurse Case Manager Senior Analyst , through the case management process,...of a defined population.** **The Case Manager will promote quality cost-effective outcomes managing care needs through the continuum… more
- Molina Healthcare (Nicholasville, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
- Healthfirst (NY)
- …policies and procedures, reporting and project specifications, job aids and workflows for Medicare products. + Leads the setup and monitoring of Medicare ... in collaboration with our Pharmacy Benefit Manager (PBM). + Collaborates with our Medicare product team to identify and implement benefit solutions to promote … more
- The Cigna Group (Bloomfield, CT)
- This position, the Nurse Case Manager Senior Analyst , through the case management process, will promote the improvement of health outcomes to members and assist ... defined population based on business perspectives. The Case Manager will promote quality cost-effective outcomes managing care needs through the continuum of care… more
- The Cigna Group (Bloomfield, CT)
- **The job profile for this position is Nurse Case Management Senior Analyst , which is a Band 3 Senior Contributor Career Track Role.** For this position, ... Nurse Case Manager Senior Analyst , through the case management process,...of a defined population. The Case Manager will promote quality cost-effective outcomes managing care needs through the continuum… more
- CVS Health (Columbus, OH)
- …affordable. **Position Summary** This position is responsible for recruitment of quality dental networks of dentists, providing access and affordability for Aetna ... Dental Commercial and Medicare clients and members. Utilizing a remote, but mobile work environment, the position additionally fosters growth of managed care… more
- Elevance Health (Hanover, MD)
- **Risk Adjustment Advanced Analyst Senior ** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles ... PulsePoint locations.** **Preferred Location:** Hanover, MD. The **Risk Adjustment Advanced Analyst Senior ** is responsible for creating statistical models to… more
- The Cigna Group (Bloomfield, CT)
- …the effectiveness of alternative care services and that cost effective, quality care is maintained. Maintains current knowledge of Cigna Healthcare Policies ... and practitioners and providers. + Evaluate each case for quality of care, document and report quality ...Management + 1-2 years of oncology nursing experience + Medicare and/or Medicaid experience with geriatric populations + Certified… more
- The Cigna Group (Denver, CO)
- …conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance External Representative's responsibilities include: + ... office staff on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment, medical cost management, etc. + Schedules, prepares… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Sr Financial & Provider Compensation Analyst Full time, 80 hours per pay period, Day shift Covenant Medical Group is Covenant Health's employed and ... to align with month end close. + Calculate cost/expense during the year for Medicare Advantage plans to offset Provider bonuses via reporting, for VP of Finance… more
- CVS Health (Providence, RI)
- …Summary** The Health Plan Client Engagement Reporting team is looking for a Senior Analyst who will collaborate with key stakeholders to assess business ... internal/external partners to ensure effective and accurate communication. The Senior Analyst must have the ability to...industry experience with at least 1 year working with Medicare or Quality reporting * Basic analytic… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …and purpose of the job. Reporting to the Director of Physician Revenue Cycle, the Senior Revenue Cycle Analyst ( Sr . RCA) is both a transformational leader ... and an analyst . The Sr . RCA has an in-depth...Children?s Healthcare Alliance (PCHA) and hospital revenue cycle. The Senior Revenue Cycle Analyst will collaborate with… more
- University of Michigan (Ann Arbor, MI)
- …Title** Programmer/ Analyst Senior underfill Intermediate **Job Title** App Programmer/ Analyst Sr **Work Location** Ann Arbor Campus Ann Arbor, MI **Modes ... Programmer/ Analyst Senior underfill Intermediate Apply Now...of health services and clinical research, implementation science and quality improvement with a focus on kidney disease but… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Senior Financial Analyst - Remote **Job Description Summary** This position requires ... and resolving complex problems and issues. + If supporting Medicare Part D, will be responsible for implementing CMS...adjust focus **Reporting Structure** + Reports to Manager or Sr Director in the Finance department **Responsibilities** + 3+… more
- Texas Health Resources (Arlington, TX)
- **Revenue Cycle Charge Capture Senior Analyst ** _Texas Health Resources is looking for a top skilled Revenue Cycle Charge Capture Senior Analyst . Is that ... Will Do** Under general direction of the Revenue Cycle Manager Charge Capture the Senior Analyst Charge Capture serves in a role tasked with improving revenue… more
- The Mount Sinai Health System (New York, NY)
- …for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting Analyst has responsibilities that include: analyzing medical and pharmacy ... largest US health systems with a strong reputation for quality of care and research. We have over 38,000...across the Mount Sinai Health System. MSHP seeks a ** Senior Contracting Analyst ** to analyze and report… more
- CVS Health (Richardson, TX)
- …is exciting opportunity to join a high performing, collaborative team as a Sr Analyst Informatics. This position will be responsible for Developing, enhancing, ... develop user friendly dashboards using complex health care datasets from different Medicare data sources. + Creates high performance Tableau reports that address… more