- Mathematica (Washington, DC)
- …https://www.mathematica.org/career-opportunities/benefits-at-a-glance. Mathematica is looking for a highly organized Medicaid Project Associate to contribute ... and support the work of projects in the Federal Medicaid practice. As a part of a project team, the Associate will be responsible for coordinating and… more
- Abt Global Inc. (Rockville, MD)
- …meaningful work? Now's your chance. **The Opportunity** Abt Global seeks an experienced Medicaid researcher (Senior Associate ) to play a leadership role in our ... technical programming staff to design and implement analyses using Medicaid claims and administrative data to meet project...to work effectively in a team environment. + Senior Associate Level: Master's degree + 13 years of relevant… more
- Humana (Washington, DC)
- …Fee Schedule Management System + Collaborate with Markets, Claims, Policy, Process and Project Managers to accommodate new Medicaid logic and identify the ... of our core cross-functional team responsible for ensuring timely and accurate Medicaid Physician reimbursement. The business needs of the team, Integrated Network… more
- Humana (Washington, DC)
- …health first** Humana Healthy Horizons is seeking a Manager, Compliance - Medicaid State Reporting to ensure compliance with governmental requirements across the ... determine approach, resources, schedules, and goals. The Manager, Compliance - Medicaid State Reporting develops and implements compliance policies and procedures,… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Medicaid Actuary role is responsible for providing actuarial support for multiple states in ... are the specific day to day responsibilities of the Medicaid Actuary role: + Frequent analysis of actual experience...of technical experience + 2 or more years of project leadership experience **Scheduled Weekly Hours** 40 **Pay Range**… more
- Humana (Washington, DC)
- …part of our caring community and help us put health first** The Physical Security Project Manager 2 will report to the Physical Security Lead and assist in managing ... protection of company assets through physical security projects. The Physical Security Project Manager 2 will be responsible for the design, implementation, and… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Associate Actuary role is a role within the Insurance Products Actuarial Medicare Advantage ... ad hoc projects and analysis to help enhance Part D accuracy. The Associate Actuary, Pricing work assignments involve moderately complex to complex issues where the… more
- Humana (Washington, DC)
- …of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex… more
- Humana (Washington, DC)
- …part of our caring community and help us put health first** The Associate Director, Privacy & Ethics monitors compliance in accordance with government regulations ... relating to the Health Insurance Portability and Accountability Act (HIPAA). The Associate Director, Privacy & Ethics requires a solid understanding of how… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** An Associate Actuary on the Medicare Financial Planning & Analysis Team will be responsible ... A foundation in Medicare and/or Corporate Finance is preferred. The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing… more
- Guidehouse (Mclean, VA)
- …and delivering impactful project results within the Centers for Medicare & Medicaid Services (CMS). You will own the delivery of projects that aim to achieve ... with a passion for creative problem-solving, client service, and project management. **Job Description/Responsibilities** + Provide leadership and oversight of… more
- Highmark Health (Washington, DC)
- …underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management ... the most complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level… more
- Humana (Washington, DC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Washington, DC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Washington, DC)
- …+ Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if there are concerns ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees… more
- Humana (Washington, DC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- CenterWell (Washington, DC)
- …on moderately complex to complex issues regarding the technical approach for project components and work without direction. The Senior Risk Professional will: + ... senior management, or regulatory agencies as required. + Ensures that project /department milestones/goals are met. + Contributes to annual and longer-range… more
- Humana (Washington, DC)
- …analytic solutions. The Stars program is the Centers for Medicare & Medicaid Services (CMS) five‐star quality rating system for measuring Medicare beneficiaries' ... improve the decision-making experience for stakeholders + 2 or more years of project leadership experience + Experience analyzing data to solve a wide variety of… more
- Humana (Washington, DC)
- …+ Master's Degree or higher in Computer Science or a related field + Associate or Professional level solution architecture certification in Azure, GCP and/or AWS. + ... in Enterprise Architecture repository tools like iServer + 2+ years of project leadership and consulting experience. + Health Care Business Domains - Medicare,… more
- Humana (Washington, DC)
- …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude ... a law firm or in-house health care organization + Experience in Medicare, Medicaid , or similar regulatory work + Strong legal research, analytical, and writing/oral… more