- Mathematica (Austin, TX)
- …searching for several seasoned professional who are recognized experts with experience leading Medicaid and programs at the state level to join our growing state ... focused on one or several of the following areas: Medicaid , CHIP, Home- and community-based services, Medicaid ...work. Position Requirements: * 10/+ years of experience (Principal Researcher ) or 15/+ years of experience (Senior Fellow) in… more
- Humana (Austin, TX)
- …This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize, ... growth partners to design and optimize clinical operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy ... to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a...with the following attributes: * Creative - Adept at research to determine the opportunity and a structured yet… more
- Mathematica (Austin, TX)
- …part of the AI Health Outcomes Challenge held by Centers for Medicare and Medicaid Services, members of this team developed a cloud data pipeline and machine ... analytics involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data...sources such as EHRs and HIEs, to effectively answer research questions about health care policy. * Incorporate client… more
- Mathematica (Austin, TX)
- …warehouses, interactive dashboards, data analytics, and visualization products; and research and advisory. * Accountability for all project deliverables alongside ... large primary and secondary data sources to effectively answer research questions and guide decision-making about health care policy....salary range of $145,000 - $185,000. This position is eligible for a discretionary bonus based on company and… more
- Mathematica (Austin, TX)
- …complex staffing or performance problems. * Work collaboratively across technology and research and advisory services teams. * Actively support the advancement of ... salary range of $100,000 - $135,000. This position is eligible for a discretionary bonus based on company and...will eventually work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on… more
- CVS Health (Austin, TX)
- …schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases for clinical and legal ... Association (AHFI) or have a minimum of three years Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience...how to do pivot tables). + Strong analytical and research skills. + Proficient in researching information and identifying… more
- AbbVie (Dallas, TX)
- …This position will call on managed care organizations, Medicare MACs, state Medicaid , Medicare Advantage and commercial plans to increase coverage of PRM (Plastic ... Principal Responsibilities: + Call on managed care organizations, Medicare MACs, state Medicaid , and Advantage plans to increase coverage of PRM product portfolio by… more
- Prime Therapeutics (Austin, TX)
- …we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal Actuary is responsible for supporting the development ... strategic pricing advice on structures and methodology using market research , financial projections, and complex actuarial modeling + Present...+ Actuarial designation (ASA or FSA) + Must be eligible to work in the United States without need… more
- Public Partnerships LLC (Austin, TX)
- …largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support ... or court orders by the requested dates . Unclaimed Property management; research , process payments & report unclaimed property . Performs non-payroll transaction… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy ... clients. We are a diverse set of highly skilled individuals with deep Medicaid subject matter expertise working in an agile, collaborative environment. To achieve… more
- Humana (Austin, TX)
- …our goals, we seek talent with the following attributes: Creative - Adept at research to determine the opportunity and a structured yet flexible approach to problem ... to maximize available resources to achieve growth. + Leads National Medicaid Strategic Priorities, effectively develops LTSS-based strategic goals and turns them… more
- Humana (Austin, TX)
- …is one of the largest health benefits organizations in the country. Location: remote The Healthcare Strategy team supports Humana's Medicare and Medicaid ... management consulting experience to support delivering some of Medicare and Medicaid 's highest priority projects and initiatives, with an emphasis on Medicare… more
- Humana (Austin, TX)
- …accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and ... + Strong written and verbal communication skills in a remote work environment + Highly motivated, and a self-starter...the requisition number so we may be able to research your request quicker. \#LI-LM1 **Scheduled Weekly Hours** 40… more
- CenterWell (Austin, TX)
- …Risk Professional develops and implements compliance policies and procedures. Research compliance issues and recommends changes that assure compliance with ... and regulations as it relates to healthcare compliance in Medicare, Medicaid , and/or clinical industries (includes anti-kickback and Stark statutes, government… more
- Cardinal Health (Austin, TX)
- …specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers. Individualized ... agreed upon by the client + As needed conduct research associated with issues regarding the payer, physician's office,...+ Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage,… more
- MD Anderson Cancer Center (Houston, TX)
- …and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, ... the rules and regulations set forth by the Centers for Medicare and Medicaid Services (CMS). **Key Functions** 1. Collaborates with management to determine the best… more
- Humana (Austin, TX)
- …and the capability to effectively communicate data insights. The candidate will research best business practices within and outside the organization to establish ... + Ability to work with Product Manager, Stakeholders, and remote teams at all levels in the organization in...education, certifications, etc.$63,400 - $87,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity… more
- Cardinal Health (Austin, TX)
- …payer issues by region with the appropriate team + As needed conduct research associated with issues regarding the payer, physician's office, and pharmacy to resolve ... + Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage,...our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. ** REMOTE DETAILS:** You will work remotely, full-time. It will… more
- Cardinal Health (Austin, TX)
- …payer issues by region with the appropriate team * As needed conduct research associated with issues regarding the payer, physician's office, and pharmacy to resolve ... * Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage,...our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. REMOTE DETAILS: You will work remotely, full-time. It will… more