- Baylor Scott & White Health (Boston, MA)
- **JOB SUMMARY** The Risk Adjustment Analyst Sr (Texas Medicaid Encounter Analyst ) is responsible for monitoring and oversight of the end-to-end encounter ... to government agencies such as Centers for Medicare and Medicaid Services (CMS) or Health & Human Services (HHS)....processing and submission issues and develops recommendations based on data and industry standards. + Performs various financial… more
- Commonwealth Care Alliance (Boston, MA)
- …TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical ... applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for...and report outcome results on edits implemented. + Utilize data to examine large claims data sets… more
- Commonwealth Care Alliance (Boston, MA)
- …Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery Analyst will assist in the development of a strategic roadmap to recover, ... programs that will drive incremental value year over year. The PI Recovery Analyst will employ use of analytics, trends, competitor benchmarking, and outcomes to… more
- Center For Health Information And Analysis (Boston, MA)
- …and analyze different datasets. Proficiency in analysis and management of financial , statistical, demographic, and clinical data primarily utilizing Excel, ... and Analysis (CHIA), we serve as stewards of Massachusetts health data , employing multifaceted datasets and cutting-edge analytics to ensure transparency in… more
- Humana (Boston, MA)
- …health first** The Actuarial Analyst 1, Analytics/Forecasting analyzes and forecasts financial , economic, and other data to provide accurate and timely ... and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Actuarial Analyst 1, Analytics/Forecasting… more
- Humana (Boston, MA)
- …health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial , economic, and other data to provide accurate and timely ... and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** Senior Actuarial Analyst - Remote **Job Description** The Senior Actuarial Analyst is ... and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid ). This role will also provide actuarial support in complex projects that are… more
- Prime Therapeutics (Boston, MA)
- …pricing support for all Prime's lines of business (commercial, Medicare and Medicaid ). **Responsibilities** + Build, support, and maintain financial and ... drives every decision we make. **Job Posting Title** Actuarial Analyst -Remote **Job Description** The Actuarial Analyst ...and projections + Perform and review ad hoc pharmacy data mining and analyses to help investigate and answer… more
- Public Consulting Group (Boston, MA)
- …specific timeline and budget while working at a detailed level. + Strong analytical and financial data analysis skills. + Attention to detail and ability to work ... to succeed. Services: + Teaching + Learning Solutions + Data Systems + IT Solutions + Financial ...service delivery for state behavioral health authorities. + Conducts financial analysis for Medicaid rate studies and… more
- Public Consulting Group (Boston, MA)
- …client relationships. + Strong quantitative skills and ability to analyze and interpret financial data . + Ability to research, analyze and interpret policy, ... HCBS waivers such as 1915(c), 1915(i), 1915(j), and 1915(k), along with Medicaid State Plan benefits, PACE, SNFs, and ICF-IID. Knowledge must include federal… more