• Capture Lead, Medicaid Clinical…

    Humana (Boise, ID)
    …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 (08/15/24)
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  • Director, Medicaid Product Management…

    Humana (Boise, ID)
    …a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy ... Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to… more
    Humana (08/15/24)
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  • Southeast Medicaid Medical Director

    Humana (Boise, ID)
    …SC Medicaid market populations. + May provide cross-coverage for other state Medicaid markets, as well as participate on project teams or organizational ... The Medical Director reports to the Lead Medical Director for the Southeast Medicaid Markets. In this role, the Medical Director actively uses a medical background,… more
    Humana (08/10/24)
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  • Actuary, Medicaid (Remote)

    Humana (Boise, ID)
    …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 (07/26/24)
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  • Associate Actuary

    Humana (Boise, ID)
    …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 (07/18/24)
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  • Associate Actuary - Analytics/Forecasting

    Humana (Boise, ID)
    …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 (07/12/24)
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  • Associate VP, Demand and Portfolio…

    Humana (Boise, ID)
    …a part of our caring community and help us put health first** The Associate VP, IT Portfolio Management collaborates with the business portfolio team to align the ... IT portfolio and demand. The Associate VP, IT Portfolio Management requires a in-depth understanding...large scale, highly visible programs with responsibility for multiple project teams **Scheduled Weekly Hours** 40 **Pay Range** The… more
    Humana (08/02/24)
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  • Lead, LTSS Process Improvement

    Humana (Boise, ID)
    …a part of our caring community and help us put health first** The Medicaid Long-Term Supports and Services (LTSS) Process Improvement Lead analyzes and measures the ... diverse scope and complexity ranging from moderate to substantial. The LTSS Medicaid Process Improvement Lead researches best business practices within and outside… more
    Humana (08/16/24)
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  • Senior Consumer Experience Professional

    Humana (Boise, ID)
    …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 (08/16/24)
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  • Business Systems Consultant

    Highmark Health (Boise, ID)
    …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
    Highmark Health (06/18/24)
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  • Medical Director - Florida

    Humana (Boise, ID)
    …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 (08/16/24)
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  • Medical Director - Intermountain Region

    Humana (Boise, ID)
    …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 (08/15/24)
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  • Medical Director - Mid West Region

    Humana (Boise, ID)
    …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 (07/25/24)
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  • Sr Agency Professional - Finance/Accounting

    Humana (Boise, ID)
    …+ 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 (07/17/24)
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  • Senior Healthcare Risk Management Professional

    CenterWell (Boise, ID)
    …on moderately complex to complex issues regarding the technical approach for project components and work without direction. The Senior Healthcare Risk Professional ... senior management, or regulatory agencies as required. + Ensures that project /department milestones/goals are met. + Contributes to annual and longer-range… more
    CenterWell (08/16/24)
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  • Business Intelligence Valuation Lead

    Humana (Boise, ID)
    …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 (07/02/24)
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  • Senior Enterprise Architect

    Humana (Boise, ID)
    …+ 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 (07/19/24)
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  • Data Lake Architect - Remote US

    Public Partnerships LLC (Boise, ID)
    …and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and ... and Nginx. + Engage with Customers and stakeholders in all phases of project life cycle - requirements gathering, solution design reviews, development, testing, UAT,… more
    Public Partnerships LLC (08/06/24)
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  • Senior Product Owner

    Humana (Boise, ID)
    …on moderately complex to complex issues regarding technical approach for project components, andwork is performed without direction. Exercises considerable latitude ... such as Word, Excel, PowerPoint + Detail oriented with excellent organizational and project management skills + Critical thinker who can anticipate team needs and… more
    Humana (08/15/24)
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  • Senior Data Scientist

    Humana (Boise, ID)
    …applies new skills and technologies to meet the evolving needs of the project . + Develops, maintains, and collects structured and unstructured data sets for analysis ... on moderately complex to complex issues concerning the technical approach for project components and perform work independently. **Use your skills to make an… more
    Humana (08/13/24)
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