- Humana (Dover, DE)
- …the needs of state clients and populations served in target growth markets. The Lead , Medicaid Clinical & Population Health Strategy, will advance Humana's ... improving the health of the communities it serves. The ** Medicaid Capture Management ** team's purpose is to...and Medicare integration, D-SNPs, and Self-Directed Services. The Capture Lead , Medicaid Clinical & Population Health Strategy… more
- Sumitomo Pharma (Dover, DE)
- …role with 2-3 days a week required in office. **Job Duties and Responsibilities** + Lead operations person for all Medicaid decisions as it relates to Model N ... data input into company systems. + Maintains service standards in processing data submitted by customers and proactively advises management of issues. + Able… more
- Public Consulting Group (Dover, DE)
- …looking for an experienced Medicaid Consultant to join our team and help lead our growth efforts. Deep Medicaid experience is critical, as well as experience ... schedule, , quality, , communications, risk, and , stakeholder management activities, all while adding deep Medicaid ...states plan for and execute SMC/OBC activities * Help lead and provide expert level guidance on various projects… more
- Humana (Dover, DE)
- …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...benefits remain attractive. + Evaluate benefit performance to develop data driven insights to inform benefit design. + Collaborate… more
- Mathematica (Dover, DE)
- …team designed, developed, and secured a cloud-based, web application to streamline data collection, management , and reporting for the public health-public safety ... development of analytics products such as interactive dashboards and data driven applications. * Lead the design...data pipelines and perform analytics involving large administrative data sources such as state Medicaid claims… more
- Humana (Dover, DE)
- …health first? The DoD SkillBridge or Military Spouse Financial Planning & Analysis Lead Intern will utilize Humana's Medicaid training and mentorships and engage ... military experience and education to perform within the finance Medicaid segment. Financial Planning & Analysis Lead ...experience developing methods and criteria for measuring and summarizing data for complex analyses + Ability to lead… more
- Humana (Dover, DE)
- …and protection of data assets, enterprise-wide governance processes and tools, sensitive data management , data literacy and data quality. This ... health first** The role of the Vice President, Enterprise Data Governance & Protection is to lead ...data rich environment, fortified by best practices in data management . Toward this goal, the Enterprise… more
- Humana (Dover, DE)
- …a part of our caring community and help us put health first** The Lead Cloud Solutions Engineer (Network) is responsible for the planning, design, and engineering of ... infrastructure and platforms related to cloud network & cloud computing. The Lead Cloud Solutions Engineer (Network) provides strategic advice and guidance to… more
- Humana (Dover, DE)
- …and accountability of deadlines and value propositions. + Strong knowledge of data governance, risk management and information security processes including SOC, ... a part of our caring community and help us put health first** The Lead Systems Engineer is responsible for the oversight of multiple systems and projects direction,… more
- Humana (Dover, DE)
- …services. **Responsibilities:** The Value-Based finance team is seeking a Financial Analytics Lead . This individual will work across the business, and will be highly ... of business and growth strategies. The position will work directly with senior management , including the Segment President, Senior Leaders, and SVPs, to validate and… more
- Humana (Dover, DE)
- …our caring community and help us put health first** The Organization Effectiveness (OE) Lead will lead strategic organizational changes with a primary focus on ... enterprise and corporate functions. The OE Lead will report to the Director, Organization Effectiveness. Primary Responsibilities: + Collaborate with senior-level… more
- Humana (Dover, DE)
- …and help us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and ... addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality audits, prior… more
- Humana (Dover, DE)
- …and help us put health first** The Strategy Advancement Advisor provides data -backed strategic direction to identify and address business issues and opportunities ... analyze complex problems and issues related to our Medicare Advantage population using data and insight from internal and external sources. They will bring expertise… more
- Humana (Dover, DE)
- …+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, ... medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Experience with national guidelines such… more
- Highmark Health (Dover, DE)
- …schedule and pricing changes made by health plans, CMS and/or the states' Medicaid programs. **ESSENTIAL RESPONSIBILITIES** + Lead in working with customers, ... the underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change … more
- Humana (Dover, DE)
- …+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, ... medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Dover, DE)
- …+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, ... medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Public Consulting Group (Dover, DE)
- …allocation for public assistance programs including but not limited to Medicaid , the Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance for ... exceeding performance expectations + Develop and deliver progress reports, project management artifacts, and client presentations + Plan, monitor, and manage ongoing… more
- Humana (Dover, DE)
- …accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and ... owner), Main Line Health System, and Jefferson Health System. Humana takes the lead in providing administrative support in various areas including HR. DVACO's MSSP… more
- Mathematica (Dover, DE)
- …deliverables alongside operations and maintenance, as well as innovating and enhancing clients' data systems, tools, resources, and services. * Lead the design ... Position Description: Mathematica applies expertise at the intersection of technology, data , methods, policy, and practice to improve well-being around the world. We… more