- Humana (Raleigh, NC)
- …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 (Raleigh, NC)
- …us put health first** Humana Healthy Horizons is seeking a Compliance Lead ( Medicaid State Reporting) to ensure compliance with governmental requirements for new ... Medicaid market implementations. This leader will work within specific...insurance, and/or financial services experience. + 2+ years of project /process leadership experience. + 4+ years of Compliance, Policy,… more
- Humana (Raleigh, NC)
- …deliver quality and value in a fast-paced, dynamic environment to support our Medicaid program through engaging in the transformation of clinical data to inform ... make an impact** **Responsibilities:** + Become an expert in HEDIS and Medicaid specifications, processes, and schedules + Partner to develop comprehensive … more
- Humana (Raleigh, NC)
- …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
- American Institutes for Research (Chapel Hill, NC)
- **Overview** Join AIR as a ** Project Associate ** with ourHealth (https://www.air.org/our-work/health) team. Our Health team works collaboratively to unravel the ... at ftc.gov/scams . \#LI-Remote #LI-SH1 Submit an interest application (https://jobs-airdc.icims.com/jobs/13149/ project - associate %2c-health/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627785) **Please note, each section of the… more
- Humana (Raleigh, NC)
- …our caring community and help us put health first** Humana is seeking a Senior Project Manager to join our growing team. The Senior Project Manager manages all ... to finish, and works to drive on-time and on-budget projects. The Senior Project Manager works on problems of diverse scope and complexity ranging from moderate… more
- American Institutes for Research (Chapel Hill, NC)
- **Overview** Join AIR as a **Research Associate ** with ourHealth (https://www.air.org/our-work/health) Division to support the implementation and evaluation of ... Federal Agencies such as the Centers for Medicare and Medicaid Services (CMS) and state and local governments. The...policies to different audiences. + Help with administrative and project management tasks. + Write, compile, and edit assigned… more
- Humana (Raleigh, NC)
- …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 (Raleigh, NC)
- …part of our caring community and help us put health first** The Associate Director, Process Improvement - Telesales Stars Program position analyzes, and measures the ... develops sustainable, repeatable and quantifiable business process improvements. The Associate Director, Process Improvement requires a solid understanding of how… more
- American Institutes for Research (Chapel Hill, NC)
- **Overview** Join AIR as a **Research Associate ** with ourHealth (https://www.air.org/our-work/health) team. Our Health team works collaboratively to unravel the ... validate, analyze, and document large datasets for both internal and project -related use. + Provide operational and programmatic support, including design,… more
- American Institutes for Research (Chapel Hill, NC)
- **Overview** Join AIR as a **Research Associate ** with ourHealth (https://www.air.org/our-work/health) team. Our Health team works collaboratively to unravel the ... Write, compile, and edit assigned portions of proposals and project reports. + Review work products to ensure quality...healthcare payment models from the Centers for Medicare and Medicaid Services (CMS) is preferred, but not required. **Skills:**… more
- Highmark Health (Raleigh, NC)
- …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 (Raleigh, NC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid , or other Medical management organizations, hospitals/ Integrated Delivery Systems, ... medical management review organization, such as Medicare Advantage and managed Medicaid + Physical Medicine and Rehabilitation, Internal Medicine, Family Practice,… more
- Humana (Raleigh, NC)
- …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 (Raleigh, NC)
- …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 (Raleigh, NC)
- …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 (Raleigh, NC)
- …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
- Humana (Raleigh, NC)
- …+ 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 (Raleigh, NC)
- …Management Professional is part of the Service Excellence team within Enterprise Associate and Business Solutions. Service Excellence plays a pivotal role in the ... with reporting, data, technology solutions and business analytics. The Enterprise Associate and Business Solutions (EABS) organization forms part of the Chief… more
- Humana (Raleigh, NC)
- …Bachelor's degree + 5+ years of technical experience + 2 years of project leadership experience + 4+ years of experience producing financial analysis, metrics, ... Understanding of data center technology and IT infrastructure + Program or Project Management Experience + Six Sigma certification + PMP certification + Demonstrated… more