- Mathematica (Raleigh, NC)
- …of Medicaid , payment and financing at the state or federal level * Senior Researcher candidates should have 10/+ years of experience working in health policy ... teams, drawing on your knowledge and past experience with Medicaid programs * Help conduct research and...anticipated base salary of $100,000 - $130,000 annually. The Senior Researcher position offers an anticipated base… more
- Humana (Raleigh, NC)
- …first** Humana Healthy Horizons is seeking exceptional candidates to join our Medicaid Product Strategy Organization to advance Humana's Medicaid products and ... to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a...model for new markets. We deliver value through detailed research , data-driven insights, strategic planning, structured problem solving, and… more
- CVS Health (Raleigh, NC)
- …make health care more personal, convenient and affordable. **Position Summary** The Medicaid senior manager, network management: * Negotiates, executes, conducts ... in contract management systems per Aetna's established policies. . * Conducts research , analysis and/or audits to identify issues and propose solutions to protect… more
- Humana (Raleigh, NC)
- …help us put health first** Humana's Corporate Marketing Organization is looking for a Senior Market Research Professional to join the Market Research team ... the health of the people we serve. As the Senior Market Research Professional, you will work...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Raleigh, NC)
- …to shape Humana's future enterprise clinical strategies and initiatives. The Senior Research Scientist applies mathematical, statistical, epidemiologic and data ... of healthcare cost using high volumes of structured and unstructured data. The Senior Research Scientist will have the opportunity to exercise considerable… more
- Humana (Raleigh, NC)
- …part of our caring community and help us put health first** The Senior Agency Management Professional analyzes transactions posted to the general ledger, 1099 ... updates for accruals, prepaid, and adjusting updates or entries. The Senior Agency Management Professional work assignments involve moderately complex to complex… more
- Humana (Raleigh, NC)
- …factors. For our Dental and Vision insurance products in Puerto Rico, the Senior Compliance Professional shall: + Research regulatory compliance issues and make ... caring community and help us put health first** This Senior Compliance Professional role supports Humana's suite of Medicare...Dental and Vision compliance issues in Puerto Rico * Research , understand and apply federal and state laws, regulations,… more
- Abt Global Inc. (Durham, NC)
- …and meaningful work? Now's your chance. **The Opportunity** Abt Global seeks a Senior Analyst / PhD Economist to support our portfolio of domestic health work ... within Abt's Research , Monitoring, & Evaluation Capability team. As a member...government agencies, such as the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, and… more
- Humana (Raleigh, NC)
- …great benefits? Then we have a role for you! Humana is seeking a Senior Business Intelligence Engineer who will solve complex business problems and issues using data ... reports and dashboards in Power BI. Apply today! The Senior Business Intelligence Engineer on the MarketPoint Sales Reporting...the requisition number so we may be able to research your request quicker. **Scheduled Weekly Hours** 40 **Pay… more
- Public Consulting Group (Raleigh, NC)
- …allocation for public assistance programs including but not limited to Medicaid , the Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance for ... effectively facilitate client discussions. + Effectively communicate with clients at senior leadership levels. + Identify and elicit requirements from key… more
- Humana (Raleigh, NC)
- …put health first** Humana's Corporate Marketing organization is looking for a Senior Product Owner that is Salesforce Marketing Cloud Email Specialist certified to ... just may be the role for you! As the Senior Product Owner, you will support Humana's marketing journeys,...of any delivery risks or issues + Identify and research potential pre and post production issues and assist… more
- UNC Health Care (Chapel Hill, NC)
- …to resolve credit balances through refunds or posting adjustments. Compiles Medicare/ Medicaid Cash Reports and quarterly Credit Balance reports. 6. Payor Audits ... to drive improvements in preventing denials or resolving aging accounts. 9. Research & Transplant: performs charge reviews, follow-up and payment allocations for HB… more
- American Institutes for Research (Chapel Hill, NC)
- …ourHealth (https://www.air.org/our-work/health) team.The selected candidate will collaborate in research , technical assistance, and operations projects funded by ... Federal Agencies (such as Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control...data and provide support to the project director and/or senior team members on various tasks including querying large… more
- Humana (Raleigh, NC)
- …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
- CVS Health (Raleigh, NC)
- …-In this role you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director, Medical Affairs. These ... -In this role you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director, Medical Affairs. These… more
- Prime Therapeutics (Raleigh, NC)
- …and potential owners and clients. This position will collaborate with the Senior Principal Actuary to provide strategic consulting support, manage the development of ... a subject matter expert (SME) with underwriters, other areas of Prime, and senior management on pricing initiatives, data analyses, and the Request For Proposal… more
- Highmark Health (Raleigh, NC)
- …health, industry trends), and lines of business (ex. ACA, commercial, Medicare Advantage, Medicaid ). The work can include new research and updating existing ... :** United Concordia Dental **Job Description :** This role conducts in-depth research and analysis, and develops and deliver reports and presentations on various… more
- Evolent Health (Raleigh, NC)
- …in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... for utilization management while working in conjunction with the Senior Medical Director. **Qualifications:** + MD/DO/MBBS + Current, unrestricted clinical… more
- Evolent Health (Raleigh, NC)
- …is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of Inspector… more
- Humana (Raleigh, NC)
- …approaches to assignments. This position will focus on supporting Humana's senior -focused primary care operations including: + Support risk adjustment activities and ... in Medicare or similar regulatory work + Strong legal research , analytical, and writing skills + Ability to work...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more