• Medicaid Project Associate

    Mathematica (Honolulu, HI)
    …https://www.mathematica.org/career-opportunities/benefits-at-a-glance. Mathematica is looking for a highly organized Medicaid Project Associate to contribute ... and support the work of projects in the Federal Medicaid practice. As a part of a project team, the Associate will be responsible for coordinating and… more
    Mathematica (06/23/24)
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  • Actuary, Medicaid (Remote)

    Humana (Honolulu, HI)
    …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 (06/24/24)
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  • Associate Actuary - Analytics/Forecasting

    Humana (Honolulu, HI)
    …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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  • Business Systems Consultant

    Highmark Health (Honolulu, HI)
    …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 / Full Time

    Humana (Honolulu, HI)
    …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 (07/12/24)
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  • Medical Director - Southeast Region

    Humana (Honolulu, HI)
    …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 (07/12/24)
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  • Medical Director - Mid West Region

    Humana (Honolulu, HI)
    …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 (07/03/24)
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  • Senior Vendor Management Professional

    Humana (Honolulu, HI)
    …Leads projects of high sensitivity/confidentiality + Report out SLA performance and project delivery to key stakeholder groups and prepare remediation plans when ... leadership on a weekly basis. + Leads continuous improvement initiatives for project management and delivery. + Has overall responsibility for service issue… more
    Humana (07/03/24)
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  • Business Intelligence Valuation Lead

    Humana (Honolulu, HI)
    …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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  • Sr Enterprise Architect

    Humana (Honolulu, HI)
    …+ 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 (07/12/24)
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  • Counsel

    Humana (Honolulu, HI)
    …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude ... a law firm or in-house health care organization + Experience in Medicare, Medicaid , or similar regulatory work + Strong legal research, analytical, and writing/oral… more
    Humana (07/03/24)
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  • Senior Process Improvement Professional

    Humana (Honolulu, HI)
    …systems strategy and functional roadmap + Responsible for the life cycle of project from planning to implementation. To include but not limited to: integration, ... + Develop and maintain relationships between TA Leadership, HR Technology Partners, project team and key stakeholders + Responsible for effective vendor management… more
    Humana (05/23/24)
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  • Business Systems Analysis Professional

    Humana (Honolulu, HI)
    …scrubbing for outgoing mailings, problem solving issues for Dental providers, project management of process improvements/business initiatives, and SME on identifying ... work experience. + 3-5 years of technical experience (data analysis, IT project work, communication) + Experience with critical thinking and problem analysis and… more
    Humana (07/10/24)
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  • Lead, IT Portfolio Management

    Humana (Honolulu, HI)
    …Qualifications** + 5 or more years of experience in IT, Process Improvement and/or Project Management + 3 or more years of experience leading special projects and ... to run large scale, highly visible programs with responsibility for multiple project teams + PMP Certification + Six Sigma or Equivalent certification **Additional… more
    Humana (07/03/24)
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  • Principal Enterprise Architect

    Humana (Honolulu, HI)
    …+ Consults and guides application development teams throughout the entire project lifecycle from conceptual solution design through implementation. + Performs ... of technical experience, or equivalent, and 2-5 years of project /people leadership **Preferred Qualifications** **Additional Information** **Scheduled Weekly Hours**… more
    Humana (06/15/24)
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  • Senior Fraud and Abuse Investigator

    Humana (Honolulu, HI)
    …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude ... Candidates located in or adjacent to Kentucky + Bachelor's degree or Associate Degree + Graduate degree and/or certifications (MBA, JD, MSN, Clinical Certifications,… more
    Humana (07/13/24)
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  • Market Finance Lead

    Humana (Honolulu, HI)
    …+ Experience in the Medicare Advantage bid process + 2+ years of project leadership experience + 3+ years of healthcare experience **Additional Information** Work at ... 10 Mbps is recommended to support Humana applications, per associate . + Wireless, Wired Cable or DSL connection is...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (07/09/24)
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  • Procurement Lead - Member Benefits & Medical…

    Humana (Honolulu, HI)
    …and Medical Records Category Lead will report directly to the Associate Director in Enterprise Procurement & Supplier Management (EPSM) supporting, developing, ... oversight. + Meticulous and critical thinker. + Experience in developing project plans and presenting business cases to Senior Leaders. **Preferred Qualifications**… more
    Humana (07/09/24)
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  • Provider Reconciliation Program Lead

    Humana (Honolulu, HI)
    …is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being, ... supervision **Preferred Qualifications** + Stars experience/knowledge + SQL experience/knowledge + Project management + Power BI experience + AAPC or AHIMA coding… more
    Humana (06/23/24)
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  • Senior Software Engineer

    Humana (Honolulu, HI)
    …on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. + Exercises considerable ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
    Humana (07/13/24)
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