- Abt Global Inc. (Durham, NC)
- …seeks to add a talented researcher to its team of experts conducting policy-relevant Medicare and Medicaid research and evaluation. The successful candidate ... key technical roles on projects for the Centers for Medicare and Medicaid Services (CMS). As a...Medicaid Services (CMS). As a member of the Research , Monitoring, and Evaluation Capability, you will collaborate on… more
- Abt Global Inc. (Durham, NC)
- … research expert with demonstrated success directing projects funded by the Centers for Medicare and Medicaid Services (CMS). As a member of the Research , ... Opportunity** Abt Global seeks to expand its health care research team with the addition of a health care...a project director or equivalent for projects focused on Medicare policy. + Contribute subject matter expertise in the… more
- Prime Therapeutics (Raleigh, NC)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- Humana (Raleigh, NC)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... our caring community and help us put health first** The MarketPoint Senior Compliance Professional ensures compliance with governmental requirements. The Senior … more
- UNC Health Care (Smithfield, NC)
- …credits to resolve credit balances through refunds or posting adjustments. Compiles Medicare / Medicaid Cash Reports and quarterly Credit Balance reports. 6. Payor ... to drive improvements in preventing denials or resolving aging accounts. 9. Research & Transplant: performs charge reviews, follow-up and payment allocations for HB… more
- UNC Health Care (Morrisville, NC)
- …staff members, department heads and senior leaders to furnish the Medicare and/or Medicaid auditors with the supporting documentation to minimize adjustments ... analysis and review, and internal consulting in preparation for filing the annual Medicare , Medicaid , and Champus/Tricare cost reports for UNC Health Care… more
- Humana (Raleigh, NC)
- …benefits organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...leveraging core consulting skills to support delivering some of Medicare and Medicaid 's highest priority projects and… more
- Elevance Health (Durham, NC)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division within...Medicare experience which includes previous experience at a Senior Auditor level in health care, public accounting, or… more
- Humana (Raleigh, NC)
- …delivering high priority projects and initiatives across our insurance products (including Medicare , Medicaid , Med Supp, PDP, and others), with an emphasis ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Raleigh, NC)
- …in the country. **Location:** remote The Insurance Strategy team supports Humana's Medicare and Medicaid lines of business. This business unit, Humana's ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Mathematica (Raleigh, NC)
- …Agile methodology. * Conceptual and practical knowledge of health data (eg commercial, Medicare , Medicaid , or APCD claims data; EHR and/or HIE data; healthcare ... sources such as EHRs and HIEs, to effectively answer research questions about health care policy. * Incorporate client...some of our largest clients, including the Centers for Medicaid & Medicare Services (CMS) and other… more
- Humana (Raleigh, NC)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Senior Product Designer partners with specialty product teams to design specialty products that… more
- Evolent (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 - Required and Preferred:** +...by any state or federal health care program, including Medicare or Medicaid , and is not identified… more
- Evolent (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 ... exclusion 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… more
- Prime Therapeutics (Raleigh, NC)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... Analyst (Regulatory Intelligence and Assessment) - Remote **Job Description** The Senior Compliance Analyst assists in the implementation of Prime's compliance… more
- Mathematica (Raleigh, NC)
- …Staff in our Health unit will eventually work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts will ... or remotely.* The HCLS business development team focuses on expanding Mathematica's research , digital, data, and advisory services offerings with clients across the… more
- Humana (Raleigh, NC)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... and Reporting: Monitor sustainability metrics and develop reports for senior leaders outlining the effectiveness of sustainability initiatives. ADD: Oversight… more
- Cardinal Health (Raleigh, NC)
- …concurrent assignments and work with a sense of urgency + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred ... specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers. Individualized… more
- Cardinal Health (Raleigh, NC)
- …benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and ... and expertise in the areas of advice and consulting, research and patient care to internal business units and...instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The… more