• Medicaid / Healthcare Systems

    TEKsystems (Monroe, NC)
    Systems /Solutions Architects for these specific openings. Overall Skills Architecture, Enterprise Architecture, Healthcare , Medicaid , Cloud, data ... Enterprise Architecture specialization. They are not seeking ...ArchiMate, TOGAF, MITA, data architecture Must-have Skills Details Architecture, Enterprise Architecture, Healthcare / Medicaid , Cloud, data… more
    TEKsystems (01/15/25)
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  • Senior Enterprise Architect

    Humana (Raleigh, NC)
    …application and/or solution architect or technical lead in large company spanning multiple enterprise systems . + 8 or more years design, development, and testing ... you IT Professional obsessed with a business-centric outlook? At the Humana Enterprise Architecture unit, our mission is to deliver a perfect member/patient… more
    Humana (01/25/25)
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  • Project Director

    HCA Healthcare (Asheville, NC)
    …leading large, enterprise -scale projects or programs preferred + Healthcare , hospital systems , hospital, supply chain, workforce management, financial ... and programs to successful completion across multiple hospitals, business offices, or health systems , preferably in healthcare revenue cycle + Minimum of 5 years… more
    HCA Healthcare (01/17/25)
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  • Value-Based Contracting Lead

    Humana (Raleigh, NC)
    …operations teams to ensure executed VBP amendments are loaded correctly into Humana systems + Manage internal contract repository for Medicaid VBP Operations ... a part of our caring community and help us put health first** The Medicaid Value Based Contracts Lead is responsible for ensuring Medicaid Value-Based Payment… more
    Humana (01/23/25)
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  • Business Consultant

    HealthEdge Software Inc (Raleigh, NC)
    …products (from basic to advanced features/functionality), payment methodologies/policies (Medicare, Medicaid , and commercial), payment integrity, and healthcare ... enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial… more
    HealthEdge Software Inc (12/18/24)
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  • Principal Application System Analyst: Facets

    BlueCross BlueShield of North Carolina (NC)
    …meet systems analysis standards and are aligned with the Enterprise Business Process Architecture. + Prioritize requirements through negotiation, release and ... elaboration and system functional design to solution the most complex enterprise -wide business demands through enabling technology and/or business processes that… more
    BlueCross BlueShield of North Carolina (12/19/24)
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  • Clinical Strategy Lead

    Humana (Raleigh, NC)
    …first** Humana is a $100 billion (Fortune 50) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As ... live life fully and be their most productive. Within Clinical Strategy, the Enterprise and Specialty Strategy team employs a rigorous process to set specific… more
    Humana (01/11/25)
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  • Value-Based Reimbursement Strategic Partners…

    Highmark Health (Raleigh, NC)
    …The incumbent influences VBR integration into the overall Enterprise strategy through collaboration with Senior-level internal/external stakeholders. Ensures ... advocacy societies and key thought leaders. + Ensure integration with Enterprise /PNR strategic direction. Collaborate with PNR stakeholders to incorporate VBR into… more
    Highmark Health (01/08/25)
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  • Provider Data Management Professional

    Humana (Raleigh, NC)
    …for quality assurance and risk mitigation in implementing Humana's Provider Medicare/ Medicaid contracts. We are in search of a Business Intelligence Engineer ... will be revised; followed by loading them into Humana systems . As a Business Intelligence Engineer 1 you will...process and make connections with other areas of the enterprise , the Provider Contract Team has a time-in-job commitment… more
    Humana (01/25/25)
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  • Senior Cloud Security Engineer(remote)

    Humana (Raleigh, NC)
    …incident response, maintaining operational integrity and minimizing downtime across enterprise systems . **Required Qualifications** + **Bachelor's Degree** in ... other cloud workflows using **IaC** . + Implement and manage enterprise security policies using **Prisma CSPM's** advanced capabilities, including preventive… more
    Humana (11/06/24)
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  • Associate Director Cloud Architecture

    Humana (Raleigh, NC)
    …mission critical data platform environments for 24x7 availability. + Experience with large enterprise level systems and managing data at scale. + Experience with ... efficient conversion of structured and unstructured data to insights at enterprise scale. The Associate Director, Cloud Architecture requires an in-depth… more
    Humana (11/02/24)
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  • Provider Reimbursement Admin (Evaluation…

    Elevance Health (Durham, NC)
    …of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. + Performs CPT/HCPCS code and fee schedule updates, ... and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication… more
    Elevance Health (01/24/25)
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