• Medicaid Analyst

    Phoebe Ministries (Allentown, PA)
    Medicaid Analyst Full-time - Allentown, PA Phoebe Ministries is hiring a Medicaid Analyst to join our long-term care facility in Allentown, PA. We show ... Reimbursement. + Service Awards & Recognition Gift Cards. Responsibilities for a Medicaid Analyst with Phoebe Allentown: The Medicaid Analyst will… more
    Phoebe Ministries (12/17/24)
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  • Analyst , Medicaid Rebates

    Sumitomo Pharma (Harrisburg, PA)
    …a dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for ... to clean up historical utilization that is routinely submitted with Medicaid claims. In addition, the analyst will load Medicaid claim information into the… more
    Sumitomo Pharma (11/07/24)
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  • Healthcare Claims - Business Analyst

    Wolters Kluwer (Philadelphia, PA)
    …teams in agile ceremonies and story grooming. **Qualifications:** + 3+ years as a Medicare/ Medicaid Compliance Analyst - Revenue Cycle​ + 1+ years of EHR or ... the Role:** We are seeking a highly skilled Business Analyst to join the Mediregs team focusing on claims...to software maintenance and final acceptance testing. The Business Analyst works closely with a cross-functional team of application… more
    Wolters Kluwer (01/11/25)
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  • Product Management Senior Analyst - Express…

    The Cigna Group (Philadelphia, PA)
    …accountabilities associated with all regulated lines of business including Medicare, Medicaid , and Marketplace (Exchange / Health Care Reform). The team supports ... be to support the Grievance functions as it relates to the Medicare, Medicaid and Marketplace (Exchange / Healthcare Reform) initiatives to ensure member/client and… more
    The Cigna Group (12/04/24)
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  • Operations Analyst , Associate (Allegheny…

    UPMC (Pittsburgh, PA)
    UPMC Health Plan is seeking a full-time Operations Analyst , Associate to support the Medicare HCC Department. This position will support operations in Allegheny and ... to travel up to 2 hours. The Associate Operations Analyst oversees administrative, system processes, and special projects as...EMR systems is a bonus. + Knowledge of Commercial, Medicaid , Medicare and Individual products preferred. + Competence in… more
    UPMC (01/10/25)
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  • Rebate Analyst II

    Takeda Pharmaceuticals (Exton, PA)
    …is true to the best of my knowledge. **Job Description** **Rebate Analyst II** **Takeda Pharmaceutical** **Exton, PA** **About the role:** Are you looking ... Analysts II located in Exton, PA. As the Rebate Analyst II, you will perform calculations and generate payments...This includes providing detailed reporting to the Centers for Medicaid and Medicare Services (CMS) auditors and/or designees in… more
    Takeda Pharmaceuticals (01/10/25)
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  • Actuarial Analyst , Pricing

    Humana (Harrisburg, PA)
    …of our caring community and help us put health first** The Actuarial Analyst 2, Pricing is responsible for setting pricing assumptions, submitting bids, filing and ... maintains pricing tools that price standard and custom benefits. The Actuarial Analyst 2, Pricing work assignments are varied and frequently require interpretation… more
    Humana (01/08/25)
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  • Product Analyst

    Prime Therapeutics (Harrisburg, PA)
    …our passion and drives every decision we make. **Job Posting Title** Product Analyst **Job Description** The Product Analyst is responsible for delivering ... and working in an Agile environment across interdependent teams, the Product Analyst clearly communicates with cross functional teams, collaborating to create and… more
    Prime Therapeutics (01/08/25)
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  • Product Management Lead Analyst - Express…

    The Cigna Group (Philadelphia, PA)
    **Position Summary** The Lead Analyst will be a part of the Regulated Markets Network Quality team. This critical role coordinates client and pharmacy reporting and ... client contractual needs. This role is highly cross-functional, with the lead analyst working across multiple departments in the company (eg Supply Chain, Knowledge… more
    The Cigna Group (12/28/24)
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  • Value-Based Programs Analyst

    Humana (Harrisburg, PA)
    …community and help us put health first** The Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department ... collaboration of provider contract loading and maintenance. The Value-Based Programs Analyst supports our Market Contracting and Market Finance partners in multiple… more
    Humana (01/10/25)
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  • Senior Business Intelligence Data Analyst

    Humana (Harrisburg, PA)
    …communicate findings, you should strongly consider the Senior Business Intelligence Data Analyst opportunity. Humana is seeking an individual for the Senior Business ... Intelligence Data Analyst to provide support for its expansion of value-based...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (01/07/25)
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  • Sr. Compliance Analyst (Regulatory…

    Prime Therapeutics (Harrisburg, PA)
    …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst (Regulatory Intelligence and Assessment) - Remote **Job Description** The Senior ... Compliance Analyst assists in the implementation of Prime's compliance programs...or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must… more
    Prime Therapeutics (12/17/24)
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  • Senior Compliance Analyst (Interpretation…

    Prime Therapeutics (Harrisburg, PA)
    …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs...or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must… more
    Prime Therapeutics (12/17/24)
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  • Board Certified Behavioral Analyst - H

    Aveanna (Downingtown, PA)
    Board Certified Behavioral Analyst - H ApplyRefer a FriendBack Job Details Requisition #: 196319 Location: Downingtown, PA 19335 Category: BCBA Salary: $35.00 - ... setting with early intervention programs. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
    Aveanna (12/14/24)
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  • Senior Analyst , Client Analytics - 2+…

    Evolent (Harrisburg, PA)
    …as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics role will be serving key internal (Evolent Account ... billing and reimbursement structures associated with Commercial, Medicare, and Medicaid lines of business. Healthcare claims: specifically, differences between… more
    Evolent (12/05/24)
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  • Quality Analyst

    CVS Health (Harrisburg, PA)
    …- Responsible for quality audits and projects, etc associated with the Medicaid /Medicare unit's functional focus. - Subject matter expert on workflows, policies, ... customer feedback and other measures. **Required Qualifications** 1-2 year within the Medicaid / Medicare MSO department. Experience with QNXT / Edifecs platform.… more
    CVS Health (01/12/25)
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  • Medicare Growth Analyst

    AmeriHealth Caritas (Philadelphia, PA)
    …research, project management, or process improvement. + Familiarity with Medicare, Medicaid , and Affordable Care Act (ACA), or the health insurance industry ... + Technical experience and understanding of Centers for Medicare & Medicaid Services (CMS) regulatory requirements. + Familiarity with Customer Relationship… more
    AmeriHealth Caritas (01/11/25)
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  • Senior Analyst ; Part D Actuarial

    CVS Health (Blue Bell, PA)
    …constant change Preferred Qualifications + Prior Pharmacy, Medicare Part D, Medicare or Medicaid experience + Successful completion of 2 or more Society of Actuaries ... Exams + Experience with SQL, SAS, and/or Python **Pay Range** The typical pay range for this role is: $64,890.00 - $158,620.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this… more
    CVS Health (01/12/25)
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  • Security Professional ;Protective Intelligence…

    Humana (Harrisburg, PA)
    …leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
    Humana (01/11/25)
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  • Senior Business Systems Analyst

    Humana (Harrisburg, PA)
    …leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
    Humana (01/10/25)
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