- Humana (Trenton, NJ)
- …of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... financial, and clinical teams to assess and determine optimal data solutions. Provide strategic recommendations on ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- Humana (Trenton, NJ)
- …and regulatory standards. Assignments are varied and often require interpretation of Medicaid -specific policies and data . The role demands independent judgment ... and apply Medicaid policies and procedures. Key responsibilities include: + Data Collection & Analysis: Gather and evaluate Medicaid eligibility data… more
- Humana (Trenton, NJ)
- …claims research, and other resources to provide insight and ensure data integrity for Medicare/ Medicaid claims errors. **Key Role Functions** + Develop ... Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes.… more
- Humana (Trenton, NJ)
- …Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... Engineer will be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities. They will… more
- Humana (Trenton, NJ)
- …of the care received by members in the KY, OH, VA, WI and IN Medicaid market populations. May provide cross-coverage for other state Medicaid markets. ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Public Consulting Group (Trenton, NJ)
- …agency and school district clients in their efforts related to special education, Medicaid reimbursement, data management and use. While a remote role, it ... and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000… more
- Humana (Trenton, NJ)
- …into provider -friendly insights. + Lead the design and refinement of provider -facing data views (dashboards, insights, performance summaries) to ensure they ... provider workflows. + Work with product leads and data teams to prioritize enhancements that make insights easier...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- CVS Health (Trenton, NJ)
- …the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners. . Developing relationships with leaders of ... chronic kidney, oncology, polychronic/complex care, and emerging specialty types) or Medicaid provider organizations to design and execute on strategies… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …and Kickoff meetings for new interoperability implementations. + Tracks and manages provider progress through the data connection lifecycle, ensuring timely and ... enhance supplemental data collection (eg, HEDIS, Lab Data ) via direct connections. + Educates provider ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... help us put health first** We're seeking a Senior Data Engineer with a strong background in cloud ...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... help us put health first** The Associate Director, Finance Data Management supports all aspects of configuration control, ...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... first** We are looking for a highly capable Senior Data Scientist to support advanced AI initiatives focused on...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... healthcare through AI excellence. We are seeking a Principal Data Scientist to guide the strategic decisions and the...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... healthcare through AI excellence. We are seeking a Lead Data Scientist to guide the strategic decisions and the...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- CVS Health (Trenton, NJ)
- …and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, ... (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... health first** Humana is seeking a Senior Responsible AI Data Scientist to champion the ethical development of artificial...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Trenton, NJ)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... healthcare through AI excellence. We are seeking a Lead Data Scientist to drive the safety, alignment, and ethical...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more