- The Cigna Group (Scottsdale, AZ)
- A member of the Cigna Medicare Business Operational Excellence Process Engineering team. This role will lead, facilitate, and drive business process ... coordinate business projects, including: + Define the business case, guide chartering, apply proper project ...changes into implementation plans (DFSS and DMAIC preferred) + Medicare Operations experience preferred. + Bachelors Degree… more
- USAA (Phoenix, AZ)
- …what makes us so special! **The Opportunity** We are currently seeking a talented ** Business Process Owner I** that will support Medicare Supplement Claims for ... end-to-end claims process. This role will work with our third-party supplier and key business partners supporting our Medicare Supplement Claims. As business … more
- CVS Health (Phoenix, AZ)
- …account team dedicated to serving a large federal client with employer, and Medicare /EGWP prescription benefit offerings. The role will be responsible to support the ... clinical benefit and formulary documentation and reporting needs across all lines of business offered by the client. + Ensuring all relevant activities are at… more
- Mathematica (Phoenix, AZ)
- …with knowledge of key organizations bringing value to the Innovation Center * Project leadership experience with the Center for Medicare and Medicaid Innovation ... a visionary, passionate leader to be the Director for business development and client relationship building for our work...relationship building for our work with the Centers for Medicare & Medicaid Services' (CMS), Center for Medicare… more
- The Cigna Group (Phoenix, AZ)
- This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region ... Provider Performance Enablement teams, Provider Education, and the Risk Adjustment Operations teams. The Prospective Program Solutions & Performance Advisor works… more
- Mathematica (Phoenix, AZ)
- …About the opportunity:* We are seeking a Director of Federal Value-Based Care Business to lead the management of Mathematica's Value-Based Payment Design and ... Operations and Technical Assistance for Healthcare Transformation staff communities....of the staff communities within the Federal Value-Based Care business by: o Tracking revenue, backlog, billability, open staffing… more
- Highmark Health (Phoenix, AZ)
- …on the most complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate ... to required standards and all necessary approvals have been obtained throughout the project lifecycle. + Interface with the business areas, customers, partners,… more
- Prime Therapeutics (Phoenix, AZ)
- …positions supporting Medicare , requires experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business Analysis Work ... and drives every decision we make. **Job Posting Title** Data & Reporting Business Analyst - Louisiana Medicaid **Job Description Summary** Serves as liaison between… more
- Humana (Phoenix, AZ)
- …SNP) who will provide data-based strategic direction to identify and address business issues and opportunities for Fully Integrated Dual Eligible Special Needs Plan ... (FIDE SNP). They will provide business intelligence and strategic planning support for ...Support the Medicaid Virginia market leadership team with specific Medicare operational impacts such as Open Enrollment and Annual… more
- Humana (Phoenix, AZ)
- … + Investigative and problem solving skills **Preferred Qualifications** + Background in Medicare , Medicaid and Commercial Group Business + Deep understanding of ... The Senior Vendor Management Professional (SVMP) is responsible for day-to-day operations and performance of Humana's vendor partnerships with a specific emphasis… more
- Humana (Phoenix, AZ)
- …complete and also work closely with the Integrated Health Patient Experience operations team. The Senior Business Intelligence Engineer's assignments involve ... part of our caring community and help us put health first** The Senior Business Intelligence Engineer solves complex business problems and issues using data from… more
- Mathematica (Phoenix, AZ)
- …developing data-driven solutions. This client-facing leadership role involves owning the project delivery and managing the relationship between the customer and ... Mathematica for a given project /engagement. The technology organizations in Health and Human Services...analytics and visualization products; and research and advisory. Includes operations and maintenance as well as innovating and enhancing… more
- Mathematica (Phoenix, AZ)
- …pressing problems and improving operations , and a strong interest in our Medicaid project area. Managing consultants often work on more than one project at a ... on complex, fast-paced projects focused on Medicaid policy, oversight, and program operations * Developing and maintaining project schedules, staffing plans, and… more
- Public Consulting Group (Phoenix, AZ)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined...with clients, vendors, team members to establish and achieve project goals * Address problems through risk management and… more
- Humana (Phoenix, AZ)
- …leadership, and external clinical vendors who aid in managing medical utilization for Medicare , Medicaid, and Commercial lines of business . + Master the ... programs to maximize revenue growth. Coordinates with other analytics, IT, and business areas across the organization to ensure work is completed with insights… more
- Mathematica (Phoenix, AZ)
- …workforce, and quality monitoring is also preferred. Understanding of dual Medicare -Medicaid eligibility and coordination is preferred, but not required. * Duties ... * Master's degree in public policy, public administration, public health, healthcare administration, business , or a related field; and 5 or more years of experience… more
- Public Consulting Group (Phoenix, AZ)
- …**Duties & Responsibilities:** + Reviews and can be the expert in the business / project operations for service and efficiency improvements. + Evaluates ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies… more
- Humana (Phoenix, AZ)
- …moderately complex to more complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable ... moderately complex to more complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable… more
- Mathematica (Phoenix, AZ)
- …health programs and interventions, or the financing of public health systems and operations through the braiding and blending of federal, state, and local funds. ... that is based on evidence; lead technical teams as project director or subject matter expert; assure quality by...and interpretation of quantitative and qualitative data * Direct business development efforts and lead proposals for new projects… more
- Humana (Phoenix, AZ)
- …help us put health first** The Market Leadership Advisor manages the development, operations , and results of a health plan. The Market Leadership Advisor works on ... skills to make an impact** **Required Qualifications** + Bachelor's Degree in Business , Accounting, Finance, Healthcare Administration and/or related field + 5 or… more