- The Cigna Group (Bloomfield, CT)
- **Summary** The Directory Data Steward is an Advisor level role within the Provider Data Quality & Accuracy team, responsible for maintaining data ... project. They will help to drive improvements in the provider data domain to ensure we meet...assisting with improved claims auto-adjudication. + Work within the Data Quality management process to champion incremental… more
- The Cigna Group (Bloomfield, CT)
- …strong organizational, problem solving and analytical skills + Must have in depth knowledge of Medicare Advantage provider data in OnBase and QNXT + Strong, ... The Medicare Provider Directory Business Analytics Advisor...is responsible for the reporting, moving, and loading of data from vendors and business systems into internal networks… more
- The Cigna Group (Bloomfield, CT)
- …within the Medicare Stars Analytics team, who's function is to provide operational and analytical support to internal and external partners to improve Cigna's ... data including healthcare claims, clinical outcomes and Stars quality measures to make recommendations based on relevant findings....to detail and accuracy + Work experience as a Data Analyst in Medicare Stars, specifically in… more
- The Cigna Group (Bloomfield, CT)
- …within the Medicare Stars Analytics team, who's function is to provide operational and analytical support to internal and external partners to improve Cigna's ... leading the analytics strategy for Cigna Healthcare within the Medicare Stars program with a focus on Part D...The Business Analytics Senior Advisor will lead development of data analyses utilizing pharmacy claims, clinical outcomes, and Stars… more
- CVS Health (Hartford, CT)
- …business problems. The position supports Medicare Stars and our mission to provide data collection for all Medicare (assets/information) supporting ... rating system that compares the quality of Medicare health and drug plans. Data Intelligence...and analytics to our reports, dashboards and applications that provide day to day operational and strategic information. We… more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for… more
- The Cigna Group (Bloomfield, CT)
- …Engineering Senior Manager will oversee a team dedicated to creating and delivering high- quality cloud solutions for our Medicare plans. To ensure future success ... The Medicare Technology Operations organization is looking for experienced,...they are delivered on time, within budget, and meet quality standards. + Develop solutions using TDD methodology. +… more
- The Cigna Group (Bloomfield, CT)
- …an individual contributor responsible for supporting the analytics strategy for Medicare Health Services, performing research and analysis within the Clinical ... team. This role will help us accomplish this through data -driven analytics, strategic insights, and collaboration with our internal...to meet our goal of reducing costs and increasing quality of care to our members. This individual will… more
- The Cigna Group (Bloomfield, CT)
- …leadership to prioritize projects. + Establishes and executes end to end universe data validation. Includes review and correction of data integrity issues in ... and execute process improvement opportunities and eliminate barriers to improve quality , implementation readiness, and reduce rework. + Bring together Business and… more
- Humana (Hartford, CT)
- …+ Accountable for meeting Key Performance Indicators regarding Turnaround Time and Quality + Analyze business metrics and provide monthly review of ... leadership role within a highly complex operational environment + Provider Experience related to data , contracting, network,...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... caring community and help us put health first** The Manager, Encounter Data Management develops business processes to ensure successful submission and reconciliation… more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... services using technology and analytics. We are looking for a Senior Data Scientist who will utilize cutting-edge AI, NLP, GenAI techniques, build predictive… more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... community and help us put health first** The Senior Data Scientist uses mathematics, statistics, modeling, business analysis, and...Please be aware that applicants may be asked to provide their Social Security Number, if it is not… more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... community and help us put health first** The Senior Data and Reporting Professional generates ad hoc reports and...age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our… more
- Elevance Health (Wallingford, CT)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs._ The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for… more
- The Cigna Group (Bloomfield, CT)
- … data related investigations, track lineage and quality issues, reviews data layout and structures + Provide support in Production issue/defect resolution ... of CMS Interoperability, FHIR Implementation Guides and Standards, and data management specific to Medicare along with...business owner review sessions and plan/execute E2E, integration, and data quality validations + Collaborate with the… more
- Elevance Health (Wallingford, CT)
- **JR130960 Business Change Director ( Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... / Quality Control Test Architect. This high-performing individual contributor will...status as defined in the test plan with supporting data . + Manages both onshore and offshore test execution… more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... and help us put health first** The RN, Compliance Nurse 2, Quality Assurance Auditor reviews utilization management activities and documentation to ensure adherence… more
- CVS Health (Hartford, CT)
- …+ Analyze various sources of patient care and claims data , including 100% Medicare data or VRDC, to provide actionable insights to stakeholders + ... **What will you do?** + Evaluate the impact of Medicare quality and risk adjustment program has...Mathematics, Statistics, Actuarial Science or closely related field. Experience w/ Medicare Limited Data Set (5% Sample … more
- Humana (Hartford, CT)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... impact on underwriting margin. They will work collaboratively with peers across Medicare Risk Adjustment, Membership Growth Analytics, Medicare Finance, and… more