• Medicaid Project Associate

    Mathematica (Columbia, SC)
    …https://www.mathematica.org/career-opportunities/benefits-at-a-glance. Mathematica is looking for a highly organized Medicaid Project Associate to contribute ... and support the work of projects in the Federal Medicaid practice. As a part of a project team, the Associate will be responsible for coordinating and… more
    Mathematica (06/23/24)
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  • Advisor, Medicaid Provider & Network…

    Humana (Columbia, SC)
    …and/or network management or provider relations experience. + 2+ years of project leadership experience + 2+ years of Medicaid experience/Managed Care ... part of our caring community and help us put health first** The Advisor, Medicaid Provider & Network Strategy will be accountable for leading the development of… more
    Humana (07/26/24)
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  • Director | Medicaid Inbound Contacts

    Humana (Columbia, SC)
    …Director will be primarily focused and responsible for the operations of Inbound Medicaid Contact Centers serving members and providers. In this role, you will have ... across multiple lines. Primarily responsible for overseeing the day-to-day Medicaid contact center operations team responsible for addressing customer needs… more
    Humana (07/27/24)
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  • Actuary, Medicaid (Remote)

    Humana (Columbia, SC)
    …a part of our caring community and help us put health first** The Medicaid Actuary role is responsible for providing actuarial support for multiple states in ... are the specific day to day responsibilities of the Medicaid Actuary role: + Frequent analysis of actual experience...of technical experience + 2 or more years of project leadership experience **Scheduled Weekly Hours** 40 **Pay Range**… more
    Humana (07/26/24)
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  • Physical Security Project Manager

    Humana (Columbia, SC)
    …part of our caring community and help us put health first** The Physical Security Project Manager 2 will report to the Physical Security Lead and assist in managing ... protection of company assets through physical security projects. The Physical Security Project Manager 2 will be responsible for the design, implementation, and… more
    Humana (07/16/24)
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  • Associate Actuary

    Humana (Columbia, SC)
    …a part of our caring community and help us put health first** The Associate Actuary role is a role within the Insurance Products Actuarial Medicare Advantage ... ad hoc projects and analysis to help enhance Part D accuracy. The Associate Actuary, Pricing work assignments involve moderately complex to complex issues where the… more
    Humana (07/18/24)
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  • Senior Process Improvement Professional;…

    Humana (Columbia, SC)
    …help us put health first** Join our Process Excellence team within Enterprise Associate and Business Solutions (EABS), a key component of the Chief Administrative ... We focus on process and continuous improvement, performance management, project and program management, knowledge management, governance, and operational readiness.… more
    Humana (07/18/24)
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  • Associate Actuary - Analytics/Forecasting

    Humana (Columbia, SC)
    …of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex… more
    Humana (07/12/24)
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  • Associate Director Privacy Office

    Humana (Columbia, SC)
    …part of our caring community and help us put health first** The Associate Director, Privacy & Ethics monitors compliance in accordance with government regulations ... relating to the Health Insurance Portability and Accountability Act (HIPAA). The Associate Director, Privacy & Ethics requires a solid understanding of how… more
    Humana (07/26/24)
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  • Associate Actuary

    Humana (Columbia, SC)
    …a part of our caring community and help us put health first** An Associate Actuary on the Medicare Financial Planning & Analysis Team will be responsible ... A foundation in Medicare and/or Corporate Finance is preferred. The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing… more
    Humana (07/19/24)
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  • Business Systems Consultant

    Highmark Health (Columbia, SC)
    …underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management ... the most complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level… more
    Highmark Health (06/18/24)
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  • Community Engagement Specialist

    Wider Circle (Columbia, SC)
    …are encouraged to apply!* Responsibilities: + You will lead the Wider Circle Medicaid program in your assigned area, using the Wider Circle-developed curriculum to ... members. + You will enroll prospective members into the Wider Circle Medicaid program. Additionally, you will hold yourself accountable to achieve membership… more
    Wider Circle (07/14/24)
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  • Medical Director - Mid West Region

    Humana (Columbia, SC)
    …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
    Humana (07/25/24)
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  • Medical Director--Claims Management

    Humana (Columbia, SC)
    …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
    Humana (07/25/24)
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  • Sr Agency Professional - Finance/Accounting

    Humana (Columbia, SC)
    …+ Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if there are concerns ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees… more
    Humana (07/17/24)
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  • Medical Director - Florida / Full Time

    Humana (Columbia, SC)
    …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
    Humana (07/12/24)
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  • Senior Vendor Management Professional

    Humana (Columbia, SC)
    …Leads projects of high sensitivity/confidentiality + Report out SLA performance and project delivery to key stakeholder groups and prepare remediation plans when ... leadership on a weekly basis. + Leads continuous improvement initiatives for project management and delivery. + Has overall responsibility for service issue… more
    Humana (07/03/24)
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  • Business Intelligence Valuation Lead

    Humana (Columbia, SC)
    …analytic solutions. The Stars program is the Centers for Medicare & Medicaid Services (CMS) five‐star quality rating system for measuring Medicare beneficiaries' ... improve the decision-making experience for stakeholders + 2 or more years of project leadership experience + Experience analyzing data to solve a wide variety of… more
    Humana (07/02/24)
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  • Senior Enterprise Architect

    Humana (Columbia, SC)
    …+ Master's Degree or higher in Computer Science or a related field + Associate or Professional level solution architecture certification in Azure, GCP and/or AWS. + ... in Enterprise Architecture repository tools like iServer + 2+ years of project leadership and consulting experience. + Health Care Business Domains - Medicare,… more
    Humana (07/19/24)
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  • Lead Enterprise Architect

    Humana (Columbia, SC)
    …cloud native architectures and agile delivery **Preferred Qualifications** + Associate or Professional level solution architecture certification in Azure, GCP ... Cloud technologies, Cloud migration or Enterprise Architecture. + 2+ years of project leadership and consulting experience. + Health Care Business Domains -… more
    Humana (07/19/24)
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