- General Dynamics Information Technology (Baltimore, MD)
- …Description:** **Seize your opportunity to make a personal impact as a** ** Medicaid Managed Care/Medicare Advantage SME ** **supporting CMS ensure Medicaid ... career.** **At GDIT, people are our differentiator. As a** ** Medicaid Managed Care/Medicare Advantage SME ** **you will...mitigation to fight fraud waste and abuse in the Medicaid Program.** **HOW A FUNCTIONAL ANALYST CONSULTANT… more
- Huntington Ingalls Industries (Woodlawn, MD)
- …technology transition assistance. What You Will Do + Serves as an Insider Threat Policy Subject Matter Expert , able to advise, draft, review, and achieve ... Communications, Computers, Cyber, Intelligence, Surveillance and Reconnaissance (C5ISR), a business group within HII's Mission Technologies division. From towers to… more
- Henry Ford Health System (Troy, MI)
- …records and supporting documentation prior to sending case to internal stakeholders for subject matter expert reviews. + Prepare cases for presentation ... Alliance Plan's (HAP's): Commercial, Medicare Advantage, Medicare- Medicaid Program (MMP), and Medicaid lines of business . Analyst must identify trending… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …reimbursement policies for the Iowa Medicaid dental program. The position serves as the subject matter expert ( SME ). As a leader within the ... of Medicaid , Bureau of Quality, Innovation, and Medical Policy is seeking a Medicaid Dental Policy Program Manager (Management Analyst 3). The Medicaid … more
- LA Care Health Plan (Los Angeles, CA)
- …overpayment project pipeline as well as development of cost avoidance practices. Acts as a Subject Matter Expert , serves as a resource and mentor for other ... identified during research or claims review. Serves as a subject matter expert and leads...as well as all vendor implementations as needed. Applies subject expertise in evaluating business operations and… more
- Prime Therapeutics (Glen Allen, VA)
- …and document system enhancement scope for assigned projects + Provide leadership and serve as subject matter expert and mentor for other members of Claims IT ... It fuels our passion and drives every decision we make. **Job Posting Title** Lead Business Analyst **Job Description** The Business Systems Analyst … more
- LA Care Health Plan (Los Angeles, CA)
- …Committee for Quality Assurance (NCQA) and Center for Disease Control (CDC). Acts as a Subject Matter Expert , serves as a resource and mentor for other ... Clinical Data Analyst III Job Category: Clinical Department: Quality Improvement...assumptions, specification in a clear and sharable fashion. Applies subject expertise in evaluating business operations and… more
- Deloitte (Austin, TX)
- Are you a Business /Data Informatics subject matter expert with technical/functional Data Analytics experience? Are you an application development ... ? Do you want to help us transform the Medicaid market as it embraces modularization, and we help...you serve Preferred:* 4+ years of experience in a Business Analytics Consulting role* 4+ years of experience creating… more
- CVS Health (Woonsocket, RI)
- … and Medicare, relative to prescription and/or medical claim processing * Serve as a subject matter expert for both internal and external representatives by ... convenient and affordable. **Position Summary** As a Healthcare Compliance Senior Analyst , you will ensure contractual and regulatory compliance as it relates… more
- Molina Healthcare (Nicholasville, KY)
- …to ad-hoc data analyses, development, and presentation of financial reports + Serve as subject matter expert on developing financial models to evaluate the ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for… more
- Point32Health (Canton, MA)
- …trends + Establish strong business relationships, and be regarded as a subject matter expert + Interface with stakeholders collaboratively, serving as ... Reimbursement analytics team in the role of Senior Data Analyst . A key role in the Corporate Data and...on medical cost, reimbursement trends, and market position across business lines and products (Commercial, Medicare, Medicaid ,… more
- State of Georgia (Dekalb County, GA)
- Operations Analyst - Region 3 Georgia - Dekalb -...Job Summary: Serves as the customer service contact and subject matter expert to providers, ... agencies and DBHDD staff regarding billing and approval processes for Medicaid waiver and DBHDD state funded services. Authorizes services including Individual… more
- Trinity Health (Livonia, MI)
- …analysis regarding operational issues, new programs, service lines, expansions, etc. Serves as a subject matter expert and resource by providing guidance and ... impact on the member organizations of major changes in Medicare and Medicaid policies. Assists in related advocacy efforts regarding such regulatory changes.… more
- Hackensack Meridian Health (Edison, NJ)
- …a **Senior Clinical Data Analyst ** at **Hackensack Meridian** **_Health_** includes: + Subject Matter Expert for regulatory, public reported and internal ... a leader of positive change. The **Senior Clinical Data Analyst ** is responsible for managing the collection, organization and...(ie CMS, TJC, etc.). + Provides measure expertise and business insights to DTS for data analytics tool development… more
- Aveanna (Atlanta, GA)
- …responsibilities in maintaining a strong control environment. + Audit Support: Serve as a subject matter expert and primary liaison for internal and external ... HRIS Reporting Analyst - SOX and Auditing ApplyRefer a FriendBack...Details Requisition #: 196060 Location: Atlanta, GA 30339 Category: Business Operations Salary: $80,000.00 - $90,000.00 per year Position… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …Sr. Revenue Integrity Analyst Reporting to Revenue Integrity Manager, serves as a subject matter expert in a high-profile group tasked with improving ... for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by...a plus + 4 yrs . Knowledge of Medicare, Medicaid , Medicare OPPS reimbursement and other third-party billing rules… more
- Waystar (Louisville, KY)
- …tasks and assignments + A passion for personal development, with a desire to become a subject matter expert and aspiring to be a leader on the Finance ... are expected to develop a broad knowledge of Waystar's business , industry, and operations to effectively support analysis and...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Fallon Health (Worcester, MA)
- **Overview** **The Premium Billing Financial Senior Analyst will require working in the office Tuesdays, Wednesdays and Thursdays and Mondays and Fridays will work ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... Purpose** : The primary role of the Risk Adjustment Analyst (RAA) will be to function as the Claims... (RAA) will be to function as the Claims SME for the Risk Adjustment & Analytics Department. The… more
- Commonwealth Care Alliance (Boston, MA)
- …overall responsibility for CCA's reimbursement policies for ICO and SCO programs. As a subject matter expert , this position will be responsible for ... care programs and reimbursement methodologies ( Medicaid and Medicare) + Applies subject matter knowledge; requires capacity to understand specific needs or… more