• Medical Economics Consultant

    Molina Healthcare (Columbus, OH)
    …and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects ... Master's Degree in Business Administration, Finance, Mathematics, Statistics, or Economics **PREFERRED EXPERIENCE:** Experience working with medical and… more
    Molina Healthcare (01/09/25)
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  • Consultant - Centers for Medicare

    Guidehouse (Hanover, MD)
    …technical competency, business development, client service and people development. As a Consultant , you will work with an experienced team to support the development ... in the following degree concentrations are preferred: Accounting, Business, Economics , Finance, Health Policy, Management/Information System, Public Health, or other… more
    Guidehouse (11/15/24)
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  • Senior Health Economics Analyst

    ChenMed (Miami, FL)
    …and prioritize opportunities, and spot trends + Extensive knowledge of healthcare/ medical economics data such as hospital/physician /ASC claims, utilization ... great people to join our team. The Senior Health Economics Analyst is responsible for identifying and delivering data-driven...to be seized. The incumbent serves as the primary medical cost analytics consultant to our Finance,… more
    ChenMed (12/06/24)
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  • Business Consultant

    HealthEdge Software Inc (Columbus, OH)
    …claim life cycle/workflow, network contracting, payment/policy configuration, provider relations, medical management, medical economics , audit, compliance) ... life cycle/workflows, network contracting, payment/policy related configuration, provider relations, medical management, medical economics , audit,… more
    HealthEdge Software Inc (12/18/24)
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  • Risk and Compliance - Healthcare Industry, Senior…

    Robert Half (Boston, MA)
    JOB REQUISITION Risk and Compliance - Healthcare Industry, Senior Consultant 2 LOCATION BOSTON ADDITIONAL LOCATION(S) NEW YORK CITY, SAN FRANCISCO, SEATTLE JOB ... Protiviti is looking for a Risk and Compliance Senior Consultant to join our growing Healthcare team. What You...healthcare payer regulations and guidance with emphasis on the Medicare Managed Care Manual. + Expertise of core business… more
    Robert Half (01/20/25)
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  • Reimbursement Consultant

    Robert Half Finance & Accounting (Dallas, TX)
    …- Deep understanding of Healthcare consulting - health care audits of Medicare and Medicaid experience desired - HealthCare Reimbursement experience - Working ... - Skilled with ERP systems - BA/BS or equivalent in Accounting, Finance or Economics - Ability to work within spreadsheets and databases - Strong analytical skills,… more
    Robert Half Finance & Accounting (12/08/24)
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  • Reimbursement Consultant

    Robert Half Finance & Accounting (Dallas, TX)
    …- ERP system experience - BA/BS or equivalent in Accounting, Finance or Economics - Experience working in a dynamic and changing company environment a plus ... of HealthCare Reimbursement - Comprehensive knowledge of health care audits of Medicare and Medicaid - Proficiency in Healthcare consulting Robert Half is the… more
    Robert Half Finance & Accounting (12/08/24)
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  • Assistant General Counsel, Market Access

    Daiichi Sankyo Inc. (Basking Ridge, NJ)
    …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and… more
    Daiichi Sankyo Inc. (11/16/24)
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  • Director Quality RN

    Providence (Portland, OR)
    …leadership and overall successful operations within Oregon Region Quality Management & Medical Staff Services (ORQMMSS) and on behalf of Providence St. Joseph Health ... Plan, Health. Reporting directly to the Executive, Oregon Region Quality and Medical Staff Services, the Regional Director works with system/enterprise and regional… more
    Providence (12/17/24)
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  • AVP, Chief Network Officer - Keystone/Capital…

    CVS Health (Washington, DC)
    …following key attributes: + 15+ years of healthcare network & contracting experience. Medical Economics experience will be valued. + Experience leading and ... and clients. + Ownership of local market specific unit cost targets, medical cost strategies, negotiation, and administration of VBC contracts, risk adjustment and… more
    CVS Health (01/11/25)
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  • Clinical Appeals Manager - RN (Hybrid)

    CareFirst (Baltimore, MD)
    …providers who appeal on behalf of members for Maryland Medicaid, Maryland Medicare including (EGWP, DSNP, MAPD). Ensures quality management of the clinical appeal ... are accurate based on the member's health benefit contract and CareFirst Medical Policy and are compliant with State, Federal and accreditation requirements. Ensures… more
    CareFirst (11/09/24)
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