- Dana-Farber Cancer Institute (Brookline, MA)
- The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other ... and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying Clinical… more
- Zelis (TX)
- Position Overview: The Medicare Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer Product team to further the company's goals by ... communicating rules, regulations, and procedures pertaining to public and private Medicare / Medicare Advantage payment systems. This position requires an in-depth… more
- Elevance Health (Grand Prairie, TX)
- **Risk Adjustment Encounters Analyst - Medicare / Medicaid** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will ... one of our Elevance Health PulsePoint locations. The **Risk Adjustment Encounters Analyst - Medicare / Medicaid** is responsible for serving as an expert in data… more
- UPMC (Pittsburgh, PA)
- **UPMC Health Plan has an exciting opportunity for a Workforce Management Analyst position in the Medicare & SNP Sales department. This is a full time position ... working variable shifts. This will be a remote position, but working in office at times could be requested.** **Responsibilities:** + Provide timely reports using Microsoft Office as requested by all departments within the Health Plan. + Provide ongoing… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** Are you an experienced actuarial professional with a passion for Medicare Advantage? Join our dynamic team as a Senior Actuarial Analyst , ... required). + Minimum of 4 years of experience in Medicare Advantage. + Completion of at least 5 actuarial...Join us and make a significant impact on our Medicare Advantage programs. Apply today to be part of… more
- Methodist Health System (Dallas, TX)
- …:** 5 days **Work Shift :** **Job Description :** Your Job: The SR REIMBURSEMENT( MEDICARE ) ANALYST will assist the Manager of Regulatory Compliance, the Manager ... * CPA Preferred * Position requires extensive knowledge of governmental programs ( Medicare and Medicaid). * Good written and oral communication skills. * Good… more
- UCLA Health (Los Angeles, CA)
- …this and more at UCLA Health. As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running processes/jobs ... required * Five or more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5 years of experience with Encounter… more
- CVS Health (Salt Lake City, UT)
- …Fully Remote ANYWHERE within the continental US **Training hours 9 - 5:30 EST or CST** **Work hours after training 10 - 6:30 pm EST** **The WorkLife Consultant (WLC) ... is part of the WorkLife Team and provides education about community resources, resource needs assessment, and community and/or national referrals to a variety of customers for a variety of needs including childcare, elder/adult care, and basic/everyday needs.… more
- CVS Health (Austin, TX)
- …Fully Remote ANYWHERE within the continental US **The schedule is Monday through Friday, 11:45am to 8:15pm Eastern Time.** The WorkLife Consultant (WLC) is part of ... the WorkLife Team and provides education about community resources, resource needs assessment, and community and/or national referrals to a variety of customers for a variety of needs including childcare, elder/adult care, and basic/everyday needs. The WLC is… more
- CVS Health (Carson City, NV)
- …Fully Remote ANYWHERE within the continental US **The schedule is Monday through Friday, 11:00am to 7:30 pm Eastern Time.** Training hours may differ from the shift ... you are hired for. The WorkLife Consultant (WLC) is part of the WorkLife Team and provides consultation, assessment, and resource referrals to a variety of customers for a variety of needs including child care, elder/adult care, and basic/everyday needs. The… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** We are seeking a highly skilled Senior Reporting Analyst to join our dynamic team. The ideal candidate will have a strong ... and Python. + Clinical Interventions experience. + Managed Care industry experience - Medicare . To all current Molina employees: If you are interested in applying… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, Business Data Analyst is instrumental in independently developing the detailed requirements ... requirements are understood and implemented consistent with the Business Data Analyst 's vision + perform testing, design and delivery requirements + work… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Sr--Medical Pharmacy Specialty/ Medicare Part B- REMOTE **Job Description** ... The Senior Compliance Analyst assists in the implementation of Prime's compliance programs...organization, or other highly regulated industry, including experience with Medicare Advantage and Medicare Part B +… more
- AmeriHealth Caritas (Manchester, NH)
- …plan and its contracted and non-contracted providers for all products, Medicaid, Medicare , and Exchange.; Provider Network Data Analyst ensures that providers' ... us at www.amerihealthcaritas.com . **Responsibilities:** The Provider Network Data Analyst is responsible for building and maintaining positive working relationships… more
- Molina Healthcare (Columbus, OH)
- …**Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and ... interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and… more
- CVS Health (Harrisburg, PA)
- …Summary** As a Manager, Business Analytics you will be part of the Medicare Grievance Team, responsible for managing business and system initiatives that focus on ... collaboration and coordination with Information Technology (IT) teams, MHK, Medicare Complaint leadership team, and other business partners/stakeholders. Responsible… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... best possible health and quality of life. Business Systems Analyst II Provides the interface between the business and...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.… more
- Rush University Medical Center (Chicago, IL)
- …Revenue Cycle, this position will create coverage analyses in accordance with Medicare 's Clinical Trial Policy (NCD 310.1) and assist research staff within the ... of related guidance and their effect on research billing processes. The analyst will provide high-level professional support in the growing efforts to conduct… more
- CommonSpirit Health (Phoenix, AZ)
- …out in the community. **Responsibilities** **Position Summary:** The Senior Reimbursement Analyst is responsible for providing cost report preparation cost report ... services of Dignity Health. The position maintains current knowledge of Medicare Medicaid and other State and Federal regulations. The Sr. Reimbursement… more
- AdventHealth (Altamonte Springs, FL)
- …Wednesday and Thursday onsite **The role you will contribute:** The Reimbursement Analyst is responsible for assisting the Reimbursement Manager with the preparation ... of work papers for the filing of the annual Medicare , Medicaid, and Champus/Tricare cost reports, audit preparation and...of accurate and timely cost reports as required by Medicare , Medicaid and other State or Federal agencies for… more