- Northeast Georgia Health System, Inc (Gainesville, GA)
- …This position is responsible for managed care financial analysis, modeling and analyzing contract proposals, contract loading in both the Epic contract ... position is responsible for providing system-level support for Epic contract applications which include technical build, configuration, migration, maintenance and… more
- MetroPlus (New York, NY)
- …including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, ... and other irregularities based upon benefit configuration, compliance with provider contract agreements, and Federal, State and Plan's established guidelines and/or… more
- Randstad US (Visalia, CA)
- medicare contract analyst . + visalia , california + posted 9 days ago **job details** summary + $18 - $20 per hour + temporary + high school + category ... must have previous healthcare experience for this role Skills + Contract Review + Medicare /Medicaid + Data Entry + Healthcare + Analytical Thinking + Research… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Sr. Contract Compliance Analyst III Date: Jun 14, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 54798 **Who ... writing to key internal and external stakeholders. In addition, the Sr. Contract Compliance Analyst will participate in identifying and recommending contracting… more
- The Mount Sinai Health System (New York, NY)
- …Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare ... and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of… more
- Medical Mutual of Ohio (OH)
- … Supplement, and individual plans.** **Responsibilities** **Provider Reimbursement Analyst II** Under general supervision, supports assigned provider network ... provides quality assurance of provider rate loading. . Prepares monthly contract performance results and related financial reporting including interpretation and… more
- Medical Mutual of Ohio (OH)
- …Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider Analyst II** Provides analytical support during contract negotiation ... review and training. . Performs other duties as assigned. **Senior Provider Analyst ** Provides analytical support during contract negotiation process. Assists… more
- MetroLink (Los Angeles, CA)
- Senior Management Analyst Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4546555) Apply Senior Management Analyst Salary $80,824.00 - ... operator of the METROLINK Commuter Rail System, is seeking a Senior Management Analyst who will maintain and improve project management practices in an assigned area… 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. Manages a portfolio ... work hybrid; Cleveland, Ohio area residents preferred._** **Responsibilities** **MA Performance Analyst ** + **Manages a portfolio of MA initiatives focused on… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …contracting initiatives. + Performs other duties as assigned. **Provider Network Performance Analyst III** + Develops Value Based Contract (VBC) amendments in ... contracting regions with quality, utilization, and cost analysis. **Provider Network Performance Analyst I** + Gathers and maintains data from multiple sources and… more
- University of Michigan (Ann Arbor, MI)
- …affiliated hospitals, payers, outside agencies and government entities. The reimbursement analyst will maintain current knowledge of Medicare , Medicaid and ... Reimbursement Analyst Senior Apply Now **How to Apply** A...our contribution to society. **Responsibilities + Analyze and complete Medicare , Medicaid, Tricare and Blue Cross cost reports, settlements,… more
- Rush University Medical Center (Chicago, IL)
- …PM) **Summary:** 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
- 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
- Scripps Health (San Diego, CA)
- …have been with Scripps Health for over 10 years. The Chargemaster Senior Analyst provides assistance and analysis to all levels of clinical management at Scripps ... payors to resolve problems. * Participating in the pre contract review process to insure that all billing requirements...all billing requirements can be met. * Working with Medicare intermediaries and CMS to clarify billing requirements. *… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by ... for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does not… more
- WellSense (Boston, MA)
- Internal Controls/ Operational Financial Analyst WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire ... through Medicare , Individual and Family, and Medicaid plans. Founded 25...their circumstances. **Job Summary:** The Internal Controls/ Operational Financial Analyst 's role is to work with the VP Finance… more
- Hartford HealthCare (Wethersfield, CT)
- …across the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst develops a modeling process for ... 2. Develops modeling process to benchmark reimbursement rates to Contracted Commercial, Medicare and Medicaid reimbursement levels. 3. Builds contract terms in… more
- University of Washington (Seattle, WA)
- …and natural beauty. We have an outstanding opportunity for a **Clinical Research Budget Analyst ** to serve as a subject matter expert in coverage analysis as well as ... setting in a fast-paced environment is crucial in this role. Regulations governing Medicare Coverage Analysis including NCDs, LCDs, LCAs, FDA approvals for drugs &… more
- Navient (IN)
- …HOME). WORK MUST BE PERFORMED IN THE UNITED STATES. Our Healthcare Data Analyst - REMOTE employees have data analytics, informatics or business backgrounds. They ... assist EY's clients in complying with Medicare , Medicaid and other regulatory requirements, in addition to...government contractors. Should this position support a Federal Government contract , now or in the future, the successful candidate… more
- The Cigna Group (Nashville, TN)
- …shifts with every other weekend (Tuesday ALT Day).** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C + ... + Identify and obtain all additional information (relevant medical records, contract language and process/procedures) needed to make an appropriate determination of… more
