- Medical Mutual of Ohio (Brooklyn, OH)
- …Medicare Supplement, and individual plans. The Medicare Advantage Products Analyst plays an integral role in the product development of the ... the development and execution of Medicare Advantage product strategy and corresponding benefits. The Analyst ...the annual CMS Bid development in partnership with the Product Managers, ensuring the products are competitive,… more
- Kelsey-Seybold Clinic (Houston, TX)
- …of high dollar claims and present summary to management. **Job Title: Medicare Claims Analyst ** **Location: Remote** **Department:** **Claims** **Job Type: Full ... professional claims. Essential job functions include: Apply knowledge of Centers for Medicare & Medicaid Services (CMS) rules specific to DRG pricing methods, APC,… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Senior Public Policy Analyst monitors, evaluates, and provides recommendations on strategy and communications regarding ... issues in support of the companys business objectives and requirements. The Analyst has key responsibility for supporting policy development on key issues, ensuring… more
- General Dynamics Information Technology (Fairfax, VA)
- …support an exciting new program focused on identifying vulnerabilities in Medicaid, Medicare and the Marketplace. The position will monitor, inspect, and propose ... established quality standards and guidelines. **Responsibilities:** + Document and reporting product or service quality levels + Develop and implementing standards… more
- Providence (OR)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... as well as analytical rigor and speed for assessing product design impacts on financial performance for Medicare... product design impacts on financial performance for Medicare Advantage plans to optimize performance + Analyzing and… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... position involves extensive interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of a Coordinated Care… more
- Insight Global (Scotts Valley, CA)
- Job Description The Medicare /DSNP ITS Implementation Analyst Consultant will ensure that partner vendors, implementation teams, UAT end-users, and quality ... existing systems in compliance with published policy guides and standards for Medi-Cal, Medicare , and D-SNP to support the 1/1/2026 launch of new Medicare /DSNP… more
- CVS Health (Chicago, IL)
- …convenient and affordable. **Position Summary** We are looking for Actuarial Senior Analyst for Medicare Dental Business to provide actuarial pricing support. ... \#AetnaActuary The Actuarial Senior Analyst responsibilities include: + Support Medicare Dental...with all CMS regulations and tests + Works with Product team to provide pricing support to identify best… more
- DCCA (Ellicott City, MD)
- Product Owner Analyst Location Ellicott City, MD Job Code 2300 # of Openings 1 Apply Now ... compensation and benefits package. Visit our website at: www.dcca.com Product Owner Analyst Candidate must have or...Framework (SAFe). . 5+ Years of experience supporting CMS Medicare or Medicaid Programs . Strong understanding of Agile… more
- The Cigna Group (Nashville, TN)
- …Finance Officer (BFO), supporting the Midwest and MidAmerica markets of our Medicare Advantage business. We are seeking a creative and strategic finance leader ... Operations. + Responsible for analysis and interpretation of moderate to complex Medicare Part C and D financial information. Utilizes independent judgment and… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …responsible for completing the Medical Policy activities outlined in BCBSLA's Medicare Advantage Medical Policy Development Policies & Procedures locating, tracking ... an as needed basis support the Medical Policy Project Analyst position when medical policy volume is elevated or...researches new treatment options, procedures, devices, drugs and biological products as needed to support the Medical Directors in… 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 ... pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve...best possible health and quality of life. Business Systems Analyst II Provides the interface between the business and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Supporting the ... underwriting system, the Specialty Group Underwriting Systems Analyst collaborates with other system developers and liaisons to...to guide decision for growth and retention of specialty product business. **_This position has the option to work… more
- Medical Mutual of Ohio (OH)
- … Supplement, and individual plans.** **Responsibilities** **Provider Reimbursement Analyst II** Under general supervision, supports assigned provider network ... payment models. . Performs other duties as assigned. **Provider Reimbursement Analyst III** Under general to limited supervision, supports assigned provider network… more
- The Cigna Group (Nashville, TN)
- …market. The Medicare Advantage business includes a broad portfolio of products and provider risk arrangements. The skill sets needed to manage this wide ... The Healthcare Financial Analyst Lead Analyst will support the...Medicare Advantage business. They will partner with the product , pricing, and strategy teams to drive the annual… more
- Medical Mutual of Ohio (OH)
- …coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider Analyst II** ... and training. . Performs other duties as assigned. **Senior Provider Analyst ** Provides analytical support during contract negotiation process. Assists contracting… more
- Medical Mutual of Ohio (OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** Senior ... Employer Group Consulting Analyst Design and execute analyses and reports for clients...strategic decision making and demonstrate the value provided by products and services purchased, Synthesizing and communicating, in writing… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Financial Analyst III** ... of complex "what if" scenarios for business planning decisions relative to new products , new territories, new projects, and other important aspects of the Company's… more
- General Dynamics Information Technology (Fairfax, VA)
- …Required:** NACI (T1) **Job Family:** Functional Experts **Skills:** Agile Methodology, Medicare ,Scrum Software Development **Experience:** 10 + years of related ... opportunity to make a personal impact as a Functional Analyst Sr Advisor supporting solutions for the Centers for... Sr Advisor supporting solutions for the Centers for Medicare and Medicaid Services. GDIT is your place to… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Medicare Supplement, and individual plans. **Responsibilities** **Operations Data Analyst III** Under limited supervision, analyzes operations data (eg, claims, ... projects. . Performs other duties as assigned. **Senior Operations Data Analyst ** Working independently, analyzes operations data (eg, claims, membership, provider,… more