- CVS Health (Downers Grove, IL)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** The Sr . Financial Analyst is a member of the Pharmacy Benefit ... in helping to establish a new department supporting member-facing financial operations activities for Medicare Part D...the Medicare Prescription Payment Program (M3P). The Sr . Analyst will provide subject matter expertise… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …departments, ensuring financial processes are efficient and aligned with company goals. Sr Financial Analyst Responsible for analyzing financial ... V-lookups, macros and formulas** **.** **Power BI (preferred)** **.** **SQL (preferred)** ** Sr Financial Analyst ** **.** **Advanced Microsoft Office and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Competitive Intelligence Analyst Sr .-Lead_ **Location:** _OH-Brooklyn_ **Requisition ID:** ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....achieve their best possible health and quality of life. ** Sr . Competitive Intelligence Analyst ** **Plays a pivotal… more
- Commonwealth Care Alliance (Boston, MA)
- …. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing prospective claims auditing ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- AdventHealth (Altamonte Springs, FL)
- ** Senior Medicare Data & Finance Analyst ** **Location:** Virtual **All the benefits and perks you need for you and your family:** + Benefits from Day One + ... Full-Time, Monday - Friday **The role you'll contribute:** The Senior Medicare Data & Finance Analyst...identifying and sharing insights that improve operational, clinical, and financial performance. The Analyst will use healthcare… more
- Providence (WA)
- …retain the best people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible ... well as analytical rigor and speed for assessing product design impacts on financial performance for Medicare Advantage plans to optimize performance + Analyzing… more
- Point32Health (Boston, MA)
- …Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** This Senior Actuarial Analyst will support the Medicare Part C Pricing work. The ... key responsibilities for this role are pricing, rate filing ( Medicare Advantage Bid) development, strategic analysis, and other ad hoc projects. This role will also… more
- Molina Healthcare (MI)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
- University of Rochester (Rochester, NY)
- …The Transplant Senior Finance Manager directs and plans the financial activity for the Transplant Institute. Develops annual operating and capital budgets ... the program accounts and oversees specialized and highly complex analysis of financial data. Develops and implements systems procedures related to the fiscal… more
- American Academy of Pediatrics (Itasca, IL)
- …research, policy analysis, and medical liability/risk management. Reporting to the Sr Director, Child Health Financing Strategy, this role will research, develop, ... that impact pediatric healthcare financing, particularly those related to Medicaid, Medicare , value-based care arrangements, and other government programs such as… more
- Point32Health (Canton, MA)
- …click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the oversight of the Senior Manager of Consulting and Operations, this individual will support the ... of risk adjustment strategy across Point32Health business lines. The Data Analyst will assist in managing vendor relationships, monitoring risk adjustment program… more
- Centene Corporation (Jefferson City, MO)
- …offering quality, competitive product solutions for growth and retention of our Medicare members. Support the development and execution of product changes within the ... performance. Support the development and execution of product changes within the Medicare product life cycle and be responsible for delivering fully compliant… more
- Healthfirst (NY)
- **Duties & Responsibilities:** + Value new medical cost initiatives, applying financial modeling expertise and using independent judgement to determine the best ... and perform due diligence on potential value-based arrangements to assess financial impact, ensure operational feasibility, and identify impact on existing programs.… more
- Healthfirst (NY)
- …management meetings to discuss analysis requests, inform network management on the latest financial trends, and to keep abreast of the changes occurring in our ... community. + Keep abreast of New York Medicaid and Medicare reforms and their impact on the health plan...Qlik View or, Power BI) + Experience in modeling financial impact of provider reimbursement changes. + Experience in… more
- Elevance Health (Norfolk, VA)
- **Risk Adjustment Advanced Analyst Senior ** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles ... PulsePoint locations.** **Preferred Location: Norfolk, VA.** The **Risk Adjustment Advanced Analyst Senior ** is responsible for creating statistical models to… more
- The Cigna Group (Sunrise, FL)
- …primary conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst 's responsibilities ... **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market...development, and vision for assigned territory. Participating with the Senior Manager/Manager in monthly financial review. +… more
- The Cigna Group (Philadelphia, PA)
- …business, including, but not limited to: medical expense analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) ... to management and associates. **Responsibilities:** Primary focus areas are Medicare pricing and CMS bid and supporting documentation development, support… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …receipt postings on a daily basis. + Balances daily system interfaces and works with Financial Analyst to assure that all out of balance conditions are addressed ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s… more
- Healthfirst (NY)
- …internal and external audiences + Support team in analysis of the financial performance of e Integrated Products, identify favorable and unfavorable trends, develop ... competitive reports + Prepare ad-hoc reporting as required by senior management and external partners + Support team in...in creation of models to forecast growth performance and financial outcomes + Effectively manage projects by setting clear… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Sr Financial & Provider Compensation Analyst Full time, 80 hours per pay period, Day shift Covenant Medical Group is Covenant Health's employed and ... Responsible for providing support to the VP of Finance by analyzing financial information and developing proformas on new practices, capital purchases, expense… more