• Amazon (San Francisco, CA)
    …an Actuarial Manager Analyst in San Francisco. This role requires expertise in Medicare Advantage and actuarial processes. The ideal candidate will lead analyses of ... healthcare data, design monthly reserving processes, and evaluate Total Medical Expense performance. With 6+ years in data science, strong communication skills, and relevant actuarial qualifications, you will contribute significantly to our success. This is a… more
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  • NHS Management (Prattville, AL)
    …well as Company policy and procedure Directs the MDS assessment and Medicare related activities of the assigned facilities, ensuring accurate and timely assessments ... each resident. Provides case management services for certain high-risk Medicare Part A residents to ensure services are provided...with at least one year experience in MDS and Medicare related activities is required. Must have excellent computer… more
    JobLookup XML (01/08/26)
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  • Gossamer Bio (San Diego, CA)
    …payer access strategy to ensure optimal coverage and reimbursement across Commercial, Medicare , and Medicaid channels. Reporting to the Vice President of Market ... execution of national and regional payer access strategies across commercial, Medicare , and Medicaid segments. Define contracting and negotiation strategies with… more
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  • Christus Health (Irving, TX)
    …Responsibilities: Coordinate and review processes throughout the System specific to Medicare cost report software implementation, usage and maintenance for HFS cost ... submission, for assigned facilities Timely completion of work is required to ensure Medicare , Medicaid and CHAMPUS cost reports are submitted by due dates to prevent… more
    JobLookup XML (01/12/26)
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  • Christus Health (Irving, TX)
    …Responsibilities: Coordinate and review processes throughout the System specific to Medicare cost report software implementation, usage and maintenance for HFS cost ... submission, for assigned facilities Timely completion of work is required to ensure Medicare , Medicaid and CHAMPUS cost reports are submitted by due dates to prevent… more
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  • Oak Street Health (Philadelphia, PA)
    …Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care ... healthcare as it should be', providing personalized primary care for older adults on Medicare , with the goal of keeping patients healthy and living life to the… more
    JobLookup XML (01/13/26)
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  • Humana Inc (Honolulu, HI)
    …CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial ... filing, reporting & analysis, reserving or trending) Preferred Qualifications * Medicare Advantage pricing and forecasting experience * Experience working with… more
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  • Volta Medical (Boston, MA)
    …collaborating with internal partners. Ability to process and work with Medicare and Commercial datasets. Strong familiarity with Medicare reimbursement, ... consensus support with stakeholders. Experience with engagement with the Centers for Medicare and Medicaid Services (CMS) and physicians who have influence on… more
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  • Chicago Family Health Center (Chicago, IL)
    …the financial plan. Interpret complex funding streams (eg, commercial payers, Medicare /Medicaid, grants) and model program impact. Financial Planning & Analysis Lead ... drive corrective action. Interpret and enforce third‑party payer rules and Medicare requirements; ensure cost reporting and related filings are completed. Operations… more
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  • Humana Inc (Honolulu, HI)
    …CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial ... focused on continuously improving consumer experiences Preferred Qualifications * Medicare Advantage pricing and forecasting experience * Experience working with… more
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  • Volta Medical (Boston, MA)
    …collaborating with internal partners Ability to process and work with Medicare and Commercial datasets Strong familiarity with Medicare reimbursement, ... consensus support withstakeholders Experience with engagement with the Centers for Medicare and Medicaid Services (CMS) andphysicians who have influence on… more
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  • Chicago Family Health Center Inc (Chicago, IL)
    …and the financial plan. Interpret complex funding streams (eg, commercial payers, Medicare / Medicaid, grants) and model program impact. Financial planning & ... drive corrective action. Interpret and enforce third‑party payer rules and Medicare requirements; ensure cost reporting and related filings are completed. Operations… more
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  • Chicagofamilyhealth (Chicago, IL)
    …the financial plan. Interpret complex funding streams (eg, commercial payers, Medicare /Medicaid, grants) and model program impact. Financial planning & analysis Lead ... drive corrective action. Interpret and enforce third-party payer rules and Medicare requirements; ensure cost reporting and related filings are completed. Operations… more
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  • habitathealth (San Francisco, CA)
    …experienced leader with proven experience managing and leading expansion processes for Medicare or Medicaid products and/or care delivery solutions, and who is ... internal and external stakeholders 6‑8+ years healthcare experience with Medicare and/or Medicaid market expansion strategy Demonstrated understanding and success… more
    job goal (01/13/26)
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  • Headspace (San Francisco, CA)
    …full suite of mental health and wellbeing solutions to commercial and managed Medicare and Medicaid health plans nationally. This team leads our efforts to expand ... partnerships with regional and national health plans across commercial, Medicare Advantage, and managed Medicaid lines of business, driving multi‑million‑dollar… more
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  • The Laurels of Huber Heights (Dayton, OH)
    …change MDS' Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days ... and RUGs utilization in the absence of the Care Management Coordinator Remains current with American Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications Registered Nurse (RN) AANC certification a plus. RAC-CT Knowledge of the… more
    JobLookup XML (01/12/26)
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  • The Laurels of Salisbury (Salisbury, NC)
    …change MDS' Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days ... and RUGs utilization in the absence of the Care Management Coordinator Remains current with the American Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications: Registered Nurse, RN or Licensed Practical Nurse AANC certification a… more
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  • The Laurels of Huber Heights (Dayton, OH)
    …change MDS' * Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and ... RUGs utilization in the absence of the Care Management Coordinator * Remains current with American Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications * Registered Nurse (RN) * AANC certification a plus. RAC-CT * Knowledge of… more
    JobLookup XML (01/12/26)
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  • Anderson Hospital (Maryville, IL)
    …for returning to the patient and reviewing the Important Message from Medicare or the Observation Letter and obtaining the appropriate signatures as applicable. ... documentation is also reviewed with the patient ie Important Message from Medicare or Observation Letter. Responsible for registering direct admissions to the TRC… more
    job goal (01/11/26)
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  • UNIVERSITY HEALTH (San Antonio, TX)
    …AHA BLS Instructor Provider card. Ambulatory Therapist must be a participating Medicaid and Medicare provider or be eligible to obtain a Medicaid and Medicare ... provider number. Send CV to ###@uhtx.com recblid au7zm9i7080832bnxz9qnzn8yyb2xt PDN-a09bf701-5c11-4c1b-9347-4f2d451d377e more
    Appcast IO CPC (01/10/26)
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