- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence ... Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing … more
- Deloitte (Detroit, MI)
- …services to public sector clients + Support engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and ... fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...plan/insurance company experience + 2+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate… more
- CVS Health (Lansing, MI)
- …heart, each and every day. **Position Summary** This role supports the Medicaid team, specifically price monitoring and behaviorial health analytics across Aetna's ... Medicaid states. Within this role, you will: * Provide...you will: * Provide actuarial support for the Aetna Medicaid Behaviorial Health Centers of Excellence. * Support nationwide… more
- Elevance Health (Dearborn, MI)
- ** Medicaid Formulary Pharmacist Clinical - CarelonRx** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... and formulary management. **How you will make an impact:** + Leads Medicaid formulary management processes. + Responsible for all member, stakeholder, and provider… more
- Humana (Lansing, MI)
- …caring community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare ... and reporting. Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to… more
- Humana (Lansing, MI)
- …in determining objectives and approaches to assignments. This role is focused on Medicaid trend analytics and program evaluation. This is an exciting opportunity to ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicaid experience + SAS/SQL experience + Databricks experience + Experience… more
- Humana (Lansing, MI)
- …Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care ... formulary management and clinical programming + Represents Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human… more
- Prime Therapeutics (Lansing, MI)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and… more
- Public Consulting Group (Lansing, MI)
- …To learn more, visit www.publicconsultinggroup.com . Employee will be responsible for Medicaid , SNAP, WIC and other state government programs. They will be analyzing ... with state health and human service programs + Experience with CMS, Medicaid , SNAP, WICK, and other state government programs **Supervisory Responsibility** + None… more
- Humana (Lansing, MI)
- …+ Three (3) or more years of managed care experience in Medicare and/or Medicaid , specifically in the delivery of care for the elderly or special needs populations ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more