• Medicaid Provider Hospital Reimbursement…

    Humana (Madison, WI)
    …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
    Humana (08/14/25)
    - Related Jobs

  • Medicaid Drug Strategy Pharmacist Lead

    CenterWell (Madison, WI)
    …a part of our caring community and help us put health first** The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, ... drug strategies to mitigate cost trend and improve health outcomes. The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex… more
    CenterWell (08/20/25)
    - Related Jobs

  • Director, Financial Planning & Analysis (CFO)…

    Humana (Madison, WI)
    …of financial operations for Humana's Michigan HIDE Plan with a focus on Medicaid and state partnership, oversees the budget, financial reporting, and all audit ... **Key Responsibilities** + Provides market specific financial leadership in the State Medicaid Market, developing a deep understanding of Humana's Medicaid … more
    Humana (08/26/25)
    - Related Jobs

  • Medicaid Pricing Actuary

    Humana (Madison, WI)
    …a part of our caring community and help us put health first** The Medicaid Pricing Actuary provides actuarial support across a broad range of actuarial and business ... needs for Medicaid product lines. The Actuary works on problems of...scope and complexity ranging from moderate to substantial. The Medicaid Pricing Actuary may be responsible for any combination… more
    Humana (08/27/25)
    - Related Jobs

  • Lead Medicaid Actuary (Manager)

    Humana (Madison, WI)
    …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager in ... review and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate advocacy communications,… more
    Humana (08/27/25)
    - Related Jobs

  • Medicaid Lead, Technology Solutions

    Humana (Madison, WI)
    …of our caring community and help us put health first** The Medicaid Lead, Technology Solutions builds strategic partnerships and manages relationships between IT ... strategy. **This State Technology Lead role will cover the Michigan Medicaid /DSNP product lines along with one additional state.** **Responsibilities** **Market… more
    Humana (08/26/25)
    - Related Jobs

  • Manager, Medical Economics ( Medicaid )…

    Molina Healthcare (Milwaukee, WI)
    …and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks… more
    Molina Healthcare (08/27/25)
    - Related Jobs

  • IT Business Systems Analyst Sr - Medicaid…

    Prime Therapeutics (Madison, WI)
    …we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job Description** The IT Business Systems Analyst ... Benefit Management (PBM) or healthcare experience with understanding of Medicare, Medicaid , the Exchanges along with regulatory compliance requirements (HIPAA and/or… more
    Prime Therapeutics (08/27/25)
    - Related Jobs

  • Senior Actuarial Analyst ( Medicaid Risk…

    Molina Healthcare (Racine, WI)
    …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
    Molina Healthcare (08/08/25)
    - Related Jobs

  • Big Data Engineer - Medicare/ Medicaid

    Molina Healthcare (WI)
    …We are seeking a highly skilled and forward-thinking Big Data Engineer to join our healthcare data team. This role encompasses the end-to-end design, development, and ... management of large-scale data systems tailored for healthcare analytics. The ideal candidate will be responsible for architecting and maintaining robust, scalable, and secure data pipelines that support critical decision-making across the organization. This… more
    Molina Healthcare (08/26/25)
    - Related Jobs