- Centers for Medicare & Medicaid Services (New York, NY)
- …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid ... developing, or managing projects or studies to test models focused on Medicare Advantage; 2) Drafting guidance or analyzing polices related to benefit design,… more
- Highmark Health (Buffalo, NY)
- …improvement models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, ... office based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement… more
- Humana (Albany, NY)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an approved… more
- Humana (Albany, NY)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... all delivery for their assigned state, supporting the business goals of the Medicaid IT program. + Identifies and implements best practice changes within their… more
- Humana (Albany, NY)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid . + Utilization management experience ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... + Understands and explains procurement and supplier oversight processes to Medicaid markets and business areas contacts + Improve and document processes… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness… more
- Humana (Albany, NY)
- …of established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more