• IT Business Systems Analyst Sr…

    Prime Therapeutics (Lansing, MI)
    …It fuels our passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote ... **Job Description** The IT Business Systems Analyst (BSA) Sr is responsible...Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid , the Exchanges along with regulatory… more
    Prime Therapeutics (08/27/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Lansing, MI)
    …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an ... complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new states. The business more
    Humana (08/14/25)
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  • Lead Analyst , Payment Integrity

    Molina Healthcare (Sterling Heights, MI)
    …synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid , and Marketplace lines of business . + Certified ... Summary** Provides lead level support as a highly capable business analyst who serves as a key...and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State… more
    Molina Healthcare (08/20/25)
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  • Compliance Analyst Principal - Remote

    Prime Therapeutics (Lansing, MI)
    …regulatory change process + Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as ... Benefit Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be… more
    Prime Therapeutics (07/07/25)
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  • Senior Analyst , Healthcare Analytics (Risk…

    Molina Healthcare (Warren, MI)
    business needs. Performs analysis across multiple states and lines of business ( Medicare , Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment… more
    Molina Healthcare (07/17/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Lansing, MI)
    …Benefit Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description**...related area of study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care… more
    Prime Therapeutics (07/25/25)
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  • Senior Analyst , Medical Economics - REMOTE

    Molina Healthcare (Grand Rapids, MI)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… more
    Molina Healthcare (07/10/25)
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  • Actuarial Analyst 2

    Humana (Lansing, MI)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to… more
    Humana (08/16/25)
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  • Risk Adjustment Audit Operations Analyst

    Molina Healthcare (Sterling Heights, MI)
    …+ Exposure to Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS audit processes ... **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the...senior analysts. + Document data sourcing steps, methodologies, and business rules to promote traceability and team learning. +… more
    Molina Healthcare (08/08/25)
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  • Analyst , Business Quality (Remote)

    Molina Healthcare (Ann Arbor, MI)
    …etc. **PREFERRED EXPERIENCE:** + SQL expertise + Excel expertise + Medicare , Medicaid , Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment ... **Job Description** **Job Summary** Assist business teams with developing requirements for major projects...+ Fields direct questions from Molina Operations Staff regarding business , technical and operations rules. + Develops technical solutions… more
    Molina Healthcare (08/24/25)
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