• Strategic Staffing Solutions (Grand Rapids, MI)
    Analyst who can bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will help ... (S3) HAS AN OPENING! Strategic Staffing Solutions is currently looking for a Business Analyst (CMS Regulations / Risk) for a contract opportunity with one of our… more
    Upward (07/05/25)
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  • Reimbursement Analyst - REMOTE

    Molina Healthcare (Sterling Heights, MI)
    …**Job Duties** + Research, review, and decipher state-specific Medicaid and Medicare reimbursement methodologies for providers, including hospitals and ... **Job Description** **Job Summary** The Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and… more
    Molina Healthcare (07/18/25)
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  • Medicaid Provider Hospital Reimbursement

    Humana (Lansing, MI)
    …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will ... System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and… more
    Humana (07/09/25)
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  • Sr. QNXT Config Analyst

    Cognizant (Lansing, MI)
    **About the role** As a QNXT Config Analyst , you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... when gaps are identified. + Interpret paper contracts for reimbursement + Work side by side with client team...cautionary reduction functionality. + QNXT SMEs with experience in Medicare Benefit. + Experience with items like Cost Share.… more
    Cognizant (07/16/25)
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  • CDM Analyst Revenue Integrity/ Full…

    Henry Ford Health System (Troy, MI)
    Reporting to the CDM Manager, the CDM Analyst is responsible for supporting and maintaining the Charge Description Master (CDM), including being responsible for the ... accuracy and completeness of the CDM. The CDM Analyst also supports the CDM Coordinator and Senior CDM Analysts. PRINCIPAL DUTIES AND RESPONSIBILITIES: 1. Reviews… more
    Henry Ford Health System (06/20/25)
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  • Senior Analyst , Medical Economics - REMOTE

    Molina Healthcare (Grand Rapids, MI)
    **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical… more
    Molina Healthcare (07/10/25)
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  • Claims Analyst

    Trinity Health (Livonia, MI)
    …1-3 years of claims, adjusting, or billing experience preferred. + Experience with Medicare reimbursement rules and CMS-1500 & UB-04 claims preferred. + Previous ... **Employment Type:** Full time **Shift:** **Description:** **Claims Analyst ** **Location:** Trinity Health PACE Corp Michigan, Livonia, MI **Status:** Full time… more
    Trinity Health (06/11/25)
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  • Senior Provider Network Operations Data…

    AmeriHealth Caritas (Detroit, MI)
    …the foundation of trust, access, and quality care. As a Senior Provider Network Data Analyst , you'll be at the center of that mission, a vital connector between our ... and the providers who care for our members across Medicare , Medicaid, and Exchange products. In this role, you...+ Strong knowledge of managed care concepts and provider reimbursement methodologies. + Proficiency in Microsoft Office and provider… more
    AmeriHealth Caritas (06/13/25)
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  • Senior Medical Economics Analyst - Health…

    Henry Ford Health System (Troy, MI)
    …medical claims data and managed care membership data. + Knowledge of reimbursement (Commercial, Medicare , Medicaid) methodologies a plus. Additional Information ... GENERAL SUMMARY: The Senior Medical Economic Analyst plays a critical role in analyzing healthcare utilization and medical cost trends to support data driven… more
    Henry Ford Health System (06/24/25)
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  • Net Revenue Analyst Senior - Hybrid…

    McLaren Health Care (Grand Blanc, MI)
    **Position Summary:** Responsible for compiling complex reimbursement data to support management decision making and internal and external reporting for assigned ... subsidiaries. Assists in coordination of reimbursement functions related to the strategic financial planning process....reviews the schedules required to support the submission of Medicare , Medicaid and Blue Cross cost report, complying with… more
    McLaren Health Care (05/16/25)
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