- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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