• Medicare Advantage Risk Adjustment…

    UCLA Health (Los Angeles, CA)
    Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... with the ability to analyze complex datasets. + Skilled in translating business questions and requirements into actionable reports, database views, and BI query… more
    UCLA Health (06/11/25)
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  • Senior Fraud Investigations Analyst

    BlueCross BlueShield of North Carolina (NC)
    …of degree, 7+ years of experience in related field **Bonus Points** + Deep Medicare and/or Medicare Advantage regulatory experience + Extensive Medicare ... and communicates the downstream impact of process weaknesses and gaps on the business /organization. + In the course of investigation, may be required to provide… more
    BlueCross BlueShield of North Carolina (07/25/25)
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  • Senior Medicare Markets Pricing Consultant…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …+ Solid understanding of Medicare and its related financial models, including Medicare FFS, Medicare Advantage , Medicare Part D, and ... BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker...and senior products. + Provide effective technical and non-technical business advice and support to internal and external customers… more
    Blue Cross Blue Shield of Massachusetts (07/30/25)
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  • Lead Director, Medicare Business

    CVS Health (Albany, NY)
    …market performance but help to shape and drive the markets bid strategy. + An analyst of Medicare business performance, meaning that the role is expected ... degree of complexity. + Working knowledge of Medicare and Medicare Advantage + Experience leading business process, project management and organizational… more
    CVS Health (08/21/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …Data and Information Set (HEDIS) lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage , and Medicaid), including ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Supports… more
    Medical Mutual of Ohio (08/16/25)
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  • Financial Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Provides basic ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
    Medical Mutual of Ohio (08/21/25)
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  • Financial Systems Analyst

    Medical Mutual of Ohio (OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. This position ... including Access. + Ability to interpret and articulate standard business and financial concepts. **Sr. Financials Systems Analyst...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
    Medical Mutual of Ohio (08/22/25)
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  • Business Analyst

    UCLA Health (Los Angeles, CA)
    Description The Business Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison between business units, IT ... external partners. This role is responsible for gathering and documenting business and system requirements, analyzing and interpreting data to support… more
    UCLA Health (08/08/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …to identify actionable opportunities for quality improvement across all lines of business (Commercial, Marketplace, Medicare Advantage , and Medicaid). ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Produces… more
    Medical Mutual of Ohio (08/08/25)
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  • DSNP Business Analyst

    NTT DATA North America (Merced, CA)
    …Overview:** We are seeking a detail-oriented and experienced DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing. The ... not just a method of gaining a one-time cost advantage , but an effective strategy for gaining and maintaining...overall sourcing strategy NTT DATA currently seeks a DSNP Business Analyst to join our team in… more
    NTT DATA North America (07/18/25)
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