• Senior Risk Adjustment Analyst - Business Ops…

    CareFirst (Baltimore, MD)
    …score calculations, enrollment, submissions, medical and pharmacy claims, and provider data . Incumbent is responsible for performing analyses and problem resolution ... requirements for Medicare Advantage(MA), Affordable Care Act (ACA) & Medicaid Lines of Business (LOB). Additional responsibilities include establishing and… more
    CareFirst (10/15/25)
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  • LVN UM Delegation Oversight Nurse Remote in

    Molina Healthcare (Los Angeles, CA)
    …with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... /Quality will be a good fit for this position. Advanced Excel skills/ data analysis. Productivity is important with quick turnaround times. Further details to be… more
    Molina Healthcare (11/23/25)
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  • Analyst, Compliance Auditing, Monitoring…

    Option Care Health (Bannockburn, IL)
    data into actionable insights. + Demonstrated proficiency and enthusiasm for data analysis and reporting tools and techniques, such as PowerBI, Tableau, ... and the ability to summarize and communicate complex findings effectively. Reporting to the Senior Manager, Compliance Auditing, Monitoring and Analytics, this… more
    Option Care Health (10/19/25)
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  • Provider Network Quality Strategy Program Manager

    Commonwealth Care Alliance (Boston, MA)
    …inquiries and facilitating collaborative discussions on improvement opportunities. **Performance Reporting & Data Management** + Partner with Quality ... on CCA's Population Health goals; including Medicare Star measures, Medicaid -Medicare Plan withhold measures, quality performance metrics incorporated into other… more
    Commonwealth Care Alliance (10/29/25)
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  • Eligibility Specialist III (COE)

    MyFlorida (Tampa, FL)
    …with information and data to make decisions and solve problems. + Reporting cases where identity theft or fraud is suspected. + Advising clients and providers ... formerly the Eligibility Specialist I position with the Specialized Medicaid Center of Excellence within the Office of Economic...salary for this position is $39,838.76 This is a professional position in the Economic Self Sufficiency Program for… more
    MyFlorida (11/15/25)
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  • Mental Health Associate

    UnityPoint Health (Cedar Rapids, IA)
    …as required and/or directed. + Contributes to the patient assessment by collecting, reporting , and recording objective and subjective data in an accurate and ... and department compliance for federally funded healthcare programs (eg Medicare and Medicaid ) regarding fraud, waste and abuse. Brings any questions or concerns… more
    UnityPoint Health (10/07/25)
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  • Financial Analyst, Onsite

    Trinity Health (Gaithersburg, MD)
    …and encounter data . + Ensure compliance with Medicare Part D reporting requirements and prepare annual bid submissions. + Complete monthly IBNR analysis and ... PACE) programs. This role manages revenue cycles for Medicare, Medicaid , and private pay, oversees expense cycles including vendors...prepare accrual entries for accurate expense reporting . + Prepare financial data for Monthly… more
    Trinity Health (11/14/25)
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  • Accounting Assistant

    Sunrise Senior Living (Fort Belvoir, VA)
    …Controller with the accuracy of monthly Profit and Loss (P&L) Summary reporting , balance sheet account reconciliations, Medicare/ Medicaid billing and adherence ... of Medicare/ Medicaid requirements to properly process billing and regulatory reporting (if applicable at community). + Reconcile and control cash accounts for… more
    Sunrise Senior Living (10/09/25)
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  • Program Research Specialist 1/Trainee 1/Trainee 2

    New York State Civil Service (Albany, NY)
    …related reports.* Create and maintain provider management tracking systems.* Support monthly data feeds and meet ongoing reporting requirements for audits and ... NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title...professional research experience performing the collection, manipulation (eg, data construction, merging data files, data more
    New York State Civil Service (11/18/25)
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  • Chief Financial Officer (CFO)

    Mobile Health (Port Washington, NY)
    …of best-in-class financial systems and processes to enable real-time financial reporting , predictive analytics, and data -driven decision-making across the ... : + Ensure the accuracy, integrity, and timeliness of all financial reporting , adhering to GAAP/IFRS standards. + Oversee month-end, quarter-end, and year-end close… more
    Mobile Health (11/23/25)
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