- Insight Global (Indianapolis, IN)
- Job Description As a Senior Financial Analyst within the Government Programs team, you will be responsible for managing 2-3 cost reports, including preparation and ... you will handle Medicaid DSH Eligibility and HSL surveys, contributing to compliance and reimbursement strategies. Prepare and review 2-3 hospital cost reports,… more
- AmeriHealth Caritas (Detroit, MI)
- **Role Overview:** The Provider Network Operations Data Analyst plays a key role in maintaining accurate provider data and fostering strong relationships between the ... health plan and its contracted and non-contracted providers across Medicaid, Medicare , and Exchange products. This role ensures provider information is correctly… more
- Mount Sinai Health System (New York, NY)
- …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject ... across the Mount Sinai Health System. MSHP seeks a **Senior Contract Manager Analyst ** will play a critical role in testing, coding, modeling, and reporting on… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... Twitter and LinkedIn. **Brief Summary of Purpose:** Seeking a motivated and detail-oriented analyst to join our team. This position is ideal for candidates who have… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... analyses and problem resolution to meet business operational requirements for Medicare Advantage(MA), Affordable Care Act (ACA) & Medicaid Lines of Business… more
- UCLA Health (Los Angeles, CA)
- …system. You'll ensure that hospital charges are processed promptly, accurately, and in compliance with Centers of Medicare & Medicaid Services (CMS), Medi-Cal, ... capture processes. + Manages and conducts special project reviews. + Maintain compliance with CMS, Medi-Cal, and health plan billing regulations. + Analyze complex… more
- Humana (Baton Rouge, LA)
- …cross-functionally with market leadership, accounting, actuarial, clinical, operations, and Medicare counterpart teams. + Work closely with market actuaries; assist ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Omaha Children's Hospital (Omaha, NE)
- …members. **Essential Functions** Cost Reporting + Coordinates preparation of all Medicare and Medicaid cost reports. + Analyzes, interprets, and utilizes statistics ... as needed + Coordinates with Graduate Medical Education office to ensure compliance with Resident reporting + Continually monitor changes in regulations and payment… more
- Sutter Health (Sacramento, CA)
- …eligible members by reconciling payments to contracted rates and maintaining compliance with Health Plan (HP) agreements and regulatory requirements. Analyzes and ... ensuring accurate setup in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores, along with payer codes, for accuracy,… more
- Molina Healthcare (MI)
- …with operations leadership and Plan Support functions to review compliance -based issues for benefit planning purposes. **KNOWLEDGE/SKILLS/ABILITIES** + Maintains ... + Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). +… more
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