• Reimbursement Analyst (Remote)

    CareFirst (Baltimore, MD)
    …methodologies. This position may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This may also include ... CareFirst corporate position. + Provide feedback on payment policies related to Medicaid and/or Medicare processing. Participate in workgroup projects around… more
    CareFirst (09/12/25)
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  • Insurance Strategy Consultant

    Humana (Indianapolis, IN)
    …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... company's total revenue and earnings. Team members partner with senior leaders of the business unit, and more broadly...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (08/29/25)
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  • Director Governmental Reporting

    Houston Methodist (Houston, TX)
    … cost reports, Federal Tax Returns Health and Human Services (HHS)/Centers for Medicare and Medicaid Services (CMS) reporting, Federal and State Charity ... Federal and State Charity Report. + Directs the coordination, review and filing of Medicare and Medicaid cost reports and associated audits by the fiscal… more
    Houston Methodist (09/01/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Phoenix, AZ)
    …experience in revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring ... caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (08/23/25)
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  • Director, Highly Integrated Dual Eligible Special…

    Corewell Health (Grand Rapids, MI)
    …receiving LTSS. It also ensures that LTSS operations align with the integration of Medicare and Medicaid benefits under Michigan's HIDE SNP model, meeting CMS ... MOC). + Ensure continuity of care during provider or service transitions, per Medicare , Medicaid , and Michigan HIDE SNP contract. Stakeholder Engagement: +… more
    Corewell Health (09/10/25)
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  • HC Quality & Population Health Data Scientist

    CVS Health (Springfield, IL)
    …RFP). **Primary Job Duties & Responsibilities** + Leads rigorous evaluation research into prioritized Medicaid population health interventions from end-to-end ... fact/dimensional data models within Power BI that serve evaluation research effort + Leads all data science efforts to...least 3 years of demonstrated healthcare analytics experience within Medicaid / Medicare space + Advanced knowledge of data… more
    CVS Health (09/05/25)
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  • Tricare Community Liaison

    Humana (Annapolis, MD)
    …+ Ability to interpret and understand policy and/or government contracts (IE TRICARE, Medicare , Medicaid , CMS etc ) + Comprehensive knowledge of Microsoft Office ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
    Humana (09/04/25)
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  • Deputy Associate General Counsel for Litigation…

    Office of the Secretary of Health and Human Services (Washington, DC)
    …legal advisor and counselor on defensive litigation brought against the Centers for Medicare & Medicaid Services (CMS). Directs all aspects of CMS Division ... overseeing complex litigation involving challenges to significant and novel programs, including Medicare , Medicaid , and ACA title I programs (private market… more
    Office of the Secretary of Health and Human Services (09/10/25)
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  • Physician Contract Administration

    AdventHealth (Maitland, FL)
    …necessary research to obtain and maintain non-contracted payer reimbursement including Medicare , Medicaid , Tricare and other govt payers. * Responsible for ... * Performs special projects and tasks as requested by senior staff and leadership. * Supports the contracting team,...current on regulatory updates and rate changes that affect Medicare , Medicaid and TriCare reimbursement for contract… more
    AdventHealth (08/26/25)
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  • Director, Product Design

    Humana (Sacramento, CA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... accessible, and aligned with business priorities. You'll collaborate with senior leaders across Product, Engineering, Marketing, and Operations to define… more
    Humana (09/10/25)
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