- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... business process and technical workflow documents. + Understand Medicaid risk score methodology, including risk score calculation, financial risk receivable… more
- General Dynamics Information Technology (Fairfax, VA)
- …experience **Job Description:** At GDIT, people are our differentiators. As Data Analyst /Statistician you will lay the groundwork for program integrity to be ... government programs grow. Our work depends on a Data Analyst /Statistician joining our team to support the Centers for...our team to support the Centers for Medicare and Medicaid Services. You will support a diverse and multi-disciplinary… more
- Emory Healthcare/Emory University (Atlanta, GA)
- **Description** JOB DESCRIPTION: The 340B Analyst will be responsible for daily operational 340B-related activities. This includes but is not limited to self-audits, ... will be expected to develop an understanding and knowledge of Medicaid in-state and out-of-state requirements, evaluate patient 340B eligibility, and continue… more
- Queen's Health System (Honolulu, HI)
- …B. EXPERIENCE: * In addition to the educational requirement, three (3) years pharmacy operations, business operations or finance experience, preferably in a ... monitoring and routine auditing of virtual inventory accumulation, purchasing procedures, Medicaid billing procedures, patient eligibility, new areas of service, and… more
- Humana (Chicago, IL)
- …caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical ... effectiveness within the Medicaid segment. This function integrates Medical Economics, Clinical Insights, and Quality to deliver improved health outcomes, optimized… more
- Prime Therapeutics (Rancho Cordova, CA)
- …Come build the future of pharmacy with us. **Job Posting Title** Consulting Business Analyst , Principal - Remote - Must be Located in CA **Job Description** ... The Consulting Business Analyst Principal provides strategic analytical leadership...Experience using the SDLC process + Experience working in Medicaid Every employee must understand, comply with and attest… more
- Insight Global (Newtown Square, PA)
- …Medicaid /Medicare) space is actively hiring for a REMOTE Sr. Business Systems Analyst to own the requirements of their Pharmacy Benefits Management (PBM) ... for delivering technical projects for the PBM line of business . As the Systems Analyst you will...re-engineering concentration. - Databricks experience - experience in the Pharmacy Benefit Management (PBM) space - Project management skills… more
- Mount Sinai Health System (New York, NY)
- … Analyst has responsibilities that include: analyzing medical and pharmacy trends, researching all facility amendments, procuring all financial data necessary ... of patients. We are accelerating a transition to a business model focused on population health management - our...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Prime Therapeutics (Columbia, SC)
- …future of pharmacy with us. **Job Posting Title** Senior Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs...to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory… more
- AmeriHealth Caritas (West Chester, PA)
- …software support preferred. + Knowledge/experience with government market lines of business ( Medicaid , Medicare) is preferred. Some knowledge/ experience with ... strong communication skills and be able to actively engage with customers and business partners to understand needs, discuss issues and guide resolution. This role… more