- R1 RCM (Salt Lake City, UT)
- …AI, intelligent automation, and workflow orchestration. We are seeking to expand our Medicare reimbursement team by adding a senior analyst. Working as a ... of the Government Navigation Suite service line, the Reimbursement Senior Analyst will partner with team members to work...variety of hospitals and systems to review and audit Medicaid eligible days for Medicare DSH reimbursement.… more
- CVS Health (Austin, TX)
- …do it all with heart, each and every day. **Position Summary** **The Medicaid Senior Manager, Network Management:** * Negotiates, executes, conducts high level ... in contract management systems per Aetna's established policies. . * Conducts research , analysis and/or audits to identify issues and propose solutions to protect… more
- Molina Healthcare (Green Bay, WI)
- …Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare - Medicaid recipients within ... School Diploma/GED/AA Degree **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** 2+ years Medicare , Medicaid , managed care or other health/insurance related… more
- Molina Healthcare (Boston, MA)
- …Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare - Medicaid recipients within ... **Required Education** High School diploma/GED **Required Experience** 2+ years Medicare , Medicaid , managed care or other health/insurance related… more
- BlueCross BlueShield of North Carolina (NC)
- …work to comply with applicable mandated State (NCDOI) and/or Federal (Centers for Medicare & Medicaid Services (CMS), ERISA, etc.) accreditation agency standards ... performance._ $45,761.00 - $73,217.00 **Skills** Confidentiality, Government Regulation, Law, Medicaid , Medicare , Policies & Procedures, Policy Development,… more
- CVS Health (Phoenix, AZ)
- …technical, analytical, and business support for all assigned programs for Medicare , Medicaid , and Commercial products. Programs currently include End-Stage ... successful audit experience for our clients. Your ability to research claims, read benefit setups in RxClaim, and articulate...**Knowledge of:** + 3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience +… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Senior Research Scientist participates in research study design, analysis and ... preparation, and management; statistical analysis and interpretation of findings. The Senior Research Scientist work assignments involve moderately complex to… more
- Humana (Charleston, WV)
- …errors that result from the data exchange between Humana and its trading partners, Medicare and Medicaid . The Senior Encounter Data Management Professional ... to ensure successful submission and reconciliation of encounter submissions to Medicaid / Medicare . Ensures encounter submissions meet or exceed all compliance… more
- Humana (Annapolis, MD)
- …In this position, the Research Scientist 2 will partner with a senior research scientist to apply advanced statistical methods to rigorously evaluate the ... caring community and help us put health first** The Research Scientist 2 participates in research study...advancing predictive modeling and analytics in support of our Medicare and Medicaid business. The HQRI team… more
- AdventHealth (Maitland, FL)
- …Senior Compliance Analyst will have expertise in Commercial and Governmental ( Medicare , Medicaid , Tricare) payer reimbursement language and methodologies. The ... Location** : Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify,… more