- Humana (Harrisburg, PA)
- …our organization's standing within the Medicaid markets. **Complex Ad-Hoc Requests:** The Data and Reporting Professional 2 will address complex ad-hoc ... caring community and help us put health first** The Medicaid Data and Reporting Analyst...operating objectives, including their linkages to related areas. The Data and Reporting Professional 2… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the ... and regulatory standards. Assignments are varied and often require interpretation of Medicaid -specific policies and data . The role demands independent judgment… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results.… more
- Humana (Harrisburg, PA)
- …and Medicaid program requirements to drive accurate and timely submissions. The Senior Data and Reporting Professional integrates data from multiple ... operations across multiple states. This role ensures compliance with state-specific Medicaid reporting implementations and requirements, will collaborate with… more
- Humana (Harrisburg, PA)
- …contracting requirements and data integrity as required in the Ohio Medicaid Provider Agreement and internal reporting compliance. This role will support ... contracting governance, process development, and data governance Ohio Medicaid , including developing contracting requirements, internal reporting compliance… more
- Humana (Harrisburg, PA)
- … requires an in-depth evaluation of variable factors. The Senior Workforce Management Professional plays a pivotal role in supporting Medicaid Inpatient and ... community and help us put health first** The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and … more
- Humana (Harrisburg, PA)
- …model designs including analyzing provider performance, reporting , and scorecard/reconciliation reporting . + Understanding of Medicaid and/or Medicaid ... first** Humana Healthy Horizons is seeking a Senior Value-Based Programs professional who will support successful value-based provider relationships with a focus… more
- Humana (Harrisburg, PA)
- …our caring community and help us put health first** The Senior Agency Management Professional provides support for handling and analyzing data that pertains to ... determination of the appropriate courses of action. The Senior Agency Management Professional provides support for handling and analyzing data that pertains… more
- CVS Health (Harrisburg, PA)
- …abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data visualization tools (eg, Tableau, Power BI ... a full time role and is ideal for a data professional with strong coding skills in...to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting . This is… more
- Humana (Harrisburg, PA)
- …caring community and help us put health first** The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics and ... reporting to develop strategic and operational insights for workforce...management, diversity and human resource compliance). The Workforce Management Professional 2 work assignments are varied and frequently require… more