- 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 ... financial, and clinical teams to assess and determine optimal data solutions. Provide strategic recommendations on ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- CVS Health (Harrisburg, PA)
- …all with heart, each and every day. **Position Summary** - Maintains the Provider Data (demographic and contractual) for all network and non-network providers. ... other departments regarding database improvements. - Provides support for baseline provider data transactions that cannot be administered automatically through… more
- Humana (Harrisburg, PA)
- …impact** **Required Qualifications** + Minimum of 2 years' professional experience in Medicaid data management, healthcare operations + Ability to monitor ... for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare, and DSNP states,...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Harrisburg, PA)
- …Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... Engineer will be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities. They will… more
- Humana (Harrisburg, PA)
- …healthcare operations, particularly around claims processing, enrollment, provider data management and clinical operations; Medicaid preferred + ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Harrisburg, PA)
- …of the care received by members in the KY, OH, VA, WI and IN Medicaid market populations. May provide cross-coverage for other state Medicaid markets. ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Deloitte (Pittsburgh, PA)
- …work. Recruiting for this role ends on December 15th, 2025.Work You'll Do + Provide strategic and technical consulting services to public sector clients + ... reimbursement, including actuarial rate development across managed care and fee-for- service , Medicaid policy, budget forecasting and fiscal analyses, and… more
- Prime Therapeutics (Harrisburg, PA)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and… more
- Highmark Health (Pittsburgh, PA)
- …solutions with seamless omni-channel handoffs. As a key leader of the Medicaid Clinical organization, role is responsible for maximizing and optimizing value of ... both internally within Highmark's membership population as well as with external provider partners.. This will require close partnership with leaders across the… 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 ... data integrity as required in the Ohio Medicaid Provider Agreement. + Supports network optimization...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more