- CVS Health (Harrisburg, PA)
- …day. **Position Summary** The Corporate Medicaid Compliance team is looking for a Sr . Analyst to support the Medicaid Business Compliance Office (BCO) ... will have a successful background in supporting cross-functional projects. The Sr . Analyst will support compliance oversight of market-specific implementations… more
- Prime Therapeutics (Harrisburg, PA)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Sr . AI Business Analyst - Remote **Job Description** **Are you a Business ... grow your career in the IT AI space.** The Sr . IT Business Systems Analyst (BSA) is...project team and various levels of management. With consistent Senior Leadership visibility, the IT BSA Sr … more
- Prime Therapeutics (Harrisburg, PA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr . Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & ... Complaints Senior Compliance Analyst assists in the implementation...or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must… more
- Baylor Scott & White Health (Harrisburg, PA)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... independently and with cross functional groups.Knowledge of ACA, Medicare, Medicaid , MCO, TPA business requirements preferred.Experience with healthcare encounters,… more
- CVS Health (Blue Bell, PA)
- …Brief Overview** + Provide actuarial support for the **Texas and Oklahoma Medicaid ** plans. + Performs actuarial functions by applying expanded quantitative skills ... with others to meet/exceed expectations. **Preferred Qualifications** + Experience in Medicaid + Experience with SQL + Experience with PowerPoint **Education** +… more
- Prime Therapeutics (Harrisburg, PA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** ... The Senior Compliance Analyst assists in the implementation...or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must… more
- CVS Health (PA)
- …internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required. +… more
- CVS Health (Blue Bell, PA)
- …the operational and financial performance evaluation across Aetna's Commercial and Medicaid Care Management programs to optimize the programs' performance, identify ... for building and maintaining staffing models that support the Commercial and Medicaid Care Management programs. Key responsibilities of this role include: + Build… more
- CVS Health (PA)
- …to multiple internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree ... or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age,… more
- Insight Global (Philadelphia, PA)
- …health insurance space ( Medicaid /Medicare) space is actively hiring for a REMOTE Sr . Business Systems Analyst to own the requirements of their Pharmacy ... for delivering technical projects for the PBM line of business. As the Systems Analyst you will leverage your SDLC knowledge to drive projects involving changes and… more