• Medicaid State Data…

    Guidehouse (Arlington, VA)
    …seeking Consultants with experience and knowledge of validating, loading, processing and analyzing Medicaid data and detailed member data across various ... analyses will be leveraged to help inform work with state Medicaid , public health or state...stay abreast of states' healthcare transformation efforts + Perform data and qualitative research activities to address state… more
    Guidehouse (07/31/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Richmond, VA)
    …an impact** **Required Qualifications** + 3+ years of experience researching state Medicaid hospital reimbursement methodologies that utilize MS-DRG, APR-DRG, ... Experience with Optum WebStrat or PSI applications + Experience interacting with a State Medicaid or Federal government agency + Intermediate Microsoft Access… more
    Humana (07/29/25)
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  • Strategy Advancement Advisor ( Medicaid )

    Humana (Richmond, VA)
    …social determinants of health data to create a foundational understanding of a state 's health care and Medicaid landscape. + Works with Market VP, Business ... presence for Humana Healthy Horizons and prepares markets for upcoming bids for state Medicaid managed care programs. The Strategy Advancement Advisor works with… more
    Humana (07/25/25)
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  • Medicaid Lead, Technology Solutions

    Humana (Richmond, VA)
    …**This State Technology Lead role will cover the Michigan Medicaid /DSNP product lines along with one additional state .** **Responsibilities** **Market ... ensuring all stakeholders are aligned and informed, including new functionality needs, data connections, adaption to changing state regulations and the like.… more
    Humana (07/15/25)
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  • Senior Product Owner ( Medicaid )

    Humana (Richmond, VA)
    …+ Bachelor's Degree + Lean Certified / Six Sigma. + Experience in Encounter Data Submissions. + Experience in Medicare/ Medicaid products. + CAS + X12 + ... help us put health first** The Senior Product Owner ( Medicaid ) is responsible for conveying product vision and roadmap...to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The… more
    Humana (07/30/25)
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  • Associate Director Finance Technology…

    Humana (Richmond, VA)
    …trends and lead innovation across our systems to deliver a modern, data -driven, and scalable associate experience. **KEY RESPONSIBILITIES** + Develop and ... part of our caring community and help us put health first** The Associate Director, Technology Solutions devises an effective strategy for executing and delivering… more
    Humana (07/31/25)
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  • Associate Director, Regulatory Intake…

    Humana (Richmond, VA)
    …part of our caring community and help us put health first** The Associate Director, Compliance ensures compliance with governmental requirements. The Associate ... be required to work in either Central or Eastern Time. Associate Director, Regulatory Intake Compliance is responsible for enterprise-wide regulatory monitoring,… more
    Humana (07/30/25)
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  • Associate Director of HR Technology - AI…

    Humana (Richmond, VA)
    …trends and lead innovation across our systems to deliver a modern, data -driven, and scalable associate experience. **KEY RESPONSIBILITIES** + Develop and ... community and help us put health first** Humana is seeking a forward-thinking Associate Director for Human Resources Technology to join our HRIT leadership team. In… more
    Humana (07/31/25)
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  • IPA Coding Associate Director

    CenterWell (Richmond, VA)
    …develop market-specific strategies to promote accurate clinical documentation, ensures all state , federal and internal policies and procedures are followed, and ... to foster consistent, compliant workflows. + Partner with Analytics teams to address data outages and communicate remediation plan to IPA Dyad partners. + Partners… more
    CenterWell (07/24/25)
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  • Senior Professional Business Intelligence Engineer

    Humana (Richmond, VA)
    …cross-functional teams **Process Improvement and Compliance:** + Responsible for Medicaid state reporting requirements, building intuitive reporting constructs ... present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of product performance +… more
    Humana (07/21/25)
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