• 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, ... and other business teams involved in the administration of Medicaid business at Humana. The Senior Business...WebStrat or PSI applications + Experience interacting with a State Medicaid or Federal government agency +… more
    Humana (07/09/25)
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  • Senior Encounter Data Management…

    Humana (Richmond, VA)
    …from the data exchange between Humana and its trading partners, Medicare and Medicaid . The Senior Encounter Data Management Professional will work with ... a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful… more
    Humana (05/31/25)
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  • Senior Data and Reporting…

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Senior Data and Reporting Professional generates ad hoc reports and regular datasets ... or data warehouse queries and scripts. The Senior Data and Reporting Professional work assignments... from multiple sources to produce requested or required data elements. This role will support our Medicaid… more
    Humana (07/10/25)
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  • Senior Professional Business Intelligence…

    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 (07/15/25)
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  • Senior , Enterprise Data Governance…

    Humana (Richmond, VA)
    …a part of our caring community and help us put health first** The Senior Enterprise Data Governance Professional is responsible for implementing, operating, and ... monitoring the company's data governance program, ensuring robust data protection,...Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will… more
    Humana (07/18/25)
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  • Senior Consultant, Epidemiology, Government…

    IQVIA (Falls Church, VA)
    …of public health, population health and high-quality research studies across Federal, State and Local government clients. A Senior Consultant supports ... ** Senior Consultant, Epidemiology, Government Solutions** **About IQVIA Government...public health leaders and practitioners by delivering health care data and by providing in-depth insights that can be… more
    IQVIA (06/18/25)
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  • Senior Actuarial Analyst - REMOTE

    Prime Therapeutics (Richmond, VA)
    … data and concepts + Collaborate with Underwriters, other areas of Prime, and senior leaders on pricing initiatives, data analyses, and the RFP process + ... and drives every decision we make. **Job Posting Title** Senior Actuarial Analyst - REMOTE **Job Description** The ...for all Prime's lines of business (commercial, Medicare and Medicaid ). This role will also provide actuarial support in… more
    Prime Therapeutics (07/12/25)
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  • Senior Analyst, Network Relations

    CVS Health (Richmond, VA)
    …are handled within a timely manner. Staff may be responsible for reviewing claims data and information. The Senior Network Relations Analyst is responsible for ... meets State requirements + Coordinates provider information with Provider Data Services including Member Services and other internal departments as requested as… more
    CVS Health (07/16/25)
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  • Audit & Reimbursement Senior - Appeals

    Elevance Health (Roanoke, VA)
    **Audit & Reimbursement Senior ** _Location:_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The **Audit and Reimbursement … more
    Elevance Health (07/03/25)
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  • Senior Market Partnership Coding…

    Humana (Richmond, VA)
    …of our caring community and help us put health first** The Senior Market Consultation/Partnership Professional interprets, analyzes, and promotes the use of ICD-10 ... for the Healthcare Quality Reporting & Improvement organization. The Senior Market Consultation/Partnership Professional work assignments involve moderately complex… more
    Humana (07/10/25)
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