- Robert Half Finance & Accounting (Eatontown, NJ)
- …Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare / Medicaid Reimbursement. + The Director will have advanced level of knowledge ... projects not listed above. + Planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with the Vice President of… more
- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible ... research, as necessary on all new and revised coding logic, related Medicare / Medicaid policies for review/approval through the Payment Integrity governance… more
- OhioHealth (Columbus, OH)
- …**Job Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This ... position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is… more
- Commonwealth Care Alliance (Boston, MA)
- …Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, ... to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Zelis (Plano, TX)
- …the personal interests that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory ... communicating rules, regulations, and procedures pertaining to public and private Medicaid payment systems. This position requires an in-depth knowledge of… more
- Elevance Health (Mendota Heights, MN)
- ** Medicare Risk Adjustment Actuarial Analyst III** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Actuarial Analyst III** is...Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives.… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. **Position Summary:** + The Sr Analyst , Internal Audit will be a key member of the Internal Audit team and will ... participate in the execution of internal audits. This role is responsible for basic auditing tasks including: developing audit objectives, documenting and evaluating critical controls, implementing audit tests, and communicating with / reporting audit findings… more
- Molina Healthcare (Grand Island, NE)
- …interaction experience + Experience working with complex, often highly technical teams + Medicaid primary and Medicare preferable payer claims experience + QNXT ... certification **State Specific Requirements:** Experience navigating Nebraska state and Medicare regulations related to claims configuration and payment accuracy. To… more
- BlueCross BlueShield of North Carolina (NC)
- …practices with complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). **What You'll Do** + Analyzes necessary ... of provider coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses all resources to ensure compliance and understanding… more
- CommonSpirit Health (Phoenix, AZ)
- …reimbursement services of Dignity Health. The position maintains current knowledge of Medicare Medicaid and other State and Federal regulations. The Sr. ... Managers and/or Directors. Accountabilities: Prepares interim and annual cost reports for Medicare Medicaid and other State or Federal agencies for Dignity… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- …to help lead the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) Next Generation Desktop platform initiative. The ... **Lead Business Analyst ** **Category:** Business Analysis (functional and technical) **Main...integrations and NGD CRM development work. The Centers for Medicare & Medicaid Services (CMS) provides healthcare… more
- MyFlorida (Tallahassee, FL)
- …This position is responsible for: * Serving as a point of contact for the Medicaid Policy Unit, Centers for Medicare and Medicaid Services (CMS) and ... 68064861 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Jul 23, 2025 The State Personnel...entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000… more
- Tidelands Health (Pawleys Island, SC)
- … will ensure timely and accurate reporting of all regulatory financial information to Medicare & Medicaid . This position requires the ability to manage strict ... is not limited to: IRS Form 990 Schedule H; Medicare , Medicaid & Tricare Cost Reports; ...years of progressive healthcare experience working as a Reimbursement Analyst in a hospital, a Medicare Administrative… more
- CommonSpirit Health (Phoenix, AZ)
- …reimbursement services of Dignity Health. The position maintains current knowledge of Medicare , Medicaid and other State and Federal regulations. The Sr. ... **Responsibilities** The **Senior Reimbursement Analyst i** s responsible for providing cost report...Accountabilities: 1. Prepares interim and annual cost reports for Medicare , Medicaid and other State or Federal… more
- Mount Sinai Health System (Astoria, NY)
- …knowledge preferred. + **Experience:** Two years minimum of healthcare experience including Medicare or Medicaid Provider or Facility Enrollment or Credentialing ... Mount Sinai Queens **Responsibilities** + Ensure enrollments for new providers in Medicaid , Medicare , Managed Care plans, Commercial Health plans and Exchange… more
- NTT DATA North America (Merced, CA)
- … Medicaid Program, the methods of product configuration in a Medicaid / Medicare environment, and medical terminology, related procedures, and national ... strategy NTT DATA currently seeks a direct hire Application Analyst III - Core to join our team in...team in remote in California. **Job Overview:** The Application Analyst III - Core Systems is the advanced working… more
- BayCare Health System (Clearwater, FL)
- …+ This position is responsible for government payer reimbursement related to Medicare , Medicaid and TRICARE/CHAMPUS, specifically completion of the annual ... responsibility and clinical excellence. **Responsibilities:** + The Senior Reimbursement Analyst will work independently within their area of responsibility while… more
- Kelly Services (Mason, OH)
- …multiple Medicaid program implementations. Serve as a Sr. Configuration Analyst on the Business Configuration Solutions team. Responsible for the enablement of ... expert representing the Configuration workstream for large Government Implementations for Medicaid , Med/Surgical, and Medicare programs. + Provide Data Analysis… more
- Mount Sinai Health System (New York, NY)
- …CPT codes for existing and new services. Assures that updated fee schedules for Medicare , Medicaid , commercial and managed care carriers are correctly entered in ... **Job Description** **Reimbursement Analyst (CCS or CPC) Coding Chargemaster/Projects Corporate 42nd...resolving billing disputes. + Keeps abreast of changes in Medicare and Medicaid regulations that impacts Practice… more