- Curant Health (Smyrna, GA)
- …Maintain the company's provider directory and pharmacy networks. Enroll pharmacies with State Medicaid agencies and Medicare Part B. Respond to requests for ... at the available career opportunities at Curant Health. Position Summary: The Contracts Analyst plays a key role in tracking and managing all pharmacy network… more
- Tennessee Hospital Association (Brentwood, TN)
- …requirements on hospital reimbursement and methodologies, including, but not limited to, Medicare and Medicaid . 4. Prepares draft letters and position statements ... system changes to state and federal regulatory agencies, including the Centers for Medicare and Medicaid Services (CMS), the Internal Revenue Service (IRS),… more
- Pyramid Consulting, Inc. (Deerfield, IL)
- …Experience: Key Skills: Reviewing and validating government pricing which may include ( Medicaid (AMP/BP), Medicare Part B (ASP), Public Health Service(340B) and ... Immediate need for a talented Financial Analyst III/ Government Price Reporting Associate. This is...on work location). Key Responsibilities: Review and payment of Medicaid Rebates and working with third-party vendor to resolve… more
- MetroPlusHealth (New York, NY)
- …comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, ... Yorkers to live their healthiest life. Position Overview The Payment Integrity (PI) Analyst will assist in the development of a strategic roadmap to recover,… more
- Mount Sinai Hospital (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... care each year for millions of patients. We are accelerating a transition to a business model focused on population health management - our goal is to keep entire… more
- BG Consulting Services LLC (Bethesda, MD)
- …to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare , Medicaid , VA, Public Health Department, and Regional and local ... Appointment booking software, Government data repositories such as P2R2 Virtual Analyst , M2 Data Mart, EDW, Population Health Operational Tracking and Optimization… more
- UHS (Riverside, CA)
- …to ensure compliance with Federal and State laws and regulations (Centers for Medicare and Medicaid Services, Department of Managed Health Care, Department of ... and health plan requirements. The Delegation Oversight Nurse works closely with business leaders in the development and implementation of external vendor initiatives… 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
- 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
- Molina Healthcare (Grand Island, NE)
- …interaction experience + Experience working with complex, often highly technical teams + Medicaid primary and Medicare preferable payer claims experience + QNXT ... on complex claims related issues and service recovery efforts.** Analyzes complex business problems and issues using data from internal and external sources to… 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...complex projects related to risk adjustment analytics in the Medicare Advantage line of business . **How You… 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 ... controls, implementing audit tests, and communicating with / reporting audit findings to business line management. + CVS Health follows a hybrid work model providing… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- **Lead Business Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Virginia, Fairfax **Alternate ... . **Position Description:** CGI Federal is seeking a Lead Business Analyst to help lead the Department...Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) Next Generation… 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 ... coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses...training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part… more
- MSys Inc. (Columbia, SC)
- …with benefits or long term hourly contract W2 only; seeking a Technical Writer, Business Analyst , or Contract Writer with experience in developing and updating ... stakeholders to maintain Advanced Planning Documents (APDs) required by Centers of Medicaid / Medicare Services (CMS). This documentation involves drafting the … 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
- University of Michigan (Ann Arbor, MI)
- …Team at Michigan Medicine is seeking a candidate to fulfill the role of Business Analyst Senior / Intermediate. The Senior / Intermediate Business ... Business Systems Analyst Senior/Intermediate Apply Now...+ Implement, track, and report on ambulatory Center for Medicare and Medicaid Services (CMS) Electronic Clinical… more
- US Tech Solutions (Columbia, SC)
- …the MES Modernization. **Daily Duties/ Responsibilities:** + Seeking a Technical Writer, Business Analyst , or Contract Writer with experience in developing and ... stakeholders to maintain Advanced Planning Documents (APDs) required by Centers of Medicaid / Medicare Services (CMS). This documentation involves drafting the … more
- Prime Therapeutics (Eagan, MN)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr. Business Systems Analyst **Job Description** The Sr. Business Systems ... organization objectives by acting as the bridge between the business systems analyst team, business ...Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid , the Exchanges along with regulatory… 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
