- The George Washington University (Washington, DC)
- I. JOB OVERVIEW Job Description Summary: The Senior Financial Analyst , Clinical Research is the primary contact in the GWCC Clinical Trials Office responsible for ... when applicable. Follow institutional guidelines and policies in performing Medicare Coverage Analysis (MCA). Responsible for entering event schedules, budgets,… more
- CareOregon (Portland, OR)
- …Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Medicare Encounter Data Analyst Exemption Status Exempt Department Finance ... one of the listed 9 states. Job Summary The Medicare Encounter Data Analyst leads the process...Medicare programs + Knowledge of medical and/or pharmacy claims + Knowledge of CPT, HCPCS, ICD10 coding; revenue… more
- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... Medicare ) + Medical Coding, Compliance, Payment Integrity and Analytics + Direct and relevant experience with HCFA/UB-04 claims management, coding rules and… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …responsible for completing the Medical Policy activities outlined in BCBSLA's Medicare Advantage Medical Policy Development Policies & Procedures locating, tracking ... will also support on an as needed basis support the Medical Policy Project Analyst position when medical policy volume is elevated or the primary Analyst … more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery Analyst will assist in ... Medicare ) + Medical Coding, Compliance, Payment Integrity and Analytics + Direct and relevant experience with HCFA/UB-04 claims management, coding rules and… more
- MetroLink (Los Angeles, CA)
- Senior Management Analyst (Project Controls) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4546555) Apply Senior Management Analyst ... operator of the METROLINK Commuter Rail System, is seeking a Senior Management Analyst (Project Controls) who will implement the tools and systems necessary to… more
- Prime Therapeutics (Glen Allen, VA)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... our passion and drives every decision we make. **Job Posting Title** Lead Business Analyst **Job Description** The Business Systems Analyst (BSA) Lead IT is… more
- Henry Ford Health System (Troy, MI)
- … Advantage, Medicare -Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause ... analysis when required. The Analyst will work with HAP's medical directors, nurses, pharmacists,...following established guidelines from: The Center for Medicaid and Medicare Services (CMS), MAXIMUS Federal Services, Department of Labor… more
- Nordstrom (Costa Mesa, CA)
- …a multiple state. You own this if you have: + At least 2 years direct workers compensation experience (actually working claims ) + Experience with Indemnity ... Job Description The Workers Compensation Risk Analyst 3 will be responsible for managing moderately... 3 will be responsible for managing moderately complex claims , including high exposure and litigated claims .… more
- The County of Los Angeles (Los Angeles, CA)
- HEALTH CARE FINANCIAL ANALYST / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659553) Apply HEALTH CARE ... FINANCIAL ANALYST / EMERGENCY APPOINTMENTS HOMELESSNESS Salary $74,197.20 - $99,983.04...for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations… more
- State of Colorado (Denver, CO)
- Rate Review Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4656192) Apply Rate Review Analyst Salary $57,708.00 - $75,024.00 ... and abilities. We are looking for a Rate Review Analyst to join our Fee for Service Rates team!...and other data, including, but not limited to administrative claims data, survey data, geographic information, and other publicly… more
- Adecco US, Inc. (Houston, TX)
- …(PBM) claim adjudication system and translate concepts into practice. . Using knowledge of Medicare Part D and claims processing be able to identify unique ... to $ 30.90/hr **Responsibilities:** . Serve as dedicated resource to multiple complex Medicare Part D plans to manage first level response and resolution of… more
- Healthfirst (NY)
- …policies and procedures, reporting and project specifications, job aids and workflows for Medicare products. + Leads the setup and monitoring of Medicare ... collaboration with our Pharmacy Benefit Manager (PBM). + Collaborates with our Medicare product team to identify and implement benefit solutions to promote quality… more
- LA Care Health Plan (Los Angeles, CA)
- Technical Project Analyst II Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support Services Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Technical Project Analyst (TPA) II will support projects with Project Managers...small to large projects with at least 5 years direct experience developing small scale technical solutions to streamline… more
- MyFlorida (Tallahassee, FL)
- 68064844 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Sep 19, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... for Health Care Administration Working Title: 68064844 - MEDICAL/HEALTH CARE PROGRAM ANALYST Pay Plan: Career Service Position Number: 68064844 Salary: $1,794.92 -… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Senior Managed Care Rebate Analyst Date: Sep 13, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57682 **Who we ... to make a difference with. **The opportunity** The Senior Managed Care Rebate Analyst is responsible for managing the reimbursement process for Teva's largest PBM… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Risk Management Analyst ** **FT Days- M-F onsite** **Mission Statement:** We, St Peter's Health ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more
- University of Rochester (Rochester, NY)
- …the scientific literature. + Must have at least 1 year of experience with Medicare claims . Familiarity with the US healthcare system and Department of Veterans ... through September 2022, with possibility of extension.** **Position Summary** Under direct supervision and with some latitude for independent judgement, creates data… more
- CAI (Harrisburg, PA)
- …encounter and claims data for both managed care and fee-for-service Medicare and Medicaid, as well as commercial and health care related insurance. + ... pre-employment testing, or otherwise participating in the employment selection process, please direct your inquiries to ###@cai.io or (888) 824 - 8111. **Equal… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Develops and maintains corporate reimbursement policies, and works collaboratively with the Claims Coding Analyst to ensure consistency with the Plan's ... for: (1) regulatory information such as proposed and final Medicare and/or Medicaid payment regulations, Medicare Manual...healthcare environment is required + 7 or more years direct work in claims processing, payment policy,… more
