- State of Michigan (Lansing, MI)
- Medicaid Utilization Analyst 9-P11 - BPHASA Medical Equipment and Services Section Print ... (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4533727) Apply Medicaid Utilization Analyst 9-P11 - BPHASA Medical Equipment and Services… more
- Teva Pharmaceuticals (North Wales, PA)
- Medicaid Claims Analyst Date: May 29, 2024 Location: North Wales, United States, Pennsylvania, 19454 Company: Teva Pharmaceuticals Job Id: 56294 **Who we are** ... people to make a difference with. **The opportunity** The Medicaid Claims Analyst is responsible for ...propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid … more
- Comunilife (Bronx, NY)
- Utilization Review Analyst Job Details...by NYS Office of Mental Health (OMH) to bill Medicaid for certain services. The program is designed to assist ... - Social Services Description Comunilife Inc.is looking for aUtilization Review Analystfor its newRehabilitation and Tenancy Support Services Program… more
- Henry Ford Health System (Troy, MI)
- …Plan's (HAP's): Commercial, Medicare 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, Legal department, and other… more
- MyFlorida (Tallahassee, FL)
- 68063432 - SENIOR MANAGEMENT ANALYST II - SES Date: May 24, 2024 Location: TALLAHASSEE, FL, US, 32308 The State Personnel System is an E-Verify employer. For more ... Agency: Agency for Health Care Administration Working Title: 68063432 - SENIOR MANAGEMENT ANALYST II - SES Pay Plan: SES Position Number: 68063432 Salary: $1,973.85… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Consulting Product Analyst ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... difference. We are looking for a dedicated Consulting Product Analyst like you to be a part of our...processes to recommend opportunities for optimizing business process through utilization of technology.** + **Works with IT and Operations… more
- Hackensack Meridian Health (Edison, NJ)
- …transform healthcare and serve as a leader of positive change. The **Pharmacy Analyst , 340B** will be responsible for ensuring 340B program compliance in HMH's 340B ... well as reviewing medication orders for replenishment. The role requires an in-depth review of data and analysis to ensure regulatory compliance and maximize program… more
- MyFlorida (Tallahassee, FL)
- GOVERNMENT ANALYST II - 48006202 Date: Jun 6, 2024 Location: TALLAHASSEE, FL, US, 32399 WEST PALM BEACH, FL, US, 33409 TALLAHASSEE, FL, US, 32305 DORAL, FL, US, ... . Requisition No: 824023 Agency: Department of Education Working Title: GOVERNMENT ANALYST II - 48006202 Pay Plan: Temp Position Number: 48006202 Salary: 24.67… more
- MyFlorida (Tallahassee, FL)
- SENIOR MANAGEMENT ANALYST SUPV - SES - 60073726 Date: May 29, 2024 Location: TALLAHASSEE, FL, US, 32303 STUART, FL, US, 34984 TERRA CEIA, FL, US, 34250 JACKSONVILLE, ... . Requisition No: 830230 Agency: Children and Families Working Title: SENIOR MANAGEMENT ANALYST SUPV - SES - 60073726 Pay Plan: SES Position Number: 60073726 Salary:… more
- CareOregon (Portland, OR)
- …Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Position Title: Actuarial Analyst I Department: Finance Title of Manager: Actuarial Services Manager ... financial sustainability efforts. Areas of analysis may include cost and utilization trend analysis, return on investment evaluations, Medicare bid development,… more
- MyFlorida (Jacksonville, FL)
- DJJ OPERATIONS ANALYST - 80059896 Date: Jun 3, 2024 Location: JACKSONVILLE, FL, US, 32202 JACKSONVILLE, FL, US, 32204 JACKSONVILLE, FL, US, 32205 JACKSONVILLE, FL, ... . Requisition No: 830214 Agency: Juvenile Justice Working Title: DJJ OPERATIONS ANALYST - 80059896 Pay Plan: Career Service Position Number: 80059896 Salary:… more
- University of Washington (Seattle, WA)
- …and an understanding of Epic applications, data/business intelligence tools and utilization **PRIMARY JOB RESPONSIBILITIES** + Review , Remediation, and Educate ... Medicine Revenue Integrity** has an outstanding opportunity for a **TEMPORARY REVENUE INTEGRITY ANALYST ** **Work Schedule** + 100% FTE - POSITION IS EXPECTED TO LAST… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... Twitter and LinkedIn. **Brief summary of purpose:** Principal responsibility of the OSS Analyst II is to consult, and produce health care reports. Reporting includes… more
- CVS Health (Charleston, WV)
- …experience + Foster care experience + Crisis intervention skills + Managed care/ utilization review experience + Case management and discharge planning experience ... 26+ year history of partnering with the State to provide West Virginia's Medicaid population with top notch health care coordination and service. The plan also… more
- CommonSpirit Health (Englewood, CO)
- …and out in the community. **Responsibilities** **Job Summary** The Senior Analyst , Contract Compliance will leverage knowledge of revenue cycle functions to ... Payment Integrity Compass, EPSI, EPIC) and external sources (eg, Medicare/ Medicaid website) to assess contract performance and contract compliance opportunities.… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Support the Medical Policy and Clinical Utilization Management (UM) Governance Committee Chairs, committee members, and related ... Medical and Clinical strategy + Perform editorial formatting and review of policies, confirm policy references, and obtain necessary...and concepts + Knowledge of Centers for Medicare and Medicaid Services (CMS) and/or New York State Department of… more
- Trinity Health (Syracuse, NY)
- …litigation, and health plan denials Compare evaluation and management code utilization by provider, with comparison to national benchmarking, to identify potential ... enterprise Policy & Procedure. Performs accurate resolve of assigned auditing charge review and claim edits WQs in defined timeframe. Develops, collaborates, and… more
- CVS Health (Charleston, WV)
- …experience + Foster care experience + Crisis intervention skills + Managed care/ utilization review experience + Case management and discharge planning experience ... + Through the use of care management tools and information/data review , conducts comprehensive evaluation of referred member's needs/eligibility and recommends an… more
- Penn Medicine (Bala Cynwyd, PA)
- …hospital based technical coding, billing and medical necessity matters related to utilization management. + Review medical documentation and provide feedback to ... participate in a critical collaborative relationship with each hospital Utilization /Case Management Committee, and the CDM Maintenance Team. **Accountabilities**… more
- The County of Los Angeles (Los Angeles, CA)
- …that affects clinical social work, such as Centers for Medicare and Medicaid Services (CMS) regulations, Joint Commission regulations and policies, Medi-Cal and ... subordinate supervisors and makes final determinations to resolve employee utilization issues, grievances and disciplinary actions. Interprets social work policies,… more