• CapB InfoteK (Minneapolis, MN)
    …an Agile Medicaid Program (RAMP) consultant to act as Business Analyst and provide strategic experienced based consultative suggestion to the team and ... For one of our ongoing Medicaid Enterprise System (MES) modernization project we are...years' experience providing consultation and guidance to a State Medicaid program Three (3) years' experience supporting the creation… more
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  • Children's National Hospital (Silver Spring, MD)
    Under direction of the Reimbursement Manager, The Senior Reimbursement Analyst will be responsible for preparing and filing the annual Medicare and Medicaid cost ... healthcare industry Required Skills/Knowledge Strong knowledge of Medicare and Medicaid reimbursement regulations for hospitals and/or physician payment mechanisms;… more
    Upward (07/17/25)
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  • AmeriHealth Caritas Health Plan (Detroit, MI)
    …Network Management in dealings with provider agreements. The Contract Management Analyst will assist the Manager, Provider Network Management in administering the ... Business, Public Health, or a related area or similar work experience Michigan Medicaid policies - state and federal managed health care requirements 3 to 5… more
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  • Arkansas Children's (Little Rock, AR)
    …collection. Advises guarantors of assistance and provide help in applying for Medicaid , prompt pay discounts, payment plans, etc. Provides prompt, accurate, and ... payer sources, is likely to qualify for other payer programs (eg, Medicaid , ARKids, Liability insurance, etc.), or might qualify for Financial Assistance programs.… more
    Upward (07/20/25)
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  • TEEMA (Austin, TX)
    Medicaid IT application enhancement initiative as a Business Analyst supporting Agile-based projects. You'll analyze business needs, refine documentation, guide ... Job Title: Business Analyst 2 Job ID: 81840 Location: Austin, Texas:...working in Agile project environments Preferred: 2+ years with Medicaid /CHIP or Texas HHSC systems Preferred: 2+ years in… more
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  • Highlight Health (Philadelphia, PA)
    …review experience More than 2 years of hands-on commercial claims experience (Medicare/ Medicaid experience is not sufficient) In depth knowledge of commercial price ... certificates (AHIMA, AAPC, ACDIS, etc.) Database query skills Medicare and/or Medicaid claims experience Experience managing ERISA appeals NSA IDR experience… more
    Upward (07/17/25)
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  • MetroPlusHealth (New York, NY)
    …list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus ... their healthiest life. Position Overview The Payment Integrity (PI) Analyst will assist in the development of a strategic...will drive incremental value year over year. The PI Analyst will employ use of analytics, trends, competitor benchmarking,… more
    Upward (07/04/25)
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  • Spherion (Madison, WI)
    …health policy and a sharp eye for detail? Are you ready to influence how Medicaid services are designed and delivered across Wisconsin? Spherion is seeking a Policy ... Analyst to support key benefit areas in the Division of Medicaid Services (DMS) - all from the comfort of your home. This is a long-term contract position… more
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  • Better-Health-Group (Tampa, FL)
    Overview Position Objective: The Quality Analyst - Risk Adjustment ("Quality") and HEDIS (Healthcare Effectiveness Data and Information Set) is responsible for ... in Quality and HEDIS processes related to Medicare Advantage, Traditional Medicare, Medicaid , and Commercial healthcare programs, with a keen eye for detail and… more
    Upward (07/03/25)
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  • Spherion (Madison, WI)
    …Wisconsin Department of Health Services (DHS), is seeking a Program and Policy Analyst - Advanced for a long-term, full-time, remote contract role within the Program ... Childrens Services (BCS). This position is open to Wisconsin residents only. The analyst will lead data-driven policy and quality improvement efforts that impact … more
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  • Takeda Pharmaceutical Company Limited (Exton, PA)
    …following job opportunity: JOB LOCATION: Exton, PA POSITION : Government Pricing Analyst I POSITION DESCRIPTION : Takeda Pharmaceuticals America, Inc. is seeking a ... Government Pricing Analyst I with the following duties: perform the end-to-end...the statutory time frames - Centers for Medicare & Medicaid Services (CMS), state agencies as required by statute… more
    Upward (07/11/25)
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  • Convey Health Solutions (Chicago, IL)
    SUMMARY The Sr. Data Analyst will be responsible for utilizing technical and industry knowledge to accelerate analytic insights and new feature enhancements to ... desired deliverables will be vital to success. Collaborating within a team, the analyst will engage with engineers, QA, Data Scientists, and Product teams using… more
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  • Cynet Systems (Raleigh, NC)
    …analysis, and finalization of information to obtain final sign-off for the Medicaid Detailed Budget Summary Tables (MDBT). Work alongside the DHB business units, ... Medicaid Enterprise System (MES) project teams, technology teams, and...related requirements to develop an appropriate MDBTs. Facilitate the Medicaid Detail Budget Summary (MDBT)review meetings with key stakeholders.… more
    Upward (07/08/25)
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  • Molina Healthcare (Long Beach, CA)
    Job Description Job Description Job Summary The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... on how to use reports related to Risk and Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. Assists with research, development, and completion of special… more
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  • CCS (Clearwater, FL)
    …and is flexible to meet the needs of the Follows all Medicare, Medicaid , HIPAA, and Private Insurance regulations and Abides by all regulations, policies, procedures ... and standards Desired Outcomes Exercises appropriate cost control measures Maintains positive internal and external customer service relationships. Maintains open lines of communication. Plans and organizes work effectively and ensures its completion. Meets… more
    Upward (07/19/25)
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  • Step Forward ABA (Broomfield, CO)
    Step Forward in Your Career: Board Certified Behavior Analyst At Step Forward ABA, we're on a mission to make a meaningful difference in the lives of individuals ... or a related field. Valid BCBA certification and licensure as a Licensed Behavior Analyst in good standing with the relevant state. Minimum 2 years of experience… more
    Upward (07/26/25)
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  • CGS Administrators, LLC (Nashville, TN)
    …travel between buildings and out of town. Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross BlueShield of South ... Carolina require CMS (Centers for Medicare and Medicaid Services) residency that requires employees to have lived in the US for at least three (3) out of the last… more
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  • JPS Health Network (Fort Worth, TX)
    …www.jpshealthnet.org, www.jpshealthnet.org/careers, or www.teamacclaim.org. Job Title: Sr Financial Analyst Reimburse Requisition Number: 38860 Employment Type: Full ... Shift Worked: Day Job Description: Job Summary: The Sr. Financial Reimbursement Analyst coordinates and provides senior level expertise and support for all… more
    Upward (07/01/25)
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  • Talent Software Services (Columbia, SC)
    …or e-business systems experience. *Background in healthcare operations (preferably Medicaid ) and business processes *Proficient in Atlassian tool suite including ... JIRA and Confluence. *Prior experience working in a standard SDLC (waterfall methodology) & in an AGILE delivery more
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  • UF Health (Jacksonville, FL)
    Overview Job Duties Under limited supervision, the Physician Billing Compliance Analyst (" Analyst ") will perform physician coding/documentation audits for ... ("COM-Jax") and the University of Florida Jacksonville Physicians Group ("UFJPI"). Analyst will also perform abbreviated reviews on newly hired providers'… more
    Upward (06/30/25)
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