• Magellan Health, Inc. (Frisco, TX)
    …experience working in Medicare Operations. General Job Information Title Senior Business Analyst - Encounter Operations Grade 26 Work Experience - Required ... sharing complex healthcare analytic data. Ability to forge effective business relationships across organizations, functional groups and levels. EDIFECs experience… more
    Upward (07/10/25)
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  • City of Rancho Palos Verdes, CA (Rancho Palos Verdes, CA)
    …to join the newly established Public Safety Division as a Senior Administrative Analyst . This is your chance to shape innovative public safety programs, enhance ... of life for residents. THE POSITION Rancho Palos Verdes seeks a Senior Administrative Analyst to join a talented team that is launching a new Public Safety Division.… more
    Upward (07/19/25)
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  • SCAN (Long Beach, CA)
    …user". Resolve system issues. Develop routine and ad hoc Sales Leadership reports. Key analyst for sales business processes. You Will Support and maintain system ... member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 300,000 members in California, Arizona, Texas… more
    Upward (07/20/25)
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  • The University of Miami (Miami, FL)
    …& Immuno department has an exciting opportunity for a Quality Management Analyst 3 position. The incumbent conducts highly complex analysis while leading the ... the mandates by state and federal programs, inclusive of the Centers for Medicare and Medicaid Services. Maintains fluency of provider workflows across UHealth that… more
    Upward (07/21/25)
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  • Healogics (Jacksonville, FL)
    …and projections. Responsibilities will also include interfacing directly with the Business Intelligence (BI) department on accessing data, building new metrics and ... accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable. Essential Duties and… more
    Upward (07/12/25)
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  • City of Santa Clara, CA (Santa Clara, CA)
    …and operation services for the City. The division also investigates resident/ business inquiries related to street parking, traffic calming, intersection control, and ... Employees: 2.0% @ age 62 formula - employee pays 7.00% of gross pay Medicare and Social Security (FICA) Employee pays 6.20% up to $10,918.20 (Social Security) and… more
    Upward (07/14/25)
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  • Pearl Health (New York, NY)
    …care across patient panels, and optimize performance in value-based care models for Traditional Medicare and Medicare Advantage. We are a team of physicians and ... storytelling, and a track record of managing high-performing teams that deliver measurable business impact. This is a unique opportunity to define and lead marketing… more
    Upward (06/25/25)
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  • eSimplicity (Columbia, MD)
    …and drill down to get details as needed Collaborate with the development and analyst to ensure implementation of the needed business , functional, and system ... to support staff. Attend requirements gathering meetings to better understand business needs, functional and system requirements Produce detailed testing documents,… more
    Upward (07/12/25)
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  • Peak Vista Community Health Centers (Colorado Springs, CO)
    …Quality Assurance RN works closely with the Quality Oversight RN and Health Informatics Analyst , as well as clinic staff and leadership to identify areas of focus ... staff and clinic leadership regarding their performance Monitor organizational performance of Medicare Annual Wellness Visits (AWVs) and provide training to all new… more
    Upward (07/17/25)
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  • Medicare Technical Business

    Insight Global (Woonsocket, RI)
    …Education: Bach degree or equivalent 2-4 years or more years of Technical Business Analyst experience Medicare or Health Insurance experience: claims, ... Job Description Insight Global is seeking a Technical Business Analyst to support a large health insurance client of ours. Work with business partners and… more
    Insight Global (07/22/25)
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  • Business Analyst II- Medicare

    Centene Corporation (Tallahassee, FL)
    …objectives for assigned function. This role will focus on data mapping for Medicare provider directories. + Support business initiatives through data analysis, ... + Perform data mapping and validation for large datasets related to Medicare provider directories + Support user acceptance testing (UAT) and troubleshoot issues… more
    Centene Corporation (07/23/25)
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  • Medicare Advantage Risk Adjustment…

    UCLA Health (Los Angeles, CA)
    Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... with the ability to analyze complex datasets. + Skilled in translating business questions and requirements into actionable reports, database views, and BI query… more
    UCLA Health (06/11/25)
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  • DSNP Business Analyst

    NTT DATA North America (Merced, CA)
    …Overview:** We are seeking a detail-oriented and experienced DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing. The ... overall sourcing strategy NTT DATA currently seeks a DSNP Business Analyst to join our team in...**Required Qualifications:** + 5+ years pf proven experience with Medicare claims, including a deep understanding of CMS requirements… more
    NTT DATA North America (07/18/25)
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  • Reimbursement Analyst (Cost Reporting…

    UTMB Health (Galveston, TX)
    Reimbursement Analyst (Cost Reporting - Medicare /Medicaid) - Government Reimbursement **Galveston, Texas, United States** Business , Managerial & Finance UTMB ... Requisition # 2503274 **Minimum Qualifications:** Bachelor's degree in Accounting, Business , or related field. and a minimum of three...related field. and a minimum of three years of Medicare and Medicaid Cost Report or related experience. An… more
    UTMB Health (06/14/25)
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  • Provider Engagement Analyst , VBP…

    Centene Corporation (Providence, RI)
    …healthcare to improve outcomes, advance quality, and promote equity. The Analyst , Value-Based Payment Initiatives (VBP) will support the expansion and performance ... of Medicare -focused VBP arrangements across New York, including ...terms, and generating insights to guide strategic decision-making. The Analyst will work closely with the VBP Manager, Director,… more
    Centene Corporation (07/23/25)
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  • Senior Medicare Markets Pricing Consultant…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …exposure to all areas of BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker with the ability to drive ... collaboratively with both technical and non-technical staff including Underwriting, Medicare Product Development, Provider Contracting, Sales, and others across the… more
    Blue Cross Blue Shield of Massachusetts (04/30/25)
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  • Medicare Risk Adjustment Actuarial…

    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
    Elevance Health (07/18/25)
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  • Sr Actuarial Analyst - Medicare

    Centene Corporation (Madison, WI)
    …actuarial opportunity offering broad exposure to the financial landscape of the ** Medicare ** business . You'll gain visibility into key financial drivers and ... play a hands-on role in shaping strategy and performance. **In this Sr. Actuarial Analyst role, you will:** + Assist ** Medicare ** bid review and perform… more
    Centene Corporation (07/05/25)
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  • Medicare Supplement Data Analyst

    CVS Health (Austin, TX)
    …Aetna, a CVS Health company, is seeking an analytical professional to join the Medicare Sales and Strategy team. The role involves supporting the Medicare Sales ... Server. Additionally, we are specifically seeking a professional with experience in Medicare Supplement. **Required Qualifications** Minimum 3 years of Medicare more
    CVS Health (07/20/25)
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  • Regulatory Analyst , Medicare

    Healthfirst (NY)
    …of material reviews in HPMS. + Actively participates in the annual Medicare Go to Market process, including working with internal stakeholders on developing ... status including approvals/denials. + Coordinates a review of the website with business owners and ensures compliance with regulatory requirements specific to annual… more
    Healthfirst (06/27/25)
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