- StateJobsNY (Schenectady, NY)
- …operated supports and services to over 8,000 recipients across New York State. The Data Analyst 2 is within DSO's Bureau of Business Analytics and Research, ... #LI-JT1 Minimum Qualifications Non-competitive: one year of permanent service as a Data Analyst 1 OR bachelor's degree and three years of… more
- Iconma LLC (Lansing, MI)
- …who can bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will help ensure ... Program Knowledge: Understanding of relevant risk adjustment programs, such as Medicare Advantage , and their specific compliance requirements. Regulatory… more
- 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 ... measurements used in both internal and external reporting. You will: + Ensure data quality and accuracy through rigorous assurance checks. + Develop and maintain… more
- Centene Corporation (Providence, RI)
- …and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). This role ... in transforming healthcare to improve outcomes, advance quality, and promote equity. The Analyst , Value-Based Payment Initiatives (VBP) will support the expansion… more
- Elevance Health (Mendota Heights, MN)
- …and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and data -driven ... ** Medicare Risk Adjustment Actuarial Analyst III**...complex projects related to risk adjustment analytics in the Medicare Advantage line of business. **How You… more
- Centene Corporation (Madison, WI)
- …Knowledge & Experience:** + Foundational understanding of the healthcare industry or ** Medicare Advantage ** (preferred but not required) + Strong technical ... in shaping strategy and performance. **In this Sr. Actuarial Analyst role, you will:** + Assist ** Medicare **...to identify cost drivers based on analysis of statistical data and other pertinent information + Learn about technical… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …+ Solid understanding of Medicare and its related financial models, including Medicare FFS, Medicare Advantage , Medicare Part D, and ... BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker...results. + Initiate and lead efforts to continually improve data and analytic capabilities considering changing state and federal… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** **Master Data Management Analyst ... III** The MDM Analyst within the Enterprise Data & Analytics department is responsible for leading the...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- Commonwealth Care Alliance (Boston, MA)
- …ensuring accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of ... Experience (nice to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred. **Required Knowledge,… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, Business Data Analyst is instrumental in independently developing the detailed ... requirements are understood and implemented consistent with the Business Data Analyst 's vision + perform testing, design...+ Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual ... for a talented and passionate Human Resource Information System Analyst to join our dynamic HRIS team! In this...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As a key member of our Medicare Advantage Operations team, you will develop detailed requirements specifications to meet our ... Five or more years of experience managing enrollment, claims, or encounters in a Medicare or managed care environment required + Five or more years of experience… more
- ChenMed (Miami, FL)
- …will make data -driven strategy recommendations in the Medicare Advantage and healthcare industry. This senior-level analyst position has the opportunity ... people to join our team. The Senior Health Economics Analyst is responsible for identifying and delivering data...(4) years of related experience + Experience in a Medicare Advantage , Hospital Systems and/or risk-based healthcare… more
- Molina Healthcare (Roswell, NM)
- …proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the ... finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + … more
- UCLA Health (Los Angeles, CA)
- Description The Business Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison between business units, IT ... and documenting business and system requirements, analyzing and interpreting data to support cross-functional operations, and driving system enhancements to… more
- TEKsystems (Boston, MA)
- Description The A/R Analyst position is responsible for the accuracy of data collection, reporting, and translation of data needed to support the Patient ... technologies in each of the functional areas, namely A/R Management, Patient Accounting Data Transactions, and Research Billing. The analyst role is focused on… more
- WTW (Raleigh, NC)
- …a leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage , Medicare Supplement and Life & Supplemental ... Our diverse team of analysts, writers, engineers, designers, business leads, data scientists and sales professionals all work together to create thoughtful,… more
- NTT DATA North America (Merced, CA)
- …US. **Job Overview:** We are seeking a detail-oriented and experienced DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing. ... At NTT DATA , we know that with the right people...not just a method of gaining a one-time cost advantage , but an effective strategy for gaining and maintaining… more
- University of Miami (Miami, FL)
- …you will: + Build and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality Payment Program ... System, "UHealth", IT Department has an exciting opportunity for a Full-time Epic Sr. Analyst - Quality and Population Health. The Epic Sr. Analyst - Quality… more
- Zelis (Plano, TX)
- …in Medicaid billing, reimbursement, claim payment or cost reporting. + Experience with Medicare / Medicare Advantage or commercial billing and reimbursement a ... that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory Pricer Product team to further… more
