- CGI (Fairfax, VA)
- …to help lead the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) Next Generation Desktop platform initiative. The ... Lead Business Analyst Category: Business Analysis (functional and technical) Main...integrations and NGD CRM development work. The Centers for Medicare & Medicaid Services (CMS) provides healthcare… more
- NYC Health Hospitals (New York, NY)
- …comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, ... Yorkers to live their healthiest life. Position Overview The Payment Integrity (PI) Analyst will assist in the development of a strategic roadmap to recover,… more
- Innova solutions (Red Bank, NJ)
- …codes used in healthcare claims across payers and lines of business (commercial, Medicare , Medicaid ). Identify root causes for claim holds and assess the ... Innova Solutions is immediately hiring a Lead Business Analyst Position type: Permanent Duration: Fulltime Location: New...Fulltime Location: New Jersey, US As a Lead Business Analyst , you will: Analyze and document the various Hold/Pend… more
- Compunnel (Louisville, KY)
- …Analyst to support initiatives in the healthcare payor domain, specifically within Medicare and/or Medicaid . The ideal candidate will have strong experience ... functions (eg, VLOOKUPs, dashboards). Understanding of the healthcare payor domain, specifically Medicare and/or Medicaid . Ability to interpret and apply legal… more
- Triple-S (Guaynabo, PR)
- …lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid , Commercial, Life and Property & Casualty Businesses. Let's ... IT Operations Observability Analyst - TSS Guaynabo, PR ABOUT US At...and support the activities related to the IT Operations Analyst . Performance Tuning & Alert Optimization Regularly review and… more
- Waystar (Louisville, KY)
- …1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational ... values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun. Waystar products have won multiple Best in KLAS(R) or Category Leader awards since 2010 and earned multiple #1 rankings from… more
- eSimplicity (Columbia, MD)
- …in software development in an agile environment Strong experience with the Centers for Medicare and Medicaid Services (CMS) and/or Medicaid CHIP data Test ... drill down to get details as needed Collaborate with the development and analyst to ensure implementation of the needed business, functional, and system requirements… more
- Indiana University Health (Indianapolis, IN)
- …This role offers an exciting opportunity to work on both 340B and Medicare / Medicaid reimbursement initiatives, helping to grow our programs and optimize ... personal and professional journey. Interested? If you're a motivated financial analyst ready to contribute to healthcare reimbursement strategies, apply today! IU… more
- Robert Half Finance & Accounting (Eatontown, NJ)
- …Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare / Medicaid Reimbursement. + The Director will have advanced level of knowledge ... projects not listed above. + Planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with the Vice President of… more
- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible ... research, as necessary on all new and revised coding logic, related Medicare / Medicaid policies for review/approval through the Payment Integrity governance… more
- OhioHealth (Columbus, OH)
- …**Job Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This ... position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is… more
- Commonwealth Care Alliance (Boston, MA)
- …Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, ... to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Zelis (Plano, TX)
- …the personal interests that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory ... communicating rules, regulations, and procedures pertaining to public and private Medicaid payment systems. This position requires an in-depth knowledge of… more
- 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...Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives.… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. **Position Summary:** + The Sr Analyst , Internal Audit will be a key member of the Internal Audit team and will ... participate in the execution of internal audits. This role is responsible for basic auditing tasks including: developing audit objectives, documenting and evaluating critical controls, implementing audit tests, and communicating with / reporting audit findings… more
- Molina Healthcare (Grand Island, NE)
- …interaction experience + Experience working with complex, often highly technical teams + Medicaid primary and Medicare preferable payer claims experience + QNXT ... certification **State Specific Requirements:** Experience navigating Nebraska state and Medicare regulations related to claims configuration and payment accuracy. To… more
- BlueCross BlueShield of North Carolina (NC)
- …practices with complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). **What You'll Do** + Analyzes necessary ... of provider coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses all resources to ensure compliance and understanding… more
- CommonSpirit Health (Phoenix, AZ)
- …reimbursement services of Dignity Health. The position maintains current knowledge of Medicare Medicaid and other State and Federal regulations. The Sr. ... Managers and/or Directors. Accountabilities: Prepares interim and annual cost reports for Medicare Medicaid and other State or Federal agencies for Dignity… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- …to help lead the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) Next Generation Desktop platform initiative. The ... **Lead Business Analyst ** **Category:** Business Analysis (functional and technical) **Main...integrations and NGD CRM development work. The Centers for Medicare & Medicaid Services (CMS) provides healthcare… more
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