• Independent Living Systems (Miami, FL)
    We are seeking a Senior Business Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida ... for all vulnerable populations. About the Role: The Senior Business Analyst in Health Care Services plays...knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid reimbursement methodologies (ie Per… more
    Upward (08/01/25)
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  • Reveal Health Tech (New York, NY)
    …and India, we deliver innovative solutions and transformative platforms. We are seeking a Business Analyst with prior experience in life sciences to join our ... mission of revolutionizing healthcare technology. Role Overview As a Business Analyst , you will have a strong...systems Medical coding standards such as FHIR, ICD, CPT Medicare / Medicaid data (payer and/or provider side) UX… more
    Upward (08/04/25)
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  • RELI GROUP INC (Baltimore, MD)
    …critical programs. Position Summary: RELI Group is seeking a detail-oriented Data Analyst / Business Activity Monitoring (BAM) Specialist to support the ... Privacy Support Services (MSSPSS) contract for the Centers for Medicare & Medicaid Services (CMS). This role...Task 7, focusing on data analytics, performance monitoring, and business activity oversight in support of Enterprise Risk Management… more
    Upward (07/31/25)
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  • Medicare / Medicaid Claims Editing…

    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
    Commonwealth Care Alliance (08/26/25)
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  • Senior Risk Adjustment Analyst

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... business process and technical workflow documents. + Understand Medicaid risk score methodology, including risk score calculation, financial risk receivable… more
    CareFirst (09/26/25)
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  • Medicare Risk Adjustment; Financial…

    Humana (Louisville, KY)
    …hybrid based on business discretion. The MRA Finance team supports Humana's Medicare Risk Adjustment business area. The Finance team develops revenue and ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
    Humana (10/02/25)
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  • ACA/ Medicare Risk Adjustment…

    Baylor Scott & White Health (Austin, TX)
    …paced environment independently and with cross functional groups.Knowledge of ACA, Medicare , Medicaid , MCO, TPA business requirements preferred.Experience ... + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight...and pharmacy data is preferred + Knowledge of ACA, Medicare , and TPA business requirements is a… more
    Baylor Scott & White Health (10/03/25)
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  • Medicaid Data and Reporting Professional

    Humana (Olympia, WA)
    **Become a part of our caring community and help us put health first** The Medicaid Data and Reporting Analyst integrates data from multiple sources to produce ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
    Humana (10/07/25)
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  • Salesforce Business Analyst

    General Dynamics Information Technology (Fairfax, VA)
    …/Tester) joining our team remotely to support the Centers for Medicare & Medicaid Services (CMS) activities. HOW A SYSTEMS ANALYST SENIOR WILL MAKE AN IMPACT ... + 3+ years of hands-on experience as a Salesforce Business Analyst and/or Salesforce Consultant. + 3+...Preferred Skills: + Experience working with the Centers for Medicare & Medicaid Services (CMS) and/or health… more
    General Dynamics Information Technology (10/04/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid ), including HEDIS audit submission, Consumer ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Supports corporate and… more
    Medical Mutual of Ohio (08/16/25)
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  • Lead Analyst , Payment Integrity - REMOTE

    Molina Healthcare (Dayton, OH)
    …synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid , and Marketplace lines of business . + Certified ... Summary** Provides lead level support as a highly capable business analyst who serves as a key...and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State… more
    Molina Healthcare (09/28/25)
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  • Sr. AI Business Analyst - Remote

    Prime Therapeutics (Baton Rouge, LA)
    …fuels our passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems ... career in the IT AI space.** The Sr. IT Business Systems Analyst (BSA) is responsible for...Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid , the Exchanges along with regulatory… more
    Prime Therapeutics (10/01/25)
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  • Health Data Analyst

    MyFlorida (Largo, FL)
    …medical billing and Health Information Systems. + Knowledge of State of Florida Medicaid and Medicare /CMS federal laws, rules, regulations related to Long Term ... HEALTH DATA ANALYST - 50000056 Date: Oct 2, 2025 The...for applicable updates. Maintain and balance monthly billing for Medicare A and B, Medicaid and third-party… more
    MyFlorida (10/03/25)
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  • Revenue Data Analyst

    Robert Half Finance & Accounting (Kansas City, MO)
    …Analyze Trends, Microsoft Excel, Medicare , Medicaid , Medicaid , Medicaid Manage Care, Data reporting, Business reporting Robert Half is the world's ... healthcare organization that is looking for a Revenue Data Analyst . The Revenue Data Analyst plays a...of healthcare billing operations and payer types such as Medicare , Medicaid , Managed Care, and Private Pay.… more
    Robert Half Finance & Accounting (10/01/25)
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  • Copy - Remote Business Systems…

    Insight Global (Philadelphia, PA)
    Job Description A leader in the health insurance space ( Medicaid / Medicare ) space is actively hiring for a REMOTE Sr. Business Systems Analyst to own the ... responsible for delivering technical projects for the PBM line of business . As the Systems Analyst you will leverage your SDLC knowledge to drive projects… more
    Insight Global (09/30/25)
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  • Application Analyst III - Core

    NTT DATA North America (Merced, CA)
    Medicaid Program, the methods of product configuration in a Medicaid / Medicare environment, and medical terminology, related procedures, and national ... DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With...strategy NTT DATA currently seeks a direct hire Application Analyst III - Core to join our team in… more
    NTT DATA North America (10/06/25)
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  • Senior Analyst , Business Analytics

    CVS Health (Workman, MN)
    …we do it all with heart, each and every day. **Position Summary** The Sr. Business Analyst supports Medicaid Enrollment Operations by making data accessible ... visualize, trend and report on vendor performance data. + Familiarity with Medicare and Medicaid regulations. **Education** + Associates degree or equivalent… more
    CVS Health (10/08/25)
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  • Senior Reimbursement Analyst - Cost…

    BayCare Health System (Clearwater, FL)
    …+ This position is responsible for government payer reimbursement related to Medicare , Medicaid and TRICARE/CHAMPUS, specifically completion of the annual ... remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Senior Reimbursement Analyst - Cost Reporting **Location** Clearwater | Business and… more
    BayCare Health System (08/09/25)
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  • Senior Health Care Fiscal Analyst (NY…

    New York State Civil Service (Oxford, NY)
    …standards are met. Develop, recommend, and implement policies and procedures for Medicare /Insurance and Medicaid /Private Pay units so that an appropriate billing ... related to reimbursement rates, principles, and practices.Senior Health Care Fiscal Analyst : A bachelor's degree in accounting, auditing, business more
    New York State Civil Service (10/02/25)
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  • Compliance Analyst Principal - Remote

    Prime Therapeutics (Carson City, NV)
    …regulatory change process + Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as ... Benefit Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be… more
    Prime Therapeutics (10/06/25)
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