- Humana (Boston, MA)
- …This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize, ... growth partners to design and optimize clinical operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy ... to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a...with the following attributes: * Creative - Adept at research to determine the opportunity and a structured yet… more
- Harvard University (Cambridge, MA)
- Details Title Research Associate /Data Analyst School Harvard School of Dental Medicine Department/Area Oral Health Policy and Epidemiology Position Description ... We are seeking a research Data Analyst in the Department of Oral Health...projects + Previous experience with health care claims (Medicare, Medicaid , and private insurance plans) strongly preferred + Ability… more
- Harvard University (Cambridge, MA)
- Details Title Research Associate /Data Analyst School Harvard School of Dental Medicine Department/Area Oral Health Policy and Epidemiology Position Description ... We seek a Research Data Analyst in the Department of Oral Health...including electronic health records, administrative claims (such as Medicare, Medicaid , and private insurance plans), and national survey data,… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Associate Actuary role is a role within the Insurance Products Actuarial Medicare Advantage ... ad hoc projects and analysis to help enhance Part D accuracy. The Associate Actuary, Pricing work assignments involve moderately complex to complex issues where the… more
- Daiichi Sankyo Inc. (Boston, MA)
- …primarily focused on providing novel therapies in oncology, as well as other research areas centered around rare diseases and immune disorders. **Summary:** The ... Associate Director Field Reimbursement (ADFR) is a critical front-line...utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes and… more
- Humana (Boston, MA)
- …our goals, we seek talent with the following attributes: Creative - Adept at research to determine the opportunity and a structured yet flexible approach to problem ... to maximize available resources to achieve growth. + Leads National Medicaid Strategic Priorities, effectively develops LTSS-based strategic goals and turns them… more
- Humana (Boston, MA)
- …**Location:** remote The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises the majority ... prior management consulting experience to support delivering some of Medicare and Medicaid 's highest priority projects and initiatives, with an emphasis on Medicare… more
- Humana (Boston, MA)
- …+ Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if there are concerns ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees… more
- Humana (Boston, MA)
- …objectives, audience(s), roadmap, features, design trends and best practices, research , metrics, VOC and other measures, competitive landscape, and full ... Humana digital ecosystem + Partner with the User Research team to create long-term research strategy to facilitate ongoing discovery and iterative delivery +… more
- Elevance Health (Hingham, MA)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Lead** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division within the Department of Health and Human Services).… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …an integrated Medicare marketing strategy through collaboration with Marketing, Market Research , Sales, Operations, and Compliance + Oversee Medicare Market project ... including local Division of Insurance (DOI), and the Centers for Medicare and Medicaid Services (CMS) + Ensure timely submission of fully substantiated rate and… more
- Humana (Boston, MA)
- …providing non-clinical support through clerical and administrative tasks through research , assessment and evaluation of members' needs and requirements to ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boston, MA)
- …management) + 3+ years' experience in demonstrating ability to analyze, research , and implement solutions while continuously pursuing improvements + Ability to ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boston, MA)
- …and feature prioritization to meet project timelines.*Skilled in conducting market research and user feedback analysis to inform product enhancements and strategic ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boston, MA)
- …the best care based on quality ratings, reviews, and outcomes + Conduct user research and usability studies to gather insights and identify pain points in the ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boston, MA)
- …organization + Experience in Medicare or similar regulatory work + Strong legal research , analytical, and writing skills + Ability to work both independently under ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boston, MA)
- …and ensure the management of any delivery risks or issues + Identify and research potential pre and post production issues and assist in resolution and provide ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boston, MA)
- …physician, advanced practitioner, and clinical pay trends and practices. Translate research , trends and best practices into plan design and administration solutions ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more