- Molina Healthcare (Madison, WI)
- …supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Compliance Analyst position is primarily responsible for Medicare Oversight. + ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It… more
- Prime Therapeutics (Madison, WI)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance ... execution of the Regulatory Intelligence communication strategy. This position acts as Compliance and regulatory liaison for all lines of business with internal… more
- Prime Therapeutics (Madison, WI)
- …fuels our passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** ... The Compliance Principal is responsible for supporting Oversight and Monitoring...or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Highmark Health (Madison, WI)
- …:** **JOB SUMMARY** This job partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or ... trends, and/or contract changes. **ESSENTIAL RESPONSIBILITIES** + Manage and coordinate compliance related processes. + Monitor governance and compliance of… more
- Humana (Madison, WI)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require… more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** This Actuarial Analyst 2 position is a part of the HealthCare Economics team focused on evaluating ... stakeholders and providing valuable input to the business. The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data… more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Actuarial Analyst 1 provides actuarial support across a broad range of actuarial and business needs ... for specific product lines. The Actuarial Analyst 1, General work assignments are often straightforward and of moderate complexity. The Actuarial Analyst 1 may… more
- Prime Therapeutics (Madison, WI)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is ... processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid, and Health Insurance Marketplace for the assigned department.… more
- Public Consulting Group (Madison, WI)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... support through review and updating reference data, contractual metrics, and compliance metrics. Ensures accurate RMC support through internal claim errors and… more
- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and ... existing lines of business and expansion into new states. The Lead Analyst , Reimbursement will be primarily responsible for implementation, maintenance, and support… more
- Humana (Madison, WI)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and developing solutions +… more
- Molina Healthcare (Madison, WI)
- **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... requirements into overall functional architecture for complex s/w solutions in compliance with industry regulations. *Provides subject matter expertise and reviews… more
- Molina Healthcare (Madison, WI)
- …internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures ... external auditors for all formal Core Operations audits that are not compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research,… more
- Molina Healthcare (Madison, WI)
- …+ Engages with operations leadership and Plan Support functions to review compliance -based issues for benefit planning purposes. **Recoveries & Disputes** + Review ... + Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). +… more