- Humana (St. Paul, MN)
- …our organization's standing within the Medicaid markets. **Complex Ad-Hoc Requests:** The Data and Reporting Professional 2 will address complex ad-hoc ... caring community and help us put health first** The Medicaid Data and Reporting Analyst...operating objectives, including their linkages to related areas. The Data and Reporting Professional 2… more
- Humana (St. Paul, MN)
- …a part of our caring community and help us put health first** The Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the ... and regulatory standards. Assignments are varied and often require interpretation of Medicaid -specific policies and data . The role demands independent judgment… more
- Humana (St. Paul, MN)
- …of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results.… more
- Humana (St. Paul, MN)
- …and Medicaid program requirements to drive accurate and timely submissions. The Senior Data and Reporting Professional integrates data from multiple ... operations across multiple states. This role ensures compliance with state-specific Medicaid reporting implementations and requirements, will collaborate with… more
- Humana (St. Paul, MN)
- …contracting requirements and data integrity as required in the Ohio Medicaid Provider Agreement and internal reporting compliance. This role will support ... contracting governance, process development, and data governance Ohio Medicaid , including developing contracting requirements, internal reporting compliance… more
- Humana (St. Paul, MN)
- … requires an in-depth evaluation of variable factors. The Senior Workforce Management Professional plays a pivotal role in supporting Medicaid Inpatient and ... community and help us put health first** The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and … more
- Humana (St. Paul, MN)
- …model designs including analyzing provider performance, reporting , and scorecard/reconciliation reporting . + Understanding of Medicaid and/or Medicaid ... first** Humana Healthy Horizons is seeking a Senior Value-Based Programs professional who will support successful value-based provider relationships with a focus… more
- Humana (St. Paul, MN)
- …our caring community and help us put health first** The Senior Agency Management Professional provides support for handling and analyzing data that pertains to ... determination of the appropriate courses of action. The Senior Agency Management Professional provides support for handling and analyzing data that pertains… more
- Humana (St. Paul, MN)
- …caring community and help us put health first** The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics and ... reporting to develop strategic and operational insights for workforce...management, diversity and human resource compliance). The Workforce Management Professional 2 work assignments are varied and frequently require… more
- CVS Health (St. Paul, MN)
- …abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data visualization tools (eg, Tableau, Power BI ... a full time role and is ideal for a data professional with strong coding skills in...to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting . This is… more
- Humana (St. Paul, MN)
- …to drive sales program effectiveness and to ensure cost efficiencies. Provide data driven expertise and management reporting to improve sales performance ... help us put health first** The Senior Enterprise Transformation Professional manages all aspects of a large-scale program, from...to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. **The… more
- Humana (St. Paul, MN)
- …and help us put health first** The IHWA Follow-up Senior Program Delivery Professional provides daily operational support to programs that impact members' lives by ... promoting preventive health activities. The IHWA Follow-up Senior Program Delivery Professional works on problems of diverse scope and complexity ranging from… more
- State of Minnesota (St. Paul, MN)
- …Medicaid program -Third party liability and benefit recovery principles -Minnesota Medicaid Information System (MMIS)and the Data Warehouse -Minnesota ... + **Bargaining Unit/Union** : 214 - MN Assoc of Professional Empl/MAPE + **FLSA Status** : Nonexempt + Designated... claims processing and coding systems -Analytic tools and data mining to identify Medicaid misbilling, overpayments,… more
- State of Minnesota (St. Paul, MN)
- … Medicaid program -Third party liability and benefit recovery principles -Minnesota Medicaid Information System (MMIS) and the Data Warehouse -Minnesota ... Status** : Classified + **Bargaining Unit/Union** : 214 - MN Assoc of Professional Empl/MAPE + **FLSA Status** : Exempt - Administrative + Designated in Connect… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for all enterprise quality performance programs across the organization's Medicare, Medicaid , ACA, and Commercial lines of business. This position leads the ... by regulation or contract. They ensure that quality initiatives are data -driven, well-governed, and effectively executed, enabling the organization to achieve… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and ... impacts using the risk adjustment and quality analytics models across ACA Commercial, Medicare, and Medicaid . * Develop, lead, and provide strategic direction for… more
- Humana (St. Paul, MN)
- …ranging from moderate to substantial. The Actuary, Analytics/Forecasting supports centralized reporting of external data sharing, oversees internal reporting ... The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …translated landing pages for various emails * Connect simple Cloudpage forms to Marketing Cloud data extensions Reporting * Work with data team and within ... abreast of changes in regulations in the rapidly evolving Medicare and Medicaid health insurance marketplace * Assist with materials-related process improvements and… more
- Humana (St. Paul, MN)
- …Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and ... operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and… more
- Humana (St. Paul, MN)
- …The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and ... operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and… more