- Humana (Boston, MA)
- …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 (Boston, MA)
- …etc. Partner with actuarial, financial, and clinical teams to align on data definitions, methodologies, and reporting . Identify cost drivers, utilization ... patterns, and anomalies in Medicaid medical claims data . Maintain dashboards to...degree, recent and relevant work experience, and/or other relevant professional designations. + MAAA + Strong communication skills +… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid billing-related certifications **Required ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports...& Abilities (must have):** + Proficiency with Excel and reporting tools for data analysis. + Understanding… more
- Datavant (Boston, MA)
- …output to enhance productivity and quality, and turn those needs into actionable reporting + Provide real-time data insights to business on-demand through ad-hoc ... Datavant is a data platform company and the world's leader in...problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Senior Agency Professional ; Finance & Accounting supports data analysis related to compliance and ... determine the best course of action. The Senior Agency Professional ; Finance & Accounting provides support for handling and...Finance & Accounting provides support for handling and analyzing data that pertains to the compliance and commissions of… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Supply Chain Budget Professional reports to the Director of Enterprise Print Management (EPM) and plays a key ... Print and Postage operations through effective budget development, management, financial reporting , and cost tracking. This position ensures accuracy and efficiency… more
- Beth Israel Lahey Health (Charlestown, MA)
- …customers to identify and appropriately scope opportunities. Examples include standardizing data to support Medicare, Medicaid and other regulatory filings, ... Demonstrated experience and interest in developing methodologies to standardize and optimize data tools and reporting requirements to achieve effective and… more
- Humana (Boston, MA)
- …and overall market sales support. The ideal candidate will be able to summarize reporting data and present ideas and results. If you are detail oriented ... and help us put health first** The Sales Support Professional 1 will provide sales support to the Large...high level of accountability + Synthesizing and analyzing financial data (ex. budgets and income statement forecasts) with consideration… more
- Commonwealth Care Alliance (Boston, MA)
- 011260 CCA-Revenue Cycle Management **Position Summary:** Reporting to the Director of Encounter Data Management within the Revenue Cycle Department, the Risk ... data processing workflows related to CMS Encounter Data Processing System (EDPS) and Massachusetts Medicaid ...revenue projections and CMS methodologies. + Maintain and enhance reporting infrastructure to track data quality, submission… more
- ManpowerGroup (Quincy, MA)
- …and Unix/Linux operating environments. + Strong domain expertise in healthcare and Medicaid /MMIS with a focus on interface design, data structures, and ... operations and technical requirements of the MMIS system, supporting ongoing ** data research and analysis efforts** . Key responsibilities include planning,… more
- Takeda Pharmaceuticals (Boston, MA)
- …but not limited to; Pricing, Pricing Compliance, Government Price Reporting , Planning, Contract Administration, Rebates, Group Purchasing Organization, Contract ... + Lead development and/or refresh business rules and playbooks thatinclude appropriate reporting and compliance + Chair the Pricing Committee (comprised of senior… more
- Elevance Health (Woburn, MA)
- …requirements from internal and external requestors to ensure that the team is meeting reporting needs and facilitates seamless data transfer. + Develops ad hoc ... studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of business. **How You... and Medicare Advantage risk adjustment initiatives. + Performs data mining and data -driven analyses to evaluate… more
- Commonwealth Care Alliance (Boston, MA)
- …needed translation activities. The Program Coordinator will assist with engagement activities, data analysis, and the creation of actionable reporting . Core ... BA/BS in a related field with strong emphasis in data analysis and reporting . * or equivalent...of health plan operations, health care quality measures, and Medicare/ Medicaid programs * Bilingual - Spanish EEO is The… more
- State of Massachusetts (Boston, MA)
- … professional or technical experience in work involving research, data analysis, compliance, records management or program administration, or (B) any ... Managers and coordination of Mental Health Parity research and reporting , The Research Analyst will also assist with the...on pharmaceutical benefits in market health plans; to analyze data and information needed for the oversight of affordable… more
- Commonwealth Care Alliance (Boston, MA)
- …* Maintain up-to-date knowledge of and compliance with CMS, NCQA and state Medicaid requirements. * Lead preparation for internal and external audits (eg CMS Program ... procedures as well as regulatory and contractual requirements and other regulatory reporting needs are met. * Tracks and monitors team's performance against targets;… more
- Vitra Health (Boston, MA)
- …recommending actions. + Provide status of financial conditions by collecting, interpreting, and reporting financial data . + Comply with federal, state, and local ... join our team. If you're a passionate, caring, motivated professional who is looking to make a difference in...and budgets and overseeing the preparation of all financial reporting . + Assist in negotiation of contract terms with… more
- Beth Israel Lahey Health (Woburn, MA)
- …and implementation skills, a strategic approach, and a good working knowledge of data reporting and analysis skills. + Knowledge of commercial behavioral ... transformational business goals and metrics, manage the analysis of population health data , and lead data driven performance management. + Oversee program… more
- State of Massachusetts (Chelsea, MA)
- …and previous experience with statistical methods relevant to the collection, analysis, and reporting of data . * Knowledge of age-specific considerations in the ... ADT and hospice care related processes and services, collect and analyzes related data , and assist with direct Veteran care when needed. The Massachusetts Veterans… more
- Cardinal Health (Boston, MA)
- …leaders and employees and proactively provides guidance and trainings on policies. Reporting to the Director, Ethics & Compliance, this position supervises and ... manages audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA's contractual obligations with our partner organization(s). * Performance tracking, reporting and outcomes of the Care Delivery programs Key Performance ... Operations to ensure operational success of the program * Gathers and synthesizes data to facilitate operational efficacy and change as needed. * Regularly providing… more