- Stony Brook University (Stony Brook, NY)
- …staff schedules, review of attendance logs, etc. Leads the staff in a professional manner and assures staff compliance with all relevant laboratory and hospital ... send-out test meets NYS DOH mandates; coordinate specimen shipment; result reporting ; manual billing; and review billing invoices for compliance. Specifics include:… more
- National Health Care Associates (Ridgefield, CT)
- …must be experienced in skilled nursing business office management including: + Medicaid , Medicare and Managed Care Billing + Revenue Cycle Management in the ... collections, write offs, refunds and deposits + Month End Processing and Reporting + Management of patient/resident trust funds and confidential files in compliance… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- …are effective in mitigating risk. This position will be responsible for providing Medicaid regulatory and reporting guidance to internal stakeholders and will ... and business stakeholders, this role will be accountable for EviCore's Medicaid Compliance program and processes, applicable state and federal regulations, and… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Senior Data & Reporting Professional tests the overall network in each county of ... requires an in-depth evaluation of variable factors. The Senior Data & Reporting Professional begins...Adequacy requirements and process optimization, primarily focusing on the Medicaid line of business, with a deep understanding of… more
- Humana (Hartford, CT)
- …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
- Nuvance Health (Norwalk, CT)
- …through identification and analysis of both organization-wide and service line specific data , utilizing appropriate data reporting tools and technology. ... database reports, report writers such as Tableau and Crystal, and other contemporary data reporting tools and technology. * Expertise in MS Excel, PowerPoint,… more
- Humana (Hartford, CT)
- … 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 (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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
- Humana (Hartford, CT)
- …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
- Nuvance Health (Danbury, CT)
- …community providers that serve in WCHN clinics. 3. Development of standardized reporting , data collection and verification. Updates all credentialing dashboards ... compliance with all third party payers including Commercial, Medicare and Medicaid programs. Credentials and re-credentials all WCHN physicians and allied… more
- Wheeler Clinic (Hartford, CT)
- …position provides timely and accurate completion of all DOC or CSSD-related correspondence, reporting and data entry as required by program, and may maintain ... data in CDCS as required. The Client Care Coordinator...system, adhering to contract guidelines. If program specified, tracks Medicaid application process via CSSD Reporting system… more
- Boehringer Ingelheim (Ridgefield, CT)
- …(CARS / Data warehouse / Applications), ensure accuracy and completeness of data in the various systems for reporting , ensure compliance with State and ... / Data warehouse / Applications); + Ensuring accuracy and completeness of data in the various systems for reporting ; assessing administrative feasibility of… more
- WellLife Network (Manorville, NY)
- …ensure accuracy and compliance.8. Manages program budgets, expenditures, and fiscal reporting in coordination with the Division Director and fiscal department.9. ... participates in SPOA Out-of-Home meetings; provides biweekly status updates and reporting .24. Reviews all referrals and determines eligibility for admission in… more
- Humana (Hartford, CT)
- …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
