- Humana (Washington, DC)
- …in the administration of Medicaid business at Humana. The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid ... Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral...+ Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance … more
- Serco (Washington, DC)
- …processing systems (including MMIS), payment policy, payment systems, coding, billing, and compliance rules in Medicaid and CHIP. + Extensive knowledge and ... processing systems (including MMIS), payment policy, payment systems, coding, billing, and compliance rules in Medicaid and CHIP; + Extensive experience in… more
- Serco (Washington, DC)
- …policies, business process; operations and contract deliverables, for estimating Medicaid and CHIP eligibility error rate and improper payments. + Oversee ... of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as… more
- Serco (Washington, DC)
- …and third- party liability; + Knowledge of payment systems and coding, billing and compliance rules; and + Knowledge of the Medicaid and/or CHIP program, ... of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as… more
- Serco (Washington, DC)
- …program management experience; + Knowledge of payment systems and coding, billing and compliance rules; + Knowledge of the Medicaid and/or CHIP program, ... claims processing systems and processes.The position advises on the business and operational processes to ensure the full optimal...Knowledge of state payment systems and coding, billing and compliance rules, preferably on Medicaid and/or CHIP… more
- General Dynamics Information Technology (Fairfax, VA)
- …Medicare and Medicaid Services (CMS) anti-fraud activities. As a Business Intelligence Manager supporting the Healthcare Fraud Prevention Partnership (HFPP), ... and to ensure compliance with applicable access standards. + The Business Intelligence Manager will document processes, best practices, and strategies for… more
- Humana (Washington, DC)
- …implement regulatory compliance policies and procedures + Research regulatory compliance issues and make business recommendations that assure compliance ... needed + Provide compliance guidance, direction, and compliance risk assessment to assigned business partners...on process and quality + High level of emotional intelligence + Ability to work independently and utilize excellent… more
- HealthEdge Software Inc (Washington, DC)
- …upstream, and all aspects of claims operations are centralized for comprehensive business intelligence . The complete suite of solutions fromHealthEdgedelivers a ... **Overview** **Overview:** The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting… more
- Serco (Washington, DC)
- …+ Oversee performance of the eligibility, medical and claims reviews for estimating Medicaid and CHIP improper payments - including business processes, staffing, ... of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as… more
- Serco (Washington, DC)
- …of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as ... medical reviews, data processing reviews, and eligibility reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting… more
- The MITRE Corporation (Mclean, VA)
- …projects as a Project Lead or Department Manager + Understanding of MITRE's Business Intelligence and Operations Systems including Salesforce, Clarity, CLM, P2P, ... Healthcare (Health FFRDC), the FFRDC sponsored by the Centers for Medicare and Medicaid Services (CMS) and the broader Department of Health and Human Services (HHS).… more
- Serco (Washington, DC)
- …of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as ... eligibility reviews, medical reviews, and data processing reviews, of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting… more
- Serco (Washington, DC)
- …policies, business process; operations and contract deliverables, for estimating Medicaid and CHIP eligibility error rate and improper payments. + Oversee ... of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as… more
- Mathematica (Washington, DC)
- …and privacy in cloud and on-prem environments. This role works across technology, business unit and project teams, with support from the IT Security, Risk and ... Compliance function, in the deployment of a data governance...bias * Exposure to analytics, machine learning and artificial intelligence * Expertise in writing, presenting, discussing and socializing… more
- General Dynamics Information Technology (Fairfax, VA)
- …joining our MATS team remotely to support the Centers for Medicare & Medicaid Services (CMS) activities. At GDIT, people are our differentiator. GDIT supports the ... You will analyze security solutions and test to ensure compliance with security standards. * **Note** : Work visa...+ Healthcare Service Industry or Center for Medicare and Medicaid Services (CMS) experience + Experience working with JIRA… more
- HealthEdge Software Inc (Washington, DC)
- …upstream, and all aspects of claims operations are centralized for comprehensive business intelligence . The complete suite of solutions fromHealthEdgedelivers a ... and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for… more