- Humana (Columbus, OH)
- …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
- Huntington Ingalls Industries (Woodlawn, MD)
- …HI This opportunity resides with Command, Control, Communications, Computers, Cyber, Intelligence , Surveillance and Reconnaissance (C5ISR), a business group ... the sensors, systems and other assets necessary to support integrated intelligence , surveillance and reconnaissance (ISR) operations, exploitation and analysis for… more
- Commonwealth Care Alliance (Boston, MA)
- …and extracts into format usable in analytical database + Works collaboratively with Business Intelligence unit and fellow Compliance team members to ... the FDR program, as well as responsibility for first-level Compliance review in onboarding of new business ...contacts due to needs of the program, Medicare, or Medicaid . + Coordinates, with the Compliance Manager,… more
- Humana (Columbus, OH)
- …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
- DATAMAXIS (IL)
- …requirements for Medicaid + Bachelor's degree or higher degree in business intelligence , analytics, computer science, engineering, or related field + Firm ... (DDI) of the project. Primary Responsibilities: + Analysis of Medicaid enrollment, provider, and claims data, current business...to data analysts for profiling, review results and infer compliance to Medicaid / CMS processes and… more
- HealthEdge Software Inc (Columbus, OH)
- …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
- State of Colorado (Denver, CO)
- …and CORE and reported on the CMS 64 report that is available in the Business Intelligence & Data Management database (BIDM) for the lines and codes that ... Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health… 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
- General Dynamics Information Technology (MD)
- …Waste and Abuse (FWA) analytics, collaborating with FWA Subject Matter Experts and Business Intelligence Developers to develop to develop FWA models and ... of Data Scientists, embedded within a multi-disciplinary organization of Data Scientists, Business Intelligence Analysts and FWA Subject Matter Experts. Our team… 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
- EssilorLuxottica (Mason, OH)
- …and layout, procedural standards and operational efficiency + Partners with the Business Intelligence team when new or modified reports require consultation ... Senior Analyst - Business Data (Reporting Design) Date: Apr 15, 2024...a managed care setting + Experience with Medicare and/or Medicaid programs and reporting + Experience with health provider… more
- The MITRE Corporation (New Windsor, MD)
- …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
- Corewell Health (Dearborn, MI)
- …securing potential funding for services provided; including but not limited to Medicaid , Medicare SSI, and any other federal, state, Corewell Health based, grants, ... and underinsured. Offers alternatives and assists with application process for Medicaid , Health Michigan, Financial Assistance and Market Place exchange plans. Works… 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