- Humana (St. Paul, MN)
- …the largest health benefits organizations in the country. Role Overview The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This ... experience to manage and deliver some of Medicare and Medicaid 's highest priority projects. As a Principal, you will...Bachelor's degree + 2-3 years or more of full-time strategy consulting experience with a leading management … more
- Humana (St. Paul, MN)
- …provides data-driven strategic guidance to deliver a consistent and best-in-class Provider Engagement function. The Strategy Advancement Advisor enhances ... **Become a part of our caring community and help us put health first** The Strategy Advancement Advisor plays a crucial leadership role that… more
- Humana (St. Paul, MN)
- …caring community and help us put health first** Come join our IT Strategy team! We design and activate strategies to address healthcare opportunities and challenges ... and members. Our team operates at the evolving and mission-driven intersection of strategy , technology, and healthcare. This role offers you the chance to help lead… more
- Humana (St. Paul, MN)
- …will join the Experience Transformation Voice & Conversational Product Team and will provide technical, program and project management support to help manage the ... variable factors. This role will be responsible for providing business/ strategy alignment, initiative prioritization, operational readiness, project management ,… more
- Humana (St. Paul, MN)
- …of our caring community and help us put health first** The Strategy Advancement Advisor provides business intelligence and strategic planning support for business ... or the company at large. The Financial Planning and Analysis, Strategy Advancement requires an in-depth understanding of how organization capabilities interrelate… more
- Humana (St. Paul, MN)
- …analyze public policy, develop positions, and draft deliverables supporting Humana business strategy . + Monitor and analyze state Medicaid trends. Contribute ... will serve as an expert in state public payer, Medicaid and dual eligible public policy while working with...and analyses to support enterprise positions and priorities. + Provide regulatory guidance, general issue management and… more
- Humana (St. Paul, MN)
- …community and help us put health first** The Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation ... of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to… more
- Humana (St. Paul, MN)
- …Cost Benefit Analysis on new vendor partners in partnership with product teams. + Provide input into the broader interoperability strategy . + Lead and develop a ... us put health first** At Humana, we are leading the industry in payer-to- provider interoperability and driving better outcomes for our providers and members. In this… more
- Elevance Health (Mendota Heights, MN)
- …+ New Jersey, Morristown **Description** Job Description **Senior Investigator - Virginia Medicaid ** **Schedule:** 1-2 days per week in the office (Hybrid 1) ... claims. Candidate will need a strong knowledge of Virginia Medicaid . **How you will make an impact:** + Claim...and/or state. + May interface internally with Senior level management and legal department throughout investigative process. + May… more
- Elevance Health (Mendota Heights, MN)
- …appropriate databases or other document management systems. + Handles Provider Contracting for Medicaid markets. **Minimum Requirements:** Requires Paralegal ... leading support staff and providing legal support services for multiple Medicaid states, enterprise-wide functions, and/or the most complex litigation through highly… more
- Pearson (St. Paul, MN)
- …curriculum offerings. Our schools, Connections Academy and Pearson Online Academy, provide a best-in-class online learning environment for K-12 students to acquire ... service. This position will work with Pearson Virtual School management and educational leaders within the various states online...role includes direct supervision of a team of OT provider **s** , including when necessary direct clinical services… more
- Humana (St. Paul, MN)
- …innovation of data products to present, transform, and distribute Medicare and Medicaid product data to better serve our associates, members, and enterprise ... to best serve seniors and low-income individuals through our Medicare and Medicaid businesses. The Senior Product Owner, Digital Benefits Experience, will contribute… more
- Humana (St. Paul, MN)
- …and ensures that all vendor-related activities align with the company's business strategy and objectives. The Vendor Management Lead's responsibilities include ... of vendor technical issues, business process compliance, inventory prioritization, change management , and provide transparency for business continuity. + Execute… more
- Humana (St. Paul, MN)
- …primary function of the role is to develop organized analytics, reports and data management to support Quality Improvement within the Medicaid product line. + ... resources. + The Senior Data and Reporting Professional influences Quality Improvement strategy . + May create specifications for reports necessary for the quality … more
- Humana (St. Paul, MN)
- …for our members. The Lead Product Manager sits in the center of strategy , design, engineering, technology, clinical, and operations and is responsible for owning the ... clinical solutions for our members and providers, with full accountability from strategy to execution. **Job Description** The Lead Product Manager partners across… more
- Humana (St. Paul, MN)
- …clinical solutions for our members and providers, with full accountability from strategy to execution. **Location:** remote The Lead Product Manager partners across ... The Lead Product Manager sits in the center of strategy , design, engineering, technology, clinical, and operations and is...multiple clinical programs and products + Utilize product management processes and tools such as: user research and… more
- Elevance Health (Mendota Heights, MN)
- …distribution to providers and legal counsel. + Creates and presents settlement offers for provider issues for review and approval by management and/or legal. + ... case reviews for quality assurance, investigative sufficiency, and case data management ; and direction of day-to-day operations as assigned by management… more
- Elevance Health (Mendota Heights, MN)
- …plan or a UM/benefits management firm. -Proven experience leading change management initiatives -Experience with Commercial, Medicaid , and Medicare lines of ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Humana (St. Paul, MN)
- …network capacity and development plan projections. Begins to influence department's strategy . Makes decisions on moderately complex to more complex issues regarding ... network capacity and development plan projections. Begins to influence department's strategy . Makes decisions on moderately complex to more complex issues regarding… more
- Bausch + Lomb (Minneapolis, MN)
- …assistance and reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant ... and Medicaid structure, systems, and reimbursement process. + Project management skills. + Ability to work independently, manage travel schedules, schedule… more