- ERP International (Laurel, MD)
- …programs. + Assess and validate how new or updated regulatory requirements affect CMS business processes, IT systems, organizational roles, data standards, and ... CMS processes and systems. + **Stakeholder Engagement:** + Work closely with CMS business owners, EA team members, compliance offices, policy experts, and… more
- Centene Corporation (Providence, RI)
- …cost and quality trends, supporting provider engagement efforts, and ensuring alignment with CMS -aligned risk-based models. The Analyst will play a key role in ... the organization drive population health improvements and financial sustainability through Medicare VBP strategies. + Partner with Contract management and… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- …and Medicaid Services ( CMS ) Next Generation Desktop platform initiative. The Business Analyst Lead is responsible for gathering, managing, and prioritizing ... **Lead Business Analyst ** **Category:** Business ...integrations and NGD CRM development work. The Centers for Medicare & Medicaid Services ( CMS ) provides healthcare… more
- Methodist Health System (Dallas, TX)
- …:** 5 days **Work Shift :** **Job Description :** Your Job: The SR REIMBURSEMENT( MEDICARE ) ANALYST will assist the Manager of Regulatory Compliance, the Manager ... the preparation and review of the financial documentation required for the annual CMS 2552-10 Medicare /Medicaid cost reports for MDMC, MCMC, MMMC, MRMC, SLMC… more
- Commonwealth Care Alliance (Boston, MA)
- …option based on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into CES (Claims Editing ... Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr....standard coding logic and policies (ie . Center for Medicare & Medicaid Services ( CMS ) & MA… more
- Advanced Systems Design (Montgomery, AL)
- …experience as a Senior Business Analyst with 3 years working on business process modelling and management . + 3 years of experience supporting provider ... is preparing for a major transition from a monolithic system with 14 different business functions to... Analyst with 3 years working on business process modelling and management . + 3… more
- CVS Health (Austin, TX)
- …1 + years of business experience in client-facing relations or account management + Prior Medicare Part-D, Employer Health Group related experience + Strong ... Part-D plans and perform in accordance with Center for Medicare & Medicaid Services ( CMS ) guidelines. Our...CMS ) guidelines. Our Sr. Analysts serve as the business expert for our clients in order to drive… more
- UCLA Health (Los Angeles, CA)
- Description The Business Data Analyst plays a key...encounters required + Minimum of five years' experience with CMS processes in a Medicare or Managed ... teams, and external partners. This role is responsible for gathering and documenting business and system requirements, analyzing and interpreting data to support… more
- Trinity Health (Columbus, OH)
- …plan in accordance with Federal regulatory requirements and the Centers for Medicare and Medicaid Services ( CMS ). Responsible for ensuring the eligibility, ... **Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other … more
- Providence (Renton, WA)
- …provide training, job aides and technical support for caregivers regarding Centers for Medicare and Medicaid Services ( CMS ) Medicare Secondary Payer ... Cyber, Managed Care, and Auto Claims. The Senior Quality Analyst assists the Claims leaders in managing a quality...experience reporting third party liability settlements to Centers for Medicare and Medicaid Services ( CMS ), and federal… more
- Trinity Health (Columbus, OH)
- …Shift **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare ... audit, provider relations and more. **Position Purpose:** Pharmacy/Clinical Service Data Analyst is responsible for data collection, data verification and data… more
- Trinity Health (Columbus, OH)
- …A thorough understanding of NCQA and HEDIS is required. Knowledge of Medicare Stars-including CAHPS, HOS, Part D, and operational measures-is strongly preferred. ... **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, Business Data Analyst is instrumental in independently developing the detailed ... non-functional requirements are understood and implemented consistent with the Business Data Analyst 's vision + perform testing,...required + Minimum of five (5) years' experience with CMS processes in a Medicare or Managed… more
- LA Care Health Plan (Los Angeles, CA)
- … CMS Audits of LA Care deficient delegates. Participates in Centers for Medicare and Medicaid Services ( CMS ) claim audit section of LA Care delegates. ... Senior Health Care Audit Analyst Job Category: Accounting/Finance Department: Financial Compliance Location:...The position is the liaison in external and or ( CMS ) claim audits Organization Determination, Appeals & Grievances (ODAG)… more
- Takeda Pharmaceuticals (Exton, PA)
- …Ensure submission of pricing information within the statutory time frames - Centers for Medicare & Medicaid Services ( CMS ), state agencies as required by statute ... job opportunity: **JOB LOCATION:** Exton, PA **POSITION** : Government Pricing Analyst I **POSITION DESCRIPTION** : Takeda Pharmaceuticals America, Inc. is seeking… more
- DCCA (Ellicott City, MD)
- …in conjunction with the CMS Product Owners . Work directly with CMS Business Owner to elicit, analyze, and document requirements, ensuring clear ... Product Owner Analyst Location Ellicott City, MD Job Code 2447...Agile Framework (SAFe). . 5+ Years of experience supporting CMS Medicare or Medicaid Programs . Strong… more
- The Cigna Group (St. Louis, MO)
- Product Management Lead Analyst - Centene Operations Management We value our talented employees, and whenever possible strive to help one of our associates ... execution of key operations accountabilities associated with all regulated lines of business including Medicare , Medicaid, and Marketplace (Exchange / Health… more
- CareOregon (Portland, OR)
- …hoc reports aligned with risk adjustment initiatives and strategies for both the Medicare and Medicaid lines of business . This position provides recommendations ... Nevada, Texas, Montana, or Wisconsin. Job Title Risk Adjustment Analyst Department Finance Exemption Status Exempt Requisition # 24959...scores and risk score related reporting for both the Medicare and Medicaid lines of business by… more
- Houston Methodist (Houston, TX)
- …government regulations (ie Centers for Medicare and Medicaid Services ( CMS ), Internal Revenue Service (IRS), Federal Emergency Management Agency (FEMA), ... of taxes due. Interfaces across the organization with various system departments as well as government and business...FUNCTIONS** + Seeks out opportunities to grow knowledge of Medicare reimbursement, tax regulations and the budget system… more
- Bloom Healthcare (Lakewood, CO)
- …health, value-based care and ACO, as well as a strong analytical and project management skills. Value Based Care Data Analyst Key Responsibilities + Review, ... Job Title: Data Analyst , Value Based Care Location: Denver, Colorado; Hybrid...and Bloom Healthcare has generated outstanding quality results in CMS Innovation Center models compared to our peers. At… more