- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Extensive understanding of healthcare industry standards, workflows, policies, procedures, and system environments. + Strong metadata management skills with the… more
- NTT DATA North America (Merced, CA)
- …Overview:** We are seeking a detail-oriented and experienced DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing. The ... overall sourcing strategy NTT DATA currently seeks a DSNP Business Analyst to join our team in...**Required Qualifications:** + 5+ years pf proven experience with Medicare claims, including a deep understanding of CMS… 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
- Healthfirst (NY)
- …review, interpretation, and dissemination of non-complex regulations such as the Health Plan Management System (HPMS) and NY State Department of Health (DOH) ... supervision. + Intermediate knowledge of Microsoft Office Suite applications. + Knowledge of Medicare and CMS guidelines as it relates to member materials. +… more
- Molina Healthcare (Boise, ID)
- …and/or detects violation of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the Business ... to the Health Care environment. **Knowledge/Skills/Abilities** The Operational/Regulatory Oversight Analyst works with health plans and operations departments to… 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
- 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
- BlueCross BlueShield of North Carolina (NC)
- …practices with complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services ( CMS ). **What You'll Do** + Analyzes necessary ... coding and reports relevant data to the Centers for Medicare and Medicaid Services ( CMS ). + Uses...Documentation, Medical Insurance Coding, Medical Record Analysis, Medical Records Management , Medicare , Medicare Plans, Payment… 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
- Huntington Ingalls Industries (Woodlawn, MD)
- …Who We Are HII - Mission Technologies is seeking a Supply Chain Risk Management (SCRM) Intelligence Analyst for a hybrid of telework and work at ... in Baltimore (Woodlawn) MD. As a Supply Chain Risk Management Intelligence Analyst , you will play a...play a vital role in supporting our Centers for Medicare and Medicaid ( CMS ) and Health and… 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
- 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
- Houston Methodist (Houston, TX)
- …with government regulations (ie Centers for Medicare and Medicaid ( CMS ), Internal Revenue Service (IRS), Federal Emergency Management Agency (FEMA), ... ensures timely payment of taxes due. Interfaces across the organization with various system departments as well as government and business partner auditors.… more
- BayCare Health System (Clearwater, FL)
- …remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Senior Reimbursement Analyst - Cost Reporting **Location** Clearwater | Business and ... responsibility and clinical excellence. **Responsibilities:** + The Senior Reimbursement Analyst will work independently within their area of responsibility while… more
- LA Care Health Plan (Los Angeles, CA)
- …those used by National Committee for Quality Assurance (NCQA), HEDIS, Centers for Medicare and Medicaid Services ( CMS ), and State. Must demonstrate advanced SQL ... are highly preferred. Licenses/Certifications Required Licenses/Certifications Preferred Statistical Analysis System (SAS) Certification Certified Healthcare Data Analyst … more
- Molina Healthcare (Roswell, NM)
- … needs. Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...in running all applicable risk models including the various CMS models for Medicare Advantage members, the… more
- UCLA Health (Los Angeles, CA)
- …a world-class health organization. Elevate the operational effectiveness of a complex health system . Take your professional expertise to the next level. You can do ... at UCLA Health. As a key member of our Medicare Advantage Operations team, you will develop detailed requirements...you will develop detailed requirements specifications to meet our business needs. This will involve working directly with and… more
- Mount Sinai Health System (New York, NY)
- …as IDX, Soarian, etc. + Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, ... **Job Description** The Data Science Analyst III is a senior role, collaborating with...develop sophisticated analytics to provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning,… more
- Mount Sinai Health System (New York, NY)
- …as IDX, Soarian, etc. + Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, ... **Job Description** The Data Science Analyst II collaborates with stakeholders from across the...develop sophisticated analytics to provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning,… more
- University of Miami (Miami, FL)
- …you will: + Build and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality Payment Program ... tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami Health System , "UHealth", IT Department has an exciting opportunity for… more