• CGI (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
    Upward (07/03/25)
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  • Innova solutions (Red Bank, NJ)
    Innova Solutions is immediately hiring a Lead Business Analyst Position type: Permanent Duration: Fulltime Location: New Jersey, US As a Lead Business ... used in healthcare claims across payers and lines of business (commercial, Medicare , Medicaid). Identify root causes...must have skills: 5+ years of experience as a Business Analyst or Product Owner in healthcare… more
    Upward (07/06/25)
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  • State of Washington (Olympia, WA)
    …payment system . Lean Principles. Proficient in Internal LCB Programs: Enterprise Content Management System (ECMS); iSeries. Proficient in OFM Programs: ... least 1 day per week.This may change based on business needs. Who we are The mission of the...opportunity for a Tax and Fee Accounting Supervisor (Fiscal Analyst 5) position in Olympia, WA . This position… more
    Upward (07/26/25)
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  • eSimplicity (Columbia, MD)
    …the development and analyst to ensure implementation of the needed business , functional, and system requirements Provide regular and open communication ... system life cycle. Serve as liaison between Program Management and other functional groups to resolve issues regarding...an agile environment Strong experience with the Centers for Medicare and Medicaid Services ( CMS ) and/or Medicaid… more
    Upward (07/12/25)
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  • Medicare Advantage Risk Adjustment…

    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
    UCLA Health (06/11/25)
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  • DSNP Business Analyst

    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
    NTT DATA North America (07/18/25)
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  • Provider Engagement Analyst , VBP…

    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
    Centene Corporation (07/23/25)
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  • Regulatory Analyst , Medicare

    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
    Healthfirst (06/27/25)
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  • Operational Regulatory Oversight Analyst

    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
    Molina Healthcare (07/19/25)
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  • Lead Business Analyst

    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
    CGI Technologies and Solutions, Inc. (05/31/25)
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  • Medicare /Medicaid Claims Editing…

    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
    Commonwealth Care Alliance (05/28/25)
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  • Coding Specialist - Medicare

    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
    BlueCross BlueShield of North Carolina (07/23/25)
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  • Business Analyst

    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
    UCLA Health (05/08/25)
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  • Hybrid Supply Chain Risk Management

    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
    Huntington Ingalls Industries (06/26/25)
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  • Data Analyst (flex-hybrid)

    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
    UCLA Health (05/03/25)
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  • Government Pricing Analyst I

    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
    Takeda Pharmaceuticals (05/17/25)
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  • Sr. Accounting and Reporting Analyst - FT…

    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
    Houston Methodist (06/24/25)
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  • Senior Reimbursement Analyst - Cost…

    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
    BayCare Health System (05/10/25)
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  • Clinical Data Analyst III (HEDIS, Tableau,…

    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
    LA Care Health Plan (07/06/25)
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  • Senior Analyst , Healthcare Analytics (Risk…

    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
    Molina Healthcare (07/17/25)
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