- eSimplicity (Columbia, MD)
- …of government healthcare directives. Responsibilities Develops, implements, and maintains quality assurance /configuration management programs in support of a ... Program Management and other functional groups to resolve issues regarding quality assurance /configuration management. Reviews and evaluates software products… more
- State of Minnesota (Vadnais Heights, MN)
- **Working Title: DCT Revenue Cycle Quality Assurance Analyst ** **Job Class: Management Analyst 4** **Agency: Direct Care and Treatment** + **Job ID** : ... join the DCT Finance Team for an exciting and rewarding opportunity as a DCT Revenue Cycle Quality Assurance Analyst ! As the DCT Revenue Cycle Quality … more
- 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 ... both internal and external reporting. You will: + Ensure data quality and accuracy through rigorous assurance checks. + Develop and maintain reports, from ad hoc… more
- Commonwealth Care Alliance (Boston, MA)
- …considered at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance , the Claims Sr. Analyst plays a critical ... and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director...the direction of the Director of Claims Operations and Quality Assurance , this role is responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- …care measures such as those used by National Committee for Quality Assurance (NCQA), HEDIS, Centers for Medicare and Medicaid Services (CMS), and State. ... are used for internal and external reporting, the tasks including data quality assurance , process programming, specification documentation and report developing.… more
- Prime Therapeutics (Eagan, MN)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... and drives every decision we make. **Job Posting Title** Sr. Business Systems Analyst **Job Description** The Sr. Business Systems Analyst (BSA) is responsible… more
- CVS Health (St. Louis Park, MN)
- …senior leaders . Assisting with documentation of work instructions . Participating in quality assurance of member materials . Tracking and submitting seasonal ... it all with heart, each and every day. **Position Summary** The Senior Analyst , Project Management will support the Minnesota Medicare market with coordination… more
- Houston Methodist (Houston, TX)
- …risk and identify and capture potential revenue opportunities. This position performs quality assurance , detailed claims analysis and medical record reviews of ... claims are being billed to patients and third-party payers. Performs quality assurance . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Proactively stays up-to-date… more
- Molina Healthcare (Omaha, NE)
- …+ Creating and executing comprehensive test plans + Ongoing pricer maintenance, quality assurance , and compliance with deployment activities. + Interpret release ... **Job Description** **Job Summary** The Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately.… more
- Zelis (Plano, TX)
- …to determine and document business requirements. + Lead pricer maintenance, quality assurance activities, audits, troubleshooting, and defect corrections. + ... that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory Pricer Product team to further… more
- Convey Health Solutions (Chicago, IL)
- …laws, rules and regulations affecting Pareto. + Responsible for participating in quality assurance , compliance and in-service and continuing education activities ... Job Description SUMMARY The Sr. Data Analyst will be responsible for utilizing technical and...procedures. + Familiarity with healthcare payer/provider claims, clinical, or quality data. + Risk Adjustment experience is preferred. OTHER… more
- Prime Therapeutics (Indianapolis, IN)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... and drives every decision we make. **Job Posting Title** IT Business Systems Analyst - ScriptMed - Remote **Job Description** The IT Business Systems Analyst… more
- Humana (Santa Fe, NM)
- …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- LA Care Health Plan (Los Angeles, CA)
- …Solution Center Business Analyst to track, trend, and analyze results of Quality Assurance (QA) scorecards for training and quality improvement. Perform ... Medicare and Medicaid Services(CMS), LACC - CalHers, and National Committee for Quality Assurance (NCQA) along with review and analysis of regulatory… more
- City and County of San Francisco (San Francisco, CA)
- …experience + Engaging staff and improving their experience + Participating in quality assurance activities Once submitted, applicant responses on the Required ... reapply. The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in… more
- City and County of San Francisco (San Francisco, CA)
- …methods, and procedures within the specialty area; including but not limited to Quality Assurance activities; prepares or reviews detailed and complex medical ... reapply. The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in… more
- City of New York (New York, NY)
- …the operation of the Office of Audit Services (OAS) and Office of Quality Assurance (OQA), Office of Accountability Strategies (OAS), Compliance and Contract ... Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE...and acquire the analytical, data mining, data matching, data quality , and data sharing methods and/or tools that drive… more
- Banner Health (AL)
- …patient treatment information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for ... accurate code assignment. 3. Provides coding quality assurance for medical records. For all...prior to referral to senior manager, educator or Coding Quality Analyst . MINIMUM QUALIFICATIONS High school diploma/GED… more
- The County of Los Angeles (Los Angeles, CA)
- …to a staff of consultants; manage informal dispute resolution, compliance, and quality assessment and assurance monitoring processes; and handle informal ... consultative and enforcement services in the evaluation of total patient quality -of-care provided by hospitals and other health care facilities in accordance… more
- State of Colorado (Denver, CO)
- …includes providing training and technical assistance, conducting monitoring and other quality assurance activities, and establishing regulatory policy and ... with APS requirements regarding CAPS use in coordination with the APS data analyst and APS policy unit; interprets Adult Protective Services policy for county staff… more
