- Novo Nordisk Inc. (WA)
- …areas may include, but are not limited to: NN Foundation, Quality, Medicare , Medicaid , Transparency, Adherence, Importation, Reference Pricing, Pricing / Price ... you ready to realize your potential? The Position The Senior Director works on complex issues that require an...Increases, Stem-Cell, Research , NIH, Reimbursement, IP, Labor / Employment, Tax, Trade,… more
- Eisai, Inc (Nutley, NJ)
- …of the US healthcare system across one or more major payer segments ( Medicare , Medicaid , Federal, and Commercial).Experience working with medical and pharmacy ... is breaking through in neurology and oncology, with a strong emphasis on research and development. Our history includes the development of many innovative medicines,… more
- R1 RCM (Salt Lake City, UT)
- …AI, intelligent automation, and workflow orchestration. We are seeking to expand our Medicare reimbursement team by adding a senior analyst. Working as a ... of the Government Navigation Suite service line, the Reimbursement Senior Analyst will partner with team members to work...variety of hospitals and systems to review and audit Medicaid eligible days for Medicare DSH reimbursement.… more
- CVS Health (Austin, TX)
- …do it all with heart, each and every day. **Position Summary** **The Medicaid Senior Manager, Network Management:** * Negotiates, executes, conducts high level ... in contract management systems per Aetna's established policies. . * Conducts research , analysis and/or audits to identify issues and propose solutions to protect… more
- Molina Healthcare (Green Bay, WI)
- …Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare - Medicaid recipients within ... School Diploma/GED/AA Degree **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** 2+ years Medicare , Medicaid , managed care or other health/insurance related… more
- Humana (Montpelier, VT)
- **Become a part of our caring community and help us put health first** Humana Medicaid is seeking a dynamic and strategic Senior Insurance Product Manager to ... for individuals who are: * Creative - Skilled in research and structured problem-solving with a flexible mindset. *...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Molina Healthcare (Boston, MA)
- …Responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare - Medicaid recipients within ... **Required Education** High School diploma/GED **Required Experience** 2+ years Medicare , Medicaid , managed care or other health/insurance related… more
- CVS Health (Phoenix, AZ)
- …technical, analytical, and business support for all assigned programs for Medicare , Medicaid , and Commercial products. Programs currently include End-Stage ... successful audit experience for our clients. Your ability to research claims, read benefit setups in RxClaim, and articulate...**Knowledge of:** + 3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience +… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Senior Claims Research and Resolution Professional reports to the Claims Research ... strategy and operating objectives, including their applications to assignments. The Senior Claims Research and Resolution Professional follows general guidance… more
- University of Michigan (Ann Arbor, MI)
- Research Area Specialist Senior /Intermediate Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as ... + At least 1 year of experience working with claims databases, such as Medicare , Medicaid , or commercial claims + Excellent communication skills + A minimum… more
- Humana (Charleston, WV)
- …errors that result from the data exchange between Humana and its trading partners, Medicare and Medicaid . The Senior Encounter Data Management Professional ... to ensure successful submission and reconciliation of encounter submissions to Medicaid / Medicare . Ensures encounter submissions meet or exceed all compliance… more
- Serco (VA)
- …in federal health program policy and regulations (particularly the Health Insurance Marketplace, Medicare , Medicaid and CHIP), policy research and data ... **Position Description** Serco is seekinga self-starter Senior Health Policy and Research Manager...research on government health programs (such as Marketplace, Medicare , Medicaid ). + Minimum 3 years management… more
- AdventHealth (Maitland, FL)
- …Senior Compliance Analyst will have expertise in Commercial and Governmental ( Medicare , Medicaid , Tricare) payer reimbursement language and methodologies. The ... Location** : Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify,… more
- CareFirst (Baltimore, MD)
- …methodologies. This position may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This may also include ... CareFirst corporate position. + Provide feedback on payment policies related to Medicaid and/or Medicare processing. Participate in workgroup projects around… more
- Huron Consulting Group (Van Buren, AR)
- …+ Ability to interpret and apply clinical guidelines including Centers for Medicare and Medicaid , Federal Drug Administration, National Comprehensive Cancer ... create your future. Your passion and expertise in clinical research will make you a key member of Huron's...and may be implemented in the future. **Position Level** Senior Analyst **Country** United States of America At Huron,… more
- Humana (Jackson, MS)
- …Engineering or related field + Experience in health insurance related data ie. Medicare , Medicaid , Claims, Premium Data, etc. + Experience with Azure Synapse ... health first** Humana is seeking an individual for the Senior Business Intelligence Data Analyst to provide support for...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- New York State Civil Service (Albany, NY)
- …management and medical malpractice; health information technology; managed care; Medicare / Medicaid Conditions of Participation (CoPs) and Conditions for ... Agency SUNY System Administration Title The State University of New York - Senior Counsel - Health Affairs Occupational Category Legal Salary Grade NS Bargaining… more
- Molina Healthcare (NY)
- …needs. Performs analysis across multiple states and lines of business ( Medicare , Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and ... applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA...provides insights needed to support strategic investment decisions + Research and develop reports and analyses for senior… more
- RWJBarnabas Health (Oceanport, NJ)
- …will serve as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment strategies ... This includes planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with...programs and will be asked to assist with regulatory research . The Director will also work closely with finance… more
- Humana (Frankfort, KY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... part of our caring community and help us put health first** The Senior Consumer Service Operations Professional is responsible for the daily activities across… more
