We interpreted Bayamón County, PR as Bayamón County, PR.
- Humana (San Juan, PR)
- …our organization's standing within the Medicaid markets. **Complex Ad-Hoc Requests:** The Data and Reporting Professional 2 will address complex ad-hoc ... caring community and help us put health first** The Medicaid Data and Reporting Analyst...operating objectives, including their linkages to related areas. The Data and Reporting Professional 2… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the ... and regulatory standards. Assignments are varied and often require interpretation of Medicaid -specific policies and data . The role demands independent judgment… more
- Humana (San Juan, PR)
- …of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results.… more
- Humana (San Juan, PR)
- …and Medicaid program requirements to drive accurate and timely submissions. The Senior Data and Reporting Professional integrates data from multiple ... operations across multiple states. This role ensures compliance with state-specific Medicaid reporting implementations and requirements, will collaborate with… more
- Humana (San Juan, PR)
- …contracting requirements and data integrity as required in the Ohio Medicaid Provider Agreement and internal reporting compliance. This role will support ... contracting governance, process development, and data governance Ohio Medicaid , including developing contracting requirements, internal reporting compliance… more
- Humana (San Juan, PR)
- … requires an in-depth evaluation of variable factors. The Senior Workforce Management Professional plays a pivotal role in supporting Medicaid Inpatient and ... community and help us put health first** The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and … more
- Humana (San Juan, PR)
- …model designs including analyzing provider performance, reporting , and scorecard/reconciliation reporting . + Understanding of Medicaid and/or Medicaid ... first** Humana Healthy Horizons is seeking a Senior Value-Based Programs professional who will support successful value-based provider relationships with a focus… more
- Humana (San Juan, PR)
- …our caring community and help us put health first** The Senior Agency Management Professional provides support for handling and analyzing data that pertains to ... determination of the appropriate courses of action. The Senior Agency Management Professional provides support for handling and analyzing data that pertains… more
- Humana (San Juan, PR)
- …caring community and help us put health first** The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics and ... reporting to develop strategic and operational insights for workforce...management, diversity and human resource compliance). The Workforce Management Professional 2 work assignments are varied and frequently require… more
- Humana (San Juan, PR)
- …to drive sales program effectiveness and to ensure cost efficiencies. Provide data driven expertise and management reporting to improve sales performance ... help us put health first** The Senior Enterprise Transformation Professional manages all aspects of a large-scale program, from...to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. **The… more
- Humana (San Juan, PR)
- …and help us put health first** The IHWA Follow-up Senior Program Delivery Professional provides daily operational support to programs that impact members' lives by ... promoting preventive health activities. The IHWA Follow-up Senior Program Delivery Professional works on problems of diverse scope and complexity ranging from… more
- Humana (San Juan, PR)
- …ranging from moderate to substantial. The Actuary, Analytics/Forecasting supports centralized reporting of external data sharing, oversees internal reporting ... The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and… more
- Humana (San Juan, PR)
- …Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and ... operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and… more
- Humana (San Juan, PR)
- …The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and ... operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and… more
- Humana (San Juan, PR)
- …Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational ... decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence....used within our Individual Medicare Advantage pricing and internal reporting process. This includes: + Helping make and test… more
- Humana (San Juan, PR)
- …The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and ... operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and… more
- Cardinal Health (San Juan, PR)
- …tool to document work and progress the patient journey. Consistently leverage CRM reporting tools and data analytics to make strategic decisions while ... long and short-range changes in the reimbursement environment including Medicare, Medicaid , Managed Care, and Commercial medical and pharmacy plans while planning… more
- Humana (San Juan, PR)
- …The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and ... operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and… more
- Cardinal Health (San Juan, PR)
- …Remain knowledgeable about changes in the reimbursement environment (Medicare, Medicaid , Managed Care, Commercial plans). **Program Expertise & Continuous ... contribute to its continuous improvement. . Track key patient metrics, analyze data for trends and improvement opportunities, and generate reports for stakeholders.… more
- Cardinal Health (San Juan, PR)
- …investigations to resolve ethics and compliance issues. **Compliance Audit Manager** Reporting to the Compliance Director, this position supervises and manages ... compliance audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services. This position will… more