- Humana (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- … 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 (Washington, DC)
- …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 (Washington, DC)
- …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
- NTT America, Inc. (Baltimore, MD)
- …completeness + PMI Certified Associate in Project Management (CAPM) or Project Management Professional (PMP) _Where required by law, NTT DATA provides a ... **Req ID:** 343399 NTT DATA strives to hire exceptional, innovative and passionate...members to coordinate, track, monitor, create, and update the Medicaid APDs as needed. He/she will actively participate in… more
- Humana (Washington, DC)
- …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
- CVS Health (Annapolis, MD)
- …abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data visualization tools (eg, Tableau, Power BI ... a full time role and is ideal for a data professional with strong coding skills in...to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting . This is… more
- Huntington Ingalls Industries (Woodlawn, MD)
- …possessing integrity. + Strong analytical and critical thinking skills. + Proficiency in data gathering, analysis, and reporting . + Excellent written and verbal ... necessary to support integrated ISR operations and accelerated decision-making. With data fusion and mission management capabilities for the Department of Defense,… more
- Humana (Arlington, VA)
- …stakeholders involved in the Intern Program. Assists the program lead with reporting and communications and manages inquiries through the Intern Program mailbox. ... + Respond to inquiries from the Intern Program mailbox, providing timely and professional support. + Support the program lead in managing reporting and… more
- Humana (Washington, DC)
- …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 (Washington, DC)
- …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
- NORC (Washington, DC)
- …of health care payment and delivery interventions on outcomes and cost using data files derived from Medicare, Medicaid , and commercial payer administrative ... input and direction to staff on research design, methodology, data analysis, and interpretation for Medicare and Medicaid...motivate, inspire, and build high-performing teams. + Experience in reporting on research to a wide range of both… more
- CareFirst (Baltimore, MD)
- …score calculations, enrollment, submissions, medical and pharmacy claims, and provider data . Incumbent is responsible for performing analyses and problem resolution ... requirements for Medicare Advantage(MA), Affordable Care Act (ACA) & Medicaid Lines of Business (LOB). Additional responsibilities include establishing and… more
- Trinity Health (Gaithersburg, MD)
- …and encounter data . + Ensure compliance with Medicare Part D reporting requirements and prepare annual bid submissions. + Complete monthly IBNR analysis and ... PACE) programs. This role manages revenue cycles for Medicare, Medicaid , and private pay, oversees expense cycles including vendors...prepare accrual entries for accurate expense reporting . + Prepare financial data for Monthly… more
- Public Citizen (Washington, DC)
- Senior investigator with outstanding investigative reporting skills and accomplishments to develop sources and assemble information to better understand what is ... Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), and other HHS agencies and government...RESPONSIBILITIES: + Review and analyze publicly available and other data and documents about a wide range of health… more
- Humana (Washington, DC)
- …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