- Humana (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- … 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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Waystar (Atlanta, GA)
- …the Sr Manager, Data Science, you will be a technical and operational leader reporting to the VP of Data Science. Your primary responsibility will be to lead ... development of technical documentation and best practices for the data science team. + Support the team's professional...systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out… more
- Humana (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Humana (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Emory Healthcare/Emory University (Atlanta, GA)
- …At Emory Healthcare.** At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs ... Reimbursements and Net Patient Service Revenue (NPSR), and oversees analysis and reporting for Governmental Reimbursements for Emory Healthcare. + The Manager of… more
- Molina Healthcare (Atlanta, GA)
- …coordination, and shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** ... Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits,… more
- Molina Healthcare (Atlanta, GA)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... abuse, and over utilization by providers and recipients. The position will review claims data , medical records, and billing data from all types of healthcare… more
- State of Georgia (Fulton County, GA)
- …coordination of resources and warm transfer of people across organizations and Medicaid Waivers Coordinate services for people across networks, funding sources, and ... work Track work completed in conjunction with long-term services and supports for reporting purposes Maintain up to date understanding of Centers for Medicare & … more
- Humana (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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