- Humana Inc (Washington, DC)
- …align with the organization's strategy and long‑term goals. Serve as a consultant to application teams, guiding them in creating enterprise‑grade applications that ... and consulting. Knowledge of healthcare business domains, including Medicare, Medicaid , Group, Specialty, etc. Development level knowledge utilizing the Power… more
- Humana Inc (Washington, DC)
- …Responsible AI governance initiatives, policies, and standards. Serve as an internal consultant and subject matter expert on Responsible AI topics such as fairness, ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. Equal… more
- Intellect Solutions LLC (Falls Church, VA)
- …Overview: Intellect Solutions is seeking a highly motivated and skilled Revenue Cycle Consultant with Subject Matter Expertise (SME) in Medical Coding to join our ... team. As a Revenue Cycle Consultant - Medical Coding SME, you will leverage your...(ICD-10-CM/PCS, CPT, HCPCS), payer rules and policies (Commercial, Medicare, Medicaid , and specifically DHA/TRICARE), evolving reimbursement methodologies (eg, DRG,… more
- Public Consulting Group (Washington, DC)
- …support the delivery of health-related services by helping schools access critical Medicaid reimbursement. The Consultant will take a client-centric view and ... Integrity, and other staff to execute contractual obligations. In addition, the Consultant will focus on growth and retention, ensuring that client relationships are… more
- Elevance Health (Washington, DC)
- …Health Medical Director - Psychiatrist - District of Columbia (aka Washington DC) Medicaid ** **Location:** This role requires associates to be in-office 4 days per ... Medical Director** is responsible for reviewing cases for DC Medicaid members including pharmacy, child, and substance use disorders,...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- Public Consulting Group (Washington, DC)
- …and the revenue generated from those identified opportunities. The Senior Consultant will manage complex projects and/or produce sophisticated deliverables; they ... and supervise staff; work independently with minimal supervision; serve as an internal consultant to other projects or product lines; play a key role in proposals… more
- CVS Health (Annapolis, MD)
- …actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job ... data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid … more
- Baylor Scott & White Health (Washington, DC)
- **Description - External** **JOB SUMMARY** The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
- Oracle (Washington, DC)
- …Applies Oracle methodology, company procedures, and leading practices. As a Lead Consultant you will consult on data and modelling impacts, guiding clients through ... visualization tool like BO or Tableau + Healthcare experience with Medicaid /Medicare Claims Reporting **Expectations** + Perform other responsibilities as assigned +… more
- Humana (Washington, DC)
- …with the organization's strategy and long-term goals. * Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that ... and consulting. + Knowledge of healthcare business domains, including Medicare, Medicaid , Group, Specialty, etc. + Development level knowledge utilizing the Power… more
- Humana (Washington, DC)
- …and help us put health first** The Risk Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and initiatives are executed upon. ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Washington, DC)
- …AI governance initiatives, policies, and standards. + Serve as an internal consultant and subject matter expert on Responsible AI topics such as fairness, ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Amgen (Washington, DC)
- …and deep experience in federal health policy issues - specifically Medicare, Medicaid , and national health programs/reform + Deep understanding of US biosimilars ... 1-pagers and presentations + Product commercialization experience desirable (direct or consultant ) + Experience in Amgen therapeutic areas preferred (health policy… more
