- Amgen (Washington, DC)
- …driven professionals in this meaningful role. **Commercial Customer MDM Domain Lead (US Remote )** **Live** **What you will do** Let's do this. Let's change the ... will partner with Marketing Operations, Commercial Data Analytics (Sales, Claims , POA), Value and Access Teams (Payer & Patient...Bachelor's degree and 4 years of MDM experience OR Associate 's degree and 8 years of MDM experience **Or**… more
- Westat (Rockville, MD)
- …team on a variety of health services research projects focused on health care delivery, payment, and policy. Remote work arrangement available. **Job ... **26825BR** **Job Title:** Senior Research Associate - Health Services - Research & Analysis...with progressively increasing responsibilities. + Demonstrated experience analyzing healthcare claims data, including Medicare, Medicaid claims and… more
- WTW (Arlington, VA)
- …in the North American market to join as a Property & Casualty (P&C) Associate Director in our Insurance Consulting and Technology (ICT) practice. You will have ... full potential. In this role you will collaborate with our team of pricing, claims , distribution, product management, underwriting and claims experts to sell and… more
- Humana (Washington, DC)
- …to drive improvements in quality and/or reductions in total cost of care + Scorecard creation and reconciliation of provider performance based on contractual ... Qualifications:** + Bachelor's Degree + 3-5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care +… more
- CareFirst (Reston, VA)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... in projects. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and compliance… more
- CareFirst (Columbia, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... of infrastructure used for business mission critical applications including Claims Processing, Enrollment, Financial, and Corporate websites and **250+** other… more
- Community Clinic Inc. (Silver Spring, MD)
- CCI Health Services' mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for ... everyone. POSITION SUMMARY: The WIC Client Services Associate assists with the delivery of WIC services at...local agency policies and procedures. This position will be remote upon completion of onboarding and onsite training. KEY… more
- AmeriHealth Caritas (Washington, DC)
- **Special Investigator Managed Care - DMV Counties only** Location: Washington, DC Primary Job Function: Compliance ID**: 29509 **Job Brief** This position will work ... as a remote employee but must reside in DC or surrounding...now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping… more
- Marriott (Washington, DC)
- …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
- Serco (Washington, DC)
- …reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims ; and supporting state and national reporting and development ... Serco is seekinga motivated Medical Records Manager for Medical Claims Review to join our talented and fast-paced Public...and quality deliver of PERM program. **_Hybrid or full-time remote work. This is position is contingent on contract… more
- Amgen (Washington, DC)
- …the team, the individual in this role will deliver analysis using PSP data, claims data, prescription data, copay claims data, and other internal/external data ... need + Understand pharmaceutical ecosystem and data sets including medial and pharmacy claims (ex. IQVIA LAAD, Symphony Claims ), prescription (ex. IQVIA NPA),… more
- Serco (Washington, DC)
- …reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims ; supporting state and national reporting; and development of ... **Position Description** Serco is seekinga motivated Policy Specialist for Medical Claims Review to join our talented and fast-paced Public Sector Solutions team in… more
- Humana (Annapolis, MD)
- …hands-on experience with healthcare data such as medical, behavioral, pharmacy claims data, financial, social and demographic data; demonstrated innovative and ... experience in health insurance domain, familiarity with products, providers and claims processing. + Experience with Data Warehousing (Azure/SQL/Synapse), ETL (Azure… more
- Humana (Washington, DC)
- …service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Coordinator 3 ... program + Network Resource Groups (NRGs) + Career development opportunities \#LI- Remote \#LI-JR1 **Use your skills to make an impact** **Required Qualifications**… more
- Humana (Washington, DC)
- …to business & customers we serve using the latest in software technology? Our claims services team is best positioned in building modernized claims eco systems ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
- Humana (Washington, DC)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Amgen (Washington, DC)
- …Or + Bachelor's degree and 5 years of experience in a quantitative field Or + Associate degree and 10 years of experience in a quantitative field Or + High school ... eg, clinical trial data, electronic medical records, and insurance claims ; or Bioscience's data, eg, protein or small molecule...us** As we work to develop treatments that take care of others, we also work to care… more
- Humana (Washington, DC)
- …+ Intermediate to advanced experience in programming, analytical work, and with claims data. + Familiarity or prior experience with data governance and literacy. ... requirements and guidelines. **Additional Information** + **Travel** : None + **Workstyle:** Remote + **Core Workdays & Hours:** Typically, 8-5 pm Monday - Friday;… more
- Humana (Washington, DC)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
- Humana (Bethesda, MD)
- …volumes of data + Good understanding of healthcare data eg, member, provider, claims and clinical data + Experience and understanding of data governance practices ... **Location/Work Style:** Hybrid Office in Louisville, KY is preferred but open to Remote US as well **Why Humana?** At Humana, we know your well-being is… more