- Corewell Health (Grand Rapids, MI)
- …operational excellence in healthcare? Priority Health is seeking a detail-oriented and analytical Operations Analyst to play a critical role in enhancing our ... and drive meaningful improvements, this role is for you! Job Summary The Operations Analyst is responsible for identification of operational quality audit error… more
- TEKsystems (Omaha, NE)
- Position: Technical Business Analyst Duration: 12 month contract Location: Omaha, NE Work Environment: REMOTE Job Description M UST HAVE previous Medicare ... Previous experience working on enrollment and customer service within Medicare Advantage. + Experience working in advanced Excel, CMS,...in this role. + Will be the liaison between operations and data engineering team. + Will gather requirements,… more
- Zelis (TX)
- Position Overview: The Medicare Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer Product team to further the company's goals by ... communicating rules, regulations, and procedures pertaining to public and private Medicare / Medicare Advantage payment systems. This position requires an in-depth… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Medicare Appeals Analyst Supervisor is responsible for managing, supporting, and oversight of the Appeals and Grievance team; this includes ... upon the operational and strategic plans to achieve expected performance. The Medicare Appeals Analyst Supervisor provide leadership to direct reports and… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …COB issues. **Job Title: Medicare Benefits Validation Analyst ** **Location: Pearland Administrative Office** **Department:** **Kelseycare Operations ** ... customer service, and third-party coverage Preferred: Prior experience with Medicare Advantage including knowledge of regulations, products, and processes. Prior… more
- UCLA Health (Los Angeles, CA)
- …do all this and more at UCLA Health. As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running ... required * Five or more years of experience with CMS processes in a Medicare or managed care environment * Must have 3-5 years of experience with Encounter… more
- Elevance Health (Norfolk, VA)
- **Risk Adjustment Advanced Analyst Senior** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of ... of our Elevance Health PulsePoint locations.** The **Risk Adjustment Advanced Analyst Senior** is responsible for creating statistical models to predict, classify,… more
- Molina Healthcare (AZ)
- …with multiple types of business data. May be internal operations -focused or external client-focused. **KNOWLEDGE/SKILLS/ABILITIES** + Elicit requirements using ... interviews, document analysis, and requirements workshops, business process descriptions, use cases, business analysis, task and workflow analysis. + Interpret customer business needs and translate them into application and operational requirements +… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s ... best possible health and quality of life. **Responsibilities** **Clinical Quality Data Analyst I** **Supports the design, execution and delivery of analyses and… more
- CareOregon (Portland, OR)
- …Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Operations Business Analyst Requisition # 24775 Exemption Status Exempt ... accommodate PST business hours (M-F 8-5pm). Job Summary The Operations Business Analyst is an advanced team...Experience and/or Education Required + 3 years' experience with Medicare and/or Oregon Medicaid + 2 years' experience related… more