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Program Analyst/SME

Unissant, Inc.

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Remote

Full-time

Unissant, Inc. delivers innovative capabilities to the agencies that keep our nation healthy and safe. We apply our domain expertise, data acumen, and technology know-how to achieve breakthrough results for our clients. Working collaboratively, we advance missions and careers through a focus on honesty, integrity, and dependability. We continuously look for talent, excited to join that effort. To learn more about our exciting organization, please visit us at . We are seeking a highly knowledgeab
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Posted 17 days ago | Updated 16 days ago

Senior Specialist, Provider Network Administration

Molina Healthcare

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Remote or Long Beach, California, USA

Full-time

Job Description JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES Generates and prepares provider-related data and reports in support of Network Mana
Posted 14 days ago | Updated 9 hours ago

Lead Cloud Architect Google Cloud Platform

Humana Inc

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Remote

Full-time

Become a part of our caring community and help us put health first The Lead Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Lead Cloud Architect works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Cloud Architect performs technical planning, architecture development and modification of specifications for Google Cloud Platform computing environments. Develops
Posted 12 days ago | Updated 9 hours ago

Sr. Configuration Analyst with Facets Exp. (Hybrid - Mason, Ohio)

OMG Technologies

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Mason, Ohio, USA

Contract

Sr. Configuration Analyst with Facets Exp. (Hybrid - Mason, Ohio) We are looking to hire a candidate with the skills sets mentioned and experience for one of our clients within the retail luxury goods and jewelry industry. This is a Hybrid role in Mason, Ohio; 2 days per week in Mason office. MUST work on W2 as this a potential full-time employment. Position Summary: Serve as a Sr. Configuration Analyst on the Business Configuration Solutions team. Responsible for the enablement of member benef
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Posted 2 days ago

Claims Examiner - Workers Compensation(California)

MetaSense, Inc.

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Remote

Contract, Third Party

ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates an
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Posted 60+ days ago | Updated 25 days ago

Lead Engineer - Adobe Experience Platform - AEP (Remote)

Cognizant

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Remote or Phoenix, Arizona, USA

Full-time

Job Summary We are seeking a highly skilled Technology Architect with 10 to 13 years of experience to join our team. The ideal candidate will have expertise in Adobe Analytics Engineering Adobe Analytics Reporting Adobe Audience Manager and Adobe Target. The candidate should also have domain experience in Medicare & Medicaid Claims Claims and Payer. This is a hybrid work model with day shifts and no travel requirements. Responsibilities Lead the design and implementation of technology solutions
Posted 18 days ago | Updated 18 hours ago

IT Project Manager

United Global Technologies

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Nashville, Tennessee, USA

Contract

Do not if you do not have Healthcare or Medicare / Medicaid experience. Non work at home position, flexible hours between 7:30-8:30 am based on business need. May require >40hrs week for some projects. Required Education: Bachelor's Degree or 4 years of job related work experience or 2 years of job related experience plus an associate s degree in any major. Required Work Experience: 3 years IT experience in a leadership capacity on one or more project teams. Oversee full SDLC - Software Develop
Posted 14 days ago | Updated 3 days ago

Network Management - Senior Analyst

CVS Health

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Arizona, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 8 days ago | Updated 9 hours ago

Manager, Data Analytics & Reporting (SQL, PowerBI)

Centene Corporation

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Indiana, USA

Full-time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Remote IN. Position Purpose: Oversee and ensure accurate, timely, and efficient reporting related to all core business functions Ensure the timeliness and accuracy of internal and external report deliverables
Posted 33 days ago | Updated 9 hours ago

Sr. Microsoft Engineer

ConsultNet, LLC

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Remote

Full-time

Sr. Microsoft Engineer Location: Remote Type: Full-time Experience Required: 8 years of related work experience Transform the Future of Healthcare IT Join a mission-driven team dedicated to reshaping healthcare for over 12 million Medicare beneficiaries and 700,000 providers. At the forefront of healthcare transformation, we believe in building better experiences-starting with innovative technology. We're seeking a Senior Microsoft Engineer to lead the evolution of our Microsoft infrastructure,
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Posted 11 days ago | Updated 9 hours ago

Senior Regional Director, SGS Program Management

Gainwell Technologies LLC

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Columbus, Ohio, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary We're on the lookout for an exceptional and visionary leader to join our dynamic organization as a Senior Regional Director. If
Posted 55 days ago | Updated 6 hours ago

Financial Analyst III

SAR TECH LLC

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Remote

Contract

Client: Baxter Job Title: Financial Analyst Location: Deerfield, IL (100% Remote) Benefits: 9 Days of Sick Leave/PTO included, Medical or Dental are not included Employment Terms: W2 only (No Corp-to-Corp or 1099) US.C Only Position Overview: The Financial Analyst / Government Price Reporting Associate will assist in reviewing and validating government pricing which may include (Medicaid (AMP/BP), Medicare Part B (ASP), Public Health Service(340B) and Non-FAMP (VA) to ensure accuracy and comp
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Posted 9 days ago | Updated 9 days ago

Pharmacy Business Analyst - Conversion & Prior Auth SME

Gainwell Technologies LLC

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Kansas City, Missouri, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Pharmacy Business Analyst - Conversion & Prior Auth SME at Gainwell, you can contribute your skills as we harness the powe
Posted 16 days ago | Updated 6 hours ago

Pharmacy Sr Business Analyst - Claims & Configuration SME

Gainwell Technologies LLC

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Kansas City, Missouri, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Pharmacy Sr Business Analyst - Claims & Configuration SME at Gainwell, you can contribute your skills as we harness the po
Posted 16 days ago | Updated 6 hours ago

Chief of Network Strategy & Management

Providence Non-RN - Oregon

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Portland, Oregon, USA

Full-time

Description Calling All Visionary Network Leaders! Are you ready to drive strategic innovation and lead the transformation of healthcare provider networks? Do you thrive on navigating complex challenges and shaping the future of healthcare delivery? If so, we have the perfect opportunity for you! The Role: As the Chief Network Strategy & Management (CNSM) for Providence Health Plan, you will spearhead the vision, strategy, and management of our provider networks. This pivotal role requires deep
Posted 7 days ago | Updated 14 hours ago

EMR Project Manager

Encompass Health

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Birmingham, Alabama, USA

Full-time

ABOUT US Join us on the heart-warming journey with a team that is a top leader in the rehabilitation industry Encompass Health is the leader in inpatient rehabilitation industry, you'll feel the Encompass Health difference as soon as you join. We collaborate and provide high-quality, compassionate, individualized care for our patients, allowing us time to get to know them and help them achieve their goals during their rehabilitation journey. POSITION PURPOSE The EMR (Electronic Medical Records
Posted 18 hours ago

Senior Business Analyst - Medicaid

Gainwell Technologies LLC

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Houston, Texas, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Senior Business Analyst - Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to he
Posted 7 days ago | Updated 6 hours ago

Senior Business Analyst - Medicaid

Gainwell Technologies LLC

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Austin, Texas, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Senior Business Analyst - Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to he
Posted 7 days ago | Updated 6 hours ago

Senior Business Analyst - Medicaid

Gainwell Technologies LLC

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Dallas, Texas, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Senior Business Analyst - Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to he
Posted 7 days ago | Updated 6 hours ago

Facets Configuration Analyst - Hybrid

VIVA USA INC

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Mason, Ohio, USA

Contract

Title: Facets Configuration Analyst - Hybrid Mandatory skills: Facets platform, Medical Plan Benefit Configuration, Provider Network, Provider Agreement Configuration, Medicare, Medicaid, SQL, Database, SQL queries, Business Configuration, Data Analysis, member benefit configuration, surgical, Healthcare claim, benefit configuration, Fit Analysis, Gap Analysis, Feedback Assessments, Facets, claims testing, Informatica, Windows Applications, data validation, documenting requirements, process flo
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Posted 2 days ago