- Huntington Ingalls Industries (Woodlawn, MD)
- …HI This opportunity resides with Command, Control, Communications, Computers, Cyber, Intelligence , Surveillance and Reconnaissance (C5ISR), a business group ... the sensors, systems and other assets necessary to support integrated intelligence , surveillance and reconnaissance (ISR) operations, exploitation and analysis for… more
- Commonwealth Care Alliance (Boston, MA)
- …and extracts into format usable in analytical database + Works collaboratively with Business Intelligence unit and fellow Compliance team members to ... the FDR program, as well as responsibility for first-level Compliance review in onboarding of new business ...contacts due to needs of the program, Medicare, or Medicaid . + Coordinates, with the Compliance Manager,… more
- Commonwealth Care Alliance (Boston, MA)
- …to ensure compliance . + Works closely with the Governance, Risk & Compliance (GRC) teams (Medicare, Medicaid , Privacy, Fraud, Waste & Abuse) for ... vendor management, health insurance government products and programs (Medicare, Duals/SNP, Medicaid , LTSS), and/or compliance experience required, on the… more
- Humana (Columbus, OH)
- …implement regulatory compliance policies and procedures + Research regulatory compliance issues and make business recommendations that assure compliance ... needed + Provide compliance guidance, direction, and compliance risk assessment to assigned business partners...on process and quality + High level of emotional intelligence + Ability to work independently and utilize excellent… more
- General Dynamics Information Technology (Menands, NY)
- …The successful candidate should have experience in or knowledge of regulatory compliance , NIST SP 800-53, Medicaid Management Information Systems and CMS. ... the ability to handle other areas of information security, including business continuity, operations security, cryptography, forensics, regulatory compliance ,… more
- CVS Health (Hartford, CT)
- …more personal, convenient and affordable. Position Summary At Aetna, our health benefits business , we are committed to helping our members achieve their best health ... of quality performance and leadership of Aetna's quality government programs (Medicare, Medicaid , IFP, Duals). This leader will focus on HEDIS Hybrid, STARS,… more
- Northern Light Health (Brewer, ME)
- …gap analysis between actual and targeted outcomes. .Monitors outcomes of business intelligence , decision support and communication applications .Manages multiple ... role is to serve as an internal consultant with strong financial and healthcare business acumen as well as the ability to clearly communicate and present analyses to… more
- Commonwealth Care Alliance (Boston, MA)
- …a vision and strategy for Internal Audit, internal controls, and Sarbanes-Oxley (SOX) compliance in alignment with CCA's priorities and business objectives while ... plan and activities, and that supports and facilitates organizational strategy, business objectives, and effective financial, operational, compliance and… more
- Highmark Health (Pittsburgh, PA)
- …activities essential to Government Market Growth in support of Medicaid membership and margin goals. Strategy Partners provide analytical/strategic-thinking and ... Highmark, (2) prioritize potential opportunities and (4) support development of business cases to facilitate decision to move forward with opportunities. Strategy… more
- Serco (Washington, DC)
- …of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as ... medical reviews, data processing reviews, and eligibility reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting… more
- Universal Health Services (Reno, NV)
- …the Product Development Director will provide essential support to the organizational business teams in the development, implementation, and compliance of new ... Development + Strategic Product Design + Product Insights and Market Intelligence + CMS/Regulatory Programming + SNP Programming + Regulatory Submissions… more
- Spokane County (Spokane, WA)
- …applications, department medical applications, operational reporting, data warehousing, and business intelligence environments, including vendor management of ... ongoing maintenance of technical documentation associated with the data warehouse and business intelligence systems. + Supervises and provides oversight for the… more
- WellSense (Manchester, NH)
- …across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, ... ensuring the Plan accurately administers those arrangements. + Ensures provider compliance with contractual, regulatory and NCQA requirements and standards. +… more
- Development InfoStructure (Arlington, VA)
- …development community, multiple civilian agencies and the nation's defense and intelligence communities. Our focused research, services and products include complex ... across multiple federal agencies, research and development for Signal Intelligence (SIGINT), Command, Control, Communications, Computers and Intelligence … more
- Commonwealth Care Alliance (Boston, MA)
- …to Us:** The Vice President, Quality & Controls Assurance reports to compliance leadership, and strategically and operationally leads various quality reviews of ... coding, call monitoring, system technology upgrades, and other critical compliance /financial/operational controls and processes across the CCA enterprise, including… more
- Highmark Health (Harrisburg, PA)
- …software packages such as Microsoft PowerPoint, Excel, Word + Knowledge of required compliance with Centers of Medicaid and Medicare services (CMS) laws and ... the Pay for Value (P4V) relationships. + Communicate with the appropriate business leaders on the P4V program participation, opportunity, performance, and progress.… more
- CareOregon (Portland, OR)
- …Job Title IS Development Manager - EDI Exemption Status Exempt Department Business Intelligence Manager Title Director, Claims Systems and Electronic Data ... effectiveness. + Work collaboratively with other teams within Information Systems Business Intelligence (ISBI) to provide expertise, support, and capacity… more
- Commonwealth Care Alliance (Boston, MA)
- …Compliance infrastructure at CCA. + Promote compliance in CCA's business operations with all Medicare and Medicaid contractual and regulatory ... identifying beneficial and value-added audits. + Maintain current knowledge of and identify business and compliance risks using various sources and methods. +… more
- Mathematica (Columbus, OH)
- …and privacy in cloud and on-prem environments. This role works across technology, business unit and project teams, with support from the IT Security, Risk and ... Compliance function, in the deployment of a data governance...bias * Exposure to analytics, machine learning and artificial intelligence * Expertise in writing, presenting, discussing and socializing… more
- HCA Healthcare (Brentwood, TN)
- …informatics required + Expert level Excel skills and previous development experience with business intelligence and analytics tools (such as Business ... limited to: MACRA/MIPS, 21st Century CURES, Centers for Medicare and Medicaid Innovation (CMMI) projects; Accountable Care Organizations (ACO); Advanced Alternative… more