Category: Curator- Job Hunter

 
 

Position Description


Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being around the world. We collaborate closely with public- and private-sector partners to translate big questions into deep insights that improve programs, refine strategies, and enhance understanding using data science and analytics. Our work yields actionable information to guide decisions in wide-ranging policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. Mathematica offers our employees competitive salaries, and a comprehensive benefits package, as well as the advantages of being 100 percent employee owned. As an employee stock owner, you will experience financial benefits of ESOP holdings that have increased in tandem with the company’s growth and financial strength. You will also be part of an independent, employee-owned firm that is able to define and further our mission, enhance our quality and accountability, and steadily grow our financial strength. Learn more about our benefits here.


Mathematica is searching for professionals with experience generating insights from data on Medicaid policy and programs at either the state or federal level. In particular, we are looking for individuals who can apply data analytics to support current and emerging work across any number of areas related to monitoring and improving Medicaid programs such as: Value-based purchasing and alternative payment models, enrollment trends, measures of delivery and quality of services for beneficiaries, and to discern outcomes of innovative programs and policies.


The successful candidate will join our group of over 400 health policy professionals, including staff with degrees in data analytics, public health, public policy, economics, behavioral or social sciences, economics, and other relevant disciplines. We offer our employees a stimulating team-oriented work environment, competitive salaries, and a comprehensive benefits package, as well as the advantages of employee ownership.


Duties Of The Position

• Participate actively and thoughtfully in multidisciplinary teams, drawing on your past experience with Medicaid programs
  
• Help conduct research and technical assistance projects on topics related to state and federal Medicaid policy
  
• Apply rigorous analytic thinking to the collection and interpretation of quantitative data including analysis of Medicaid administrative data
  
• Bring creative ideas to the development of proposals for new projects
  
• Author project reports, memos, technical assistance tools, issue briefs, and webinar presentations
  
• Contribute to the growth, expertise, and institutional knowledge of staff working in the Medicaid area
  
  
  

Qualifications


Position Requirements:

• 3-8 years of experience working in health policy or health research, with a substantial portion of that time related to some aspect of the Medicaid program at the state or federal level
  
• Masters or doctoral degree or equivalent experience in data analytics, public health, public policy, economics, behavioral or social sciences, economics, or other relevant disciplines
  
• Demonstrated ability at modeling program outcomes would be ideal
  
• Strong foundation in quantitative methods and a broad understanding of health policy issues
  
• Excellent written and oral communication skills, including an ability to explain observations and findings to diverse stakeholder audiences including program administrators and policymakers
  
• Demonstrated ability to provide task leadership and coordinate the work of multidisciplinary teams
  
• Strong organizational skills and high level of attention to detail; flexibility to lead and manage multiple priorities, sometimes simultaneously, under deadlines
  
  
  

To apply, please submit a cover letter, resume, writing sample, and salary expectations at the time of your application.

Available Locations: Washington, DC; Princeton, NJ; Cambridge, MA; Woodlawn, MD; Ann Arbor, MI; Chicago, IL; Oakland, CA; Seattle, WA

This position offers an anticipated annual base salary of $90,000 – $140,000. This position may be eligible for a discretionary bonus based on company and individual performance.

Various federal agencies with whom we contract require that staff successfully undergo a background investigation or security clearance as a condition of working on a project. If you are assigned to such a project, you will be required to obtain the requisite security clearance.

In accordance with Executive Order 14042 and its implementing guidelines, all Mathematica employees must provide documentation that they have been fully vaccinated or obtain an accommodation through Human Resources by providing documentation from a licensed health care provider that they are unable to be vaccinated against COVID-19 because of a disability (which would include medical conditions) or provide an attestation that they are entitled to an accommodation because of a sincerely held religious belief, practice, or observance.

 
 

Clipped from: https://www.linkedin.com/jobs/view/researcher-medicaid-at-mathematica-2731810834/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

 

 
 

THIS IS A WORK FROM HOME OPPORTUNITY – TEXAS PREFERRED

 
 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. 

 
 

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health benefits companies and a Fortune Top 50 Company.

 
 

The Medicaid Business Analyst Intern will be responsible for…

 
 

Primary responsibilities include supporting:

 
 

• Support business strategies through an integrated portfolio of internal and external client facing programs, projects, and initiatives such as provider data management, implementation of new tool suites, and operational processes
  
• Facilitate cost of care and population health initiatives through ideation sessions, documentation and management of goals, strategies, KPIs and metrics
  

 
 

• Be the point of contact to triage and track post implementation concerns
  
• Support in logistics and coordination with state projects
  
• Help support internal and external meetings with agendas, minutes and follow up items
  

 
 

Qualifications

• Pursuing an undergraduate degree in Public Health, Public Policy, Business Management, Healthcare Administration, Health Operations Management, or Business Analytics
  
• This internship is from June to August and is 40 hours per week/or 20 hours per week depending on school schedule in a virtual setting
  
• Must be enrolled fulltime at an accredited college or university during internship
  
• Students must be authorized to work in the U.S. without future visa sponsorship requirements
  

 
 

Preferred Qualifications

 
 

Students must reside or attend school in Texas

 
 

 
 

Clipped from: https://anthemcareers.ttcportals.com/jobs/7886608-medicaid-business-analyst-intern-summer-2022?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description
The purpose of the Director, Strategy Advancement -Medicaid, is to work with the Medicaid Operations team to drive operational strategies in support our growing Medicaid portfolio. Advises and makes recommendations to senior executives on matters of significance in the National Medicaid Operations and Divisional teams, Business Development, Network, Finance and Clinical areas, as well as other stakeholders within and outside the Retail Segment.
Focused on optimizing the operating model of the National Medicaid Operations and Divisional structure while serving as an instrumental leader in achieving the Medicaid Growth Strategy and assuring an exceptional customer experience.
Responsibilities
+ Provides end-to-end support to VP, National Medicaid Operations including but not limited to cross -functional coordination with his/her leadership team and key aligned partners on all initiatives, communications, and executive reporting. Key member of the National Medicaid Operations Leadership team. Represents the VP, National Medicaid Operations as needed in strategic settings to advance the priorities of the Medicaid portfolio
+ Builds relationships with executives and senior leaders across the Medicaid segment and with key business partners supporting the Medicaid and leads change management to execute the new Medicaid Market Operating Model across enterprise partners
+ Assumes leadership of complex strategic initiatives that are broad in scope. Identifies opportunities and leads large scale initiatives and programs for the segment from conceptualizing through implementation
+ Provides visibility and coordination of all large-scale initiatives within the National Medicaid Operations and Divisional teams, supporting cross-functional collaboration across Business Development, Network, Finance and Clinical areas
+ Actively engages in strategy execution to deliver business critical outcomes that advance our 1.5M Medical Member BHAG
+ Actively engages National Medicaid Operations Leadership Team in strategy development and execution in order to achieve successful growth and meaningful customer experience, including support and management of administrative budgets and business planning
+ Assumes a leadership position in promoting strong team health, particularly with National Medicaid Operations Leadership Team; but also key contributor to initiatives that strengthens the culture and improves the associate experience within the National Medicaid Operations organization in partnership with Medicaid Culture Team and Retail Communications, as well as key aligned partners including HR.
Required Qualifications
+ Bachelor’s Degree or equivalent experience
+ Experience in a matrix organization with proven ability to leader others by influence
+ 8 or more years of experience in change management, process improvement and leading large projects
+ 5 or more years of management experience or management consulting
+ 5 or more years advising executives
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ We will required full COVID vaccination for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve. If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Preferred Qualifications
+ Medicaid knowledge
+ Motivated self-starter; excited to work with cross-functional team members to execute against an end-to-end program scope
+ Strategic mindset with critical thinking skills to connect disparate dots and overcome ambiguity. Ability to evaluate and solve problems with rigorous logic that pushes beyond the obvious to uncover root cause issues and creative solutions
+ Adept at forming strong relationships with diverse teams and personalities through effective trust building and _collaboration_ . Strength in persuading multiple parties to align around one vision, and exudes the confidence to drive execution and adoption.
+ Strong communication skills, both verbal and written (including reporting and presentations) with demonstrated ability to use language that is succinct and clear and, when appropriate, strengthens new business positioning and emphasizes customer value
+ Experience leading large projects and programs from the conceptualizing through implementation. Comfort managing several different initiatives at one time and prioritizing efforts that deliver the greatest return for the business, all while leveraging standard methodologies, tools and platforms. Experience driving large scale change initiatives. _Track record of meeting deadlines and focusing on deliverables_ .
+ Experience leading and facilitating sessions where content is delivered and change management and adoption techniques are deployed
+ Intellectual curiosity with excellent listening skills and a passion for learning
+ Outcome orientation with the ability to use data to establish quantifiable success criteria and measure progress toward targeted results.
Scheduled Weekly Hours
40
 

Clipped from: https://www.recruit.net/job/director-jobs/F06E6FFFEB06569A?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Description:

Are you an experienced, passionate pioneer in technology? An operations professional who wants to work in a collaborative environment.

As a Medicaid Functional Specialist, you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel.

Consider an opportunity with our US Delivery Center – we are breaking the mold of a typical Delivery Center.


Our US Delivery Centers have been growing since 2014 with significant, continued growth on the horizon. Interested? Read more about our opportunity below …


Work you’ll do/Responsibilities

 

• Perform discovery of Medicaid business requirements
  
• Translate business requirements into user stories and technical requirements
  
• Communicate the project status throughout the project lifecycle to all team members.
  
• Identify and resolve issues that may negatively impact project deliverables
  
• Act as a SME on questions surrounding the Medicaid industry
  

The Team


Deloitte’s Government & Public Services practice-our people, ideas, technology and outcomes-is designed for impact.

Our team of over 15,000+ professionals bring fresh perspective to help you anticipate disruption, reimagine the possible, and fulfill your mission promise.

Our Health Technology team implements repeatable solutions to solve our government clients’ most critical health technology related issues.

We advise on, design, implement and deploy solutions focused on government health agencies “heart of the business” issues including claims management, electronic health records, health information exchanges, health analytics and health case management.

Our clients seek a fresh perspective on how to leverage reusable, interoperable and flexible solutions that will enable them to reduce costs, improve health outcomes and respond to public health crises.

Professionals will use their deep health, government and technology consulting experience to strategically help solve our client’s technology challenges.


Required Qualifications

 

• Bachelors’ degree in business related field and or equivalent professional work experience
  
• 3 years of experience in the Medicaid industry
  
• 1 years of experience working with claims authorizations
  
• 1 years of experience writing business requirement and user stories on technology projects
  
• Strong written and verbal communication skills, especially related to client-facing environments
  
• Travel up to 10% annually
  
• Limited immigration sponsorship may be available.
  

Preferred Qualifications

 

• PMP Certification
  
• Active Security Clearance
  

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.

calendar_today 20 hours ago

 
 

Clipped from: https://us.bebee.com/job/20211130-799c80492bbd849897f195edc30f65c6?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Found in: beBee S2 US

 

 
 

**Description**

Humana’s Enterprise Shared Services (ESS) organization is looking for a Senior Acquisition & Integration Professional to join the Business Management team working from home anywhere in the U.S. The Business Management team leads and operationalizes large-scale, cross functional initiatives to successful and timely outcomes. As part of this team, you will perform project-oriented duties related to the integration of acquired entities into the company as well as support new State Medicaid implementation.

As the Senior Acquisition Integration Professional you will work side by side with leaders and associates within teams across the Consumer and provider Services and Solutions Organization (CPSS), the Medicaid & Duals Organization and the Corporate Mergers & Acquisitions Organization. You will implement activities and projects associated with the assimilation of practices and systems where the primary competence is in project management and integration related disciplines. You must be high energy but easygoing, love collaboration, drive change and possess an outstanding and trusted leadership presence.


**Responsibilities**

The Senior Acquisition Integration Professional must be resilient and comfortable operating within in ambiguous environment. You will provide project management expertise while executing implementations that focus on delivering successful and timely outcomes including the following:

+ Managing & executing implementations (both Medicaid & Medicare) through all project phases including execution, go live and retrospective


+ Support and empower teams to identify milestones, handle dependencies and risks, track deliverables and remove blockers


+ Facilitates cross-functional meetings with internal and external stakeholders to vet thru challenges, develop mitigation plans and update project artifacts


+ Provides regular status updates to leadership by communicating updates, dependencies, escalations, etc.


+ Collaborates with CPSS business partners and Medicaid Program Operations to improve and build repeatable models for future Implementations.


+ Assist in moving top priority initiatives to green while ensuring transparency to the sponsors and across CPSS work streams


+ Interprets Contracts, RFP’s, CMS memos, etc. to consult and guide business implementations

**Required Qualifications:**

+ 5+ years’ project management experience leading large-scale projects, meetings and collaboration across internal and external stakeholders


+ Knowledge of project management tools, change management, dependency management, risk management and when to use them, when not to use them


+ 5+ years’ experience in health care operations industry


+ Core business hours align to Eastern Standard Time (EST)


+ Superior interpersonal and facilitation skills. Ability to quickly build rapport, trust and strong collaboration


+ Ability to contribute consistently and positively in a fast-paced, ever changing environment. Remain flexible and calm in the face of uncertainty and ambiguity


+ Able to exercise independent judgement


+ Excellent organizational, written and oral communications and presentation skills


+ Self-starter and critical thinker


+ Proficient in Microsoft Office applications including Project, Power Point, Visio, Teams, SharePoint and Excel


+ Must have the ability to travel up to 15% based on business need

**Work-At-Home Requirements**

+ WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.


+ A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

**Preferred Qualifications:**

+ PMP certification


+ Advanced Degree


+ Prior Medicaid experience


+ Prior Due Diligence/Acquisition experience


+ Possess solid understanding of how organizational capabilities interrelate across operational work streams


+ Proven ability to influence at all levels of the organizational model


+ Experience developing and managing implementations thru run-out and systems sun-setting phases

**Covid-19 Vaccine Policy**

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

+ Provide proof of full vaccination OR


+ Commit to weekly testing, following all CDC protocols, OR


+ Provide documentation for a medical or religious exemption consideration.

This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work

**Scheduled Weekly Hours**

40
 

Clipped from: https://www.mendeley.com/careers/job/senior-acquisition-integration-professional-medicare-medicaid-remote-8437211?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Position:  Medicaid – Planning & Performance Director – Birmingham – 35237
b”Description SHIFT:
Day Job SCHEDULE:
Full-time Your Talent. Our Vision. At Anthem, Inc., it e2 80 99s a powerful combination, and the foundation upon which we e2 80 99re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company.

Preferred

Location:

Nashville, TN but open to other locations. Responsible for supporting the annual planning, strategy and business change management for a VP/GM. Primary duties may include, but are not limited to:  
* Supports the annual planning efforts and the execution of the 3 year annual business plan that includes internal and external communications and associate engagement activities.  
* Program responsibilities such as executive reporting, project communications, management of issues logs and change requests, facilitating project meetings, managing deliverables and ensuring resolution of escalated issues.  
* Develops and coordinates presentations and materials for executive management meetings, internal and external speaking engagements and meetings.  
* Responsible for the implementation and execution of strategy that includes change management, sponsorship and buy-in and advocacy efforts to get business results.  
* Provides process, project, and change management methodology coaching/consulting support for initiatives including regulatory and mandated projects, health care reform special projects, and corporate initiatives.  
* Leads, identifies, tracks and reports on areas for increased efficiency.  
* Develops, monitors, and tracks metrics supporting budget and spend.  
* Manages variance process, staffing plans, and adds to staff (budget neutral).

Qualifications The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide  e2 80 93 and Anthem approves  e2 80 93 a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate.

Anthem will also follow all relevant federal, state and local laws.

Minimum Requirements:

Requires a BA/BS degree in a related field and a minimum of 7 years of related experience; or any combination of education and experience, which would provide an equivalent background. Preferred

Qualifications:

* Master e2 80 99s degree preferred.  
* Government Healthcare programs experience preferred;
Medicaid experience strongly preferred.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For c2 ae, is ranked as one of the 2020 World e2 80 99s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America e2 80 99s Best Employers for Diversity by Forbes.

To learn more about our company and apply, please visit us heminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Applicants who require accommodation to participate in the job application process may contact [email c2 a0protected] [/cdn-cgi/l/email-protection] for assistance.”

 
 

Clipped from: https://www.learn4good.com/jobs/birmingham/alabama/management_and_managerial/783457152/e/

 
 

The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. In 2020, ODM introduced a new vision for Ohio’s Medicaid program — one that strengthens Ohio’s future and ensures everyone has the chance to live life to its full potential.


Today, more than 90 percent of Ohio Medicaid members are supported by managed care organizations. During the year ahead, ODM will begin implementing a new vision for care; focusing on the individual, a strong partnership among MCOs and the department, and supporting specialization in addressing critical needs.


A program that puts the individual first


They Are


Adopting Governor DeWine’s philosophy of service to Ohioans, ODM embarked on an aggressive effort to redesign its managed care program. The goal is to provide more personal, holistic care and supports for millions of Ohioans served by Medicaid. Listening to feedback from more than 1,100 individuals and organizations we identified five procurement goals that would put the individual front and center of Medicaid’s program and policy decisions.

• Emphasize a personalized care experience,
  
• Improve care for children and adults with complex behavioral health needs,
  
• Improve wellness and health outcomes,
  
• Support providers in better patient care and
  
• Increase program transparency and accountability.
  
  
  

Unless required by legislation or union contract, starting salary will be set at step 1 of the pay range.


Working Title: Managed Care Contract Administrator

Classification: Medicaid Health Systems Administrator 1 (PN 20096540)


Office: Managed Care


Bureau: Managed Care Compliance & Oversight


Job Overview


As the Managed Care Contract Administrator in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities will include:

• Managing program information and conducting analyses to inform and direct policy changes and updates
  
• Conducting evaluations for managed care plans
  
• Performing research and answering questions related to legislative and policy initiatives such as implementation and ongoing assessment of new programs, populations and/or initiatives
  
• Leading on managed care related policy issues, implementations, and targeted reviews
  
• Working with the managed care plans to identify areas of concern
  
• Reviewing and approving policies
  
• Ensuring system updates are implemented timely and accurately, and providing technical assistance when required
  
• Communicating any compliance actions to the assigned Managed Care Plans
  
  
  

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 months experience in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).

• Or 12 months experience as a Medicaid Health Systems Specialist, 65293.
  
• Or equivalent of Minimum Class Qualifications for Employment noted above.
  
  
  

Primary Location


United States of America-OHIO-Franklin County-Columbus


Work Locations


Lazarus 4


Organization


Ohio Department of Medicaid


Classified Indicator


Classified


Bargaining Unit / Exempt


Exempt


Schedule


Full-time


Work Hours


8:00AM – 5:00PM


Compensation


$33.69/hour


Unposting Date


Dec 6, 2021, 11:59:00 PM


Job Function


Health Administration


Job Level


Individual Contributor


Agency Contact Information


HumanResources@medicaid.ohio.gov

 
 

Clipped from: https://www.linkedin.com/jobs/view/managed-care-contract-administrator-medicaid-health-systems-administrator-1-at-ohio-department-of-medicaid-2799424605/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Location: Company:

Description
SHIFT: Day Job
SCHEDULE: Full-time
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health benefits companies and a Fortune T

 
 

Clipped from: https://www.adzuna.com/details/2658272004?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

UnitedHealth Group is a company that’s on the rise. We’re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn’t about another gadget, it’s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life’s best work.(sm)


If you are located in FL or GA, you will have the flexibility to telecommute* as you take on some tough challenges.


Primary Responsibilities

• Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
  
• Develop and execute strategies for a function or discipline that span a large business unit or multiple markets/sites
  
• Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
  
• Direct others to resolve business problems that affect multiple functions or disciplines
  
• Direct work that impacts entire functions and/or customer accounts (internal or external)
  
  
  

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


Required Qualifications

• 8+ years of management experience in a network management-related role handling complex network providers with accountability for business results
  
• 5+ years of experience developing product pricing and utilizing financial modeling in making rate decisions
  
• 5+ years of experience with provider contracting
  
• 3+ years of experience developing and managing a medical cost and administrative budget
  
• Expert level of knowledge of Medicare Resource Based Relative Value System (RBRVS), Diagnosis Related Groups, Ambulatory Surgery Center Groups, etc.
  
• Undergraduate degree or equivalent experience
  
  
  

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.


Careers at UnitedHealth Group. We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these select few, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks. And we offer a world of rewards and benefits for performance. We believe the most important is the opportunity to do your life’s best work.(sm)

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
  
  
  

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Medicaid, Provider Network Contracting, Vice President, Community & State, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote, Tampa, FL, Miramar, FL, Jacksonville, FL, Atlanta, GA, Tallahassee, FL

 
 

Clipped from: https://www.linkedin.com/jobs/view/vice-president-community-state-medicaid-provider-network-programs-se-region-at-unitedhealthcare-2799470437/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

 

Responsible for researching, analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues for the Health Plan and requires expert knowledge of all systems, tools and processes.

Primary duties may include, but are not limited to: 

• Receiving and responding to state or federal regulatory complaints related to claims
  
• Managing health plan dispute escalations
  
• Quality review of various dispute outcomes
  
• Managing complex system issues
  
• Managing state updates
  

Qualifications

Requirements: 

• BA/BS degree
  
• Minimum of 5 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry
  
• Or any combination of education and experience which would provide an equivalent background
  

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

 
 

Clipped from: https://anthemcareers.ttcportals.com/jobs/7886612-medicaid-state-operations-analyst?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic