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Conduct Medicare, VA, and Medicaid payment policy research and analysis, develop strategic recommendations. Broad knowledge of Medicare, managed care, third party payers, and Medicaid required; knowledge of Medicare rulemaking process, Durable Medical Equipment benefit category preferred.
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2+ years of experience in experience in Medicaid programs, D-SNP programs and/or Managed Care Organizations (MCOs) Intermediate or higher level of proficiency with MS Office (Word, Outlook, PowerPoint) Resides in the District of Columbia, Maryland or Virginia Preferred Qualifications: Experience in project management, program management and/or event management Experience and knowledge of health care and managed care delivery systems, including quality improvement and utilization mgmt.
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Extensive knowledge of Medicare payment policy, Medicare Advantage, and/or Medicaid. The candidate should have knowledge and experience with federal agencies, including but not limited to the Centers for Medicare and Medicaid Services (CMS.
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Establish regular communication and a working relationship with Medicaid MCOs for network development and to monitor performance, stay attuned to market changes and MCO and stakeholder managed care contract priorities.
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Researching, reviewing, and providing interpretation on federal and local rules and Medicaid policies. Providing schedules, analysis, work papers, and explanations for the Medicaid Year End Accrual.
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Prior experience supporting the Centers for Medicare and Medicaid Services (CMS). Experience with Atlassian tools, including Jira or Confluence. creating visuals and dashboards using Tableau, Power BI, or similar tools.
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Fully licensed and accredited Laboratory by The College of American Pathologists (CAP), Government of the District of Columbia, the Center for Medicare and Medicaid Services (CLIA) and U.S. Department of Health and Human Services (Medicare.
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Are you looking for a new challenge in a critical strategic role designed to optimize access to ViiV Healthcare products across a variety of payers (AIDS Drug Assistance Program, Fee for Service Medicaid, Managed Medicaid, Medicare Part D, PBMs and PBAs as well as assigned Commercial Accounts within the region.
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Principal Research Scientist - Health Care Program Integrity and Oversight: Medicare & Medicaid Programs. Principal Research Scientist - Health Care Program Integrity and Oversight: Medicare & Medicaid Programs.
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Experience with Atlassian tools, including Jira or ConfluenceKnowledge of basic business analysis, such as assessment of risk, strategic planning, and quality management and reporting. 5+ years of experience in management or IT5+ years of experience supporting delivery of multi-system solutions for healthcare systems as a product owner responsible for managing and delivering system requirements, testing, change management, and risk management.
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Advocacy - Leading voice with Administration officials to improve federal rules and regulations affecting Medicare, Medicaid, Duals, and CHIP. Work in close partnership with lobbying team to support congressional education and engagement, including federal lobbying activities on Capitol Hill, as well as with state officials focused on Medicaid solutions.
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A successful applicant will have a sophisticated understanding of payment and delivery system transformation; health system and organized medicine strategy; Medicaid policy, redesign and innovation; state health policy and strategy; and life sciences market access, coverage and reimbursement strategies.
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As a cyber mission specialist, you will help develop new business with the Centers for Medicare and Medicaid Services (CMS) based on your experience and understanding of cybersecurity Federal landscape.
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Healthcare knowledge within a claims processing environment preferably in Medicaid. ESI is seeking a Data Analyst who will be responsible for performing research and requirement analysis, creation and design of mapping documents, and presenting findings to appropriate team members, clients and vendors.
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Assures staff and program goals are met in accordance with established program policies and procedures, regulations and guidelines issued by the District of Columbia Department of Behavioral Health and Department of Health, Medicaid Program and other applicable laws and regulations and professional standards.
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medicaid job in Bethesda, MD
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