Senior Healthcare Claims Policy Architect
US101 Guidehouse Inc.
Guidehouse Inc. is seeking a Healthcare Claims Payment Policy expert to draft, standardize, implement, and maintain payment policies in a large payer environment.
You will translate research and policy decisions into operational guidance for claims adjudication and stakeholder understanding. The ideal candidate has extensive reimbursement policy experience, including Medicare, Medicaid, TRICARE, and commercial payer policies, with strong data interpretation and cross‑functional collaboration
#J-18808-Ljbffr€76.22k per year
...sungen mit uns gemeinsam um.Wir suchen einen Business Architect (m/w/d)zur Verstärkung unseres Bereiches Healthcare und Life Sciences in Österreich. Healthcare in Ö... ...as false websites, or through unsolicited emails claiming to be from the company. These emails may request...SeniorClaimsFull timeFlexible hours$120k - $150k
Join AIR as a Senior Quantitative Researcher - CMS Innovation Center... ...(CMMI) Evaluations with our Healthcare Innovations team. Our team... ...research, Medicare and/or Medicaid claims analyses, analysis of EHR... ...of Medicare payment policy, Medicare Advantage, and/or Medicaid...SeniorPolicyClaimsFull timeFixed term contractH1bWork at officeLocal areaRemote work- ...Join VHC Health as Senior Vice President/Chief Legal Officer! VHC Health, a premier healthcare provider, is seeking a dynamic and experienced... ..., Stark Law, and the False Claims Act, while also overseeing... ...will be essential in shaping policies and providing counsel to...SeniorPolicyClaimsContract workFor contractorsFlexible hours
$98k - $163k
...Do:We are seeking Consultants with foundational experience in healthcare claims data, including exposure to validating, loading, processing,... ...potential fraud, and uncovering patterns that inform payment policy and cost-saving strategies.Demonstrate working knowledge of claims...SeniorPolicyClaimsFull timeWork at officeLocal areaRemote workFlexible hours2 days per week3 days per week$126k - $145k
...Blu Omega is seeking a Senior Health Analytics Consultant to support... ...analytics and health policy initiatives. This role is responsible... ...and translating large-scale healthcare data into actionable insights... ...Conduct Medicaid claims analysis, including encounter...SeniorPolicyClaimsTemporary workRemote work$172.2k - $236.9k
...Principal Product Owner / Architect is a dual-mandate... ...Humana Military. This senior individual contributor... ...ownership experience within healthcare IT; demonstrated... ...principles, bias mitigation, policy enforcement, and... ...dispensing systems and PBM claims engines....PolicyClaimsFull timeTemporary workApprenticeshipImmediate start$90k - $120k
...are seeking a highly motivated Senior Associate with at least four... ...pricing or deep healthcare industry expertise. The ideal... ...ability to translate complex policy and pricing frameworks into actionable... ...with government or commercial claims data.Key ResponsibilitiesAnalyze...SeniorPolicyClaimsFull timeWork at officeWork from homeFlexible hours$210k - $240k
...including: Subsidized personal healthcare coverage : Medical, Dental &... ...reimbursement The AVP, Senior Counsel role will primarily... ...’s internal contracting policies, playbooks, and templates, including... ...and Anti-Kickback, False Claims Act, corporate practice of medicine...SeniorPolicyClaimsFull timeContract workFlexible hours- ...CACI International Inc. in Arlington, VA is seeking a Senior Mac Mobility Engineer to lead enterprise Apple endpoint management for a... ...baselines. The role emphasizes automation, RBAC, enrollment, and policy development, with scripting in Bash/Zsh/PowerShell and API...SeniorPolicy
$122.7k - $182.2k
...02This OpportunityWSP is currently initiating a search for a Senior Architect for our Arlington, VA office. Be involved in projects with WSP... ...and conduct, and adhere to WSP’s Code of Conduct and related policies and procedures.Perform additional responsibilities as...SeniorPolicyWork at officeLocal areaFlexible hoursNight shift- ...intelligence. Guided by our ambition — “Architect the Autonomous Enterprise, Develop and Deliver... ...migration from legacy approachesAs a senior member of the SAP architecture practice,... ...eligibility rules set in the SAP Referral Policy. Specific conditions may apply for roles...SeniorPolicyPermanent employmentFull timeLocal areaWorldwideFlexible hours
$122.7k - $182.2k
...Opportunity WSP is currently initiating a search for a Senior Architect for our Arlington, VA office. Be involved in projects with WSP... ...and conduct, and adhere to WSP's Code of Conduct and related policies and procedures. Perform additional responsibilities as required...SeniorPolicyWork at officeLocal areaNight shift$235k - $260k
...Senior Corporate Counsel, ComplianceOur mission is to detect cancer... ...cancer care.We are a healthcare company, pioneering new technologies... ...flexible work arrangement policy requires that a minimum of 40... ...Anti-Kickback Statute, False Claims Act, EKRA, anti-bribery and anti...SeniorPolicyClaims16 hoursFull timeWork at officeLocal areaWorldwideFlexible hours- ## Senior Red Hat Architect - Hybrid Cloud and DataAnnapolis Junction, Chantilly, WASHINGTON, Reston... ...employees may have access to:- Healthcare benefits including medical & prescription... ...bonding leave in accordance with IBM Policy, and other Paid Care Leave programs....SeniorPolicyFull timeTemporary workPart timeWorldwide
- ...’s designers and project managers, ensuring high-quality designs and coordinated execution across projects, while upholding LDI’s policies and standards. Responsibilities include developing the group’s business plan, building client relationships as a Sponsor, negotiating...SeniorPolicy
- ...support the PlainID Authorization Platform for enterprise clients. You will work closely with client IT teams to model roles and policies, integrate with existing IAM ecosystems, and deliver proactive support. Candidates should have 8+ years in IAM, strong scripting...SeniorPolicy
- EY is seeking a Senior IAM Consultant to design, engineer, maintain, and troubleshoot a broad range of Enterprise Employee Solutions... ...professionals to translate business requirements into technical designs, implement policies, and guide client engagements. #J-18808-Ljbffr EYSeniorPolicy
- ...us develop game-changing, high-quality solutions. As a Senior Lead Architect at JPMorganChase within Corporate Technology’s Enterprise... ...and governance with architecture decision records and policies. Create durable, reusable software frameworks that improve...SeniorPolicy
- .../ Attributes Experience as a senior Oracle DBA, Oracle Architect, or similar role. Experience with... ...created pursuant to the Alaska Native Claims Settlement Act, in accordance with... ...STATEMENT Additionally, it is our policy to select, place, train and promote...PolicyClaimsContract workLocal area
$150k - $170k
...Title: Senior Director, Revenue Operations Reporting to: Chief... ...required for a rapidly growing healthcare technology company while also... ...information security policies and protect all sensitive information... ..., 4.4 billion total annual claims, and 1.8 million healthcare professionals...SeniorPolicyClaimsCasual workLocal areaRemote work- ...finesse of a trusted advisor. In this role, you’ll wear both your architect and consultant hats—crafting smart, scalable integrations in... ...copy of the Accenture Equal Opportunity and Affirmative Action Policy StatementAccenture is an EEO and Affirmative Action Employer of...SeniorPolicyWork experience placementLive inWork at officeLocal area
$97.7k - $152.7k
...design firm in the Government, Commercial, Healthcare, Data Center and University sectors. We... ...here at Jacobs .We are seeking an architect who brings a natural curiosity and growth... ...U.S. Personalized Paid Time Off (PPTO) policy for full-time salaried/exempt employees,...PolicyFull timeContract workWork at officeLocal areaRemote workWorldwideOverseas2 days per week- ...Senior Contract SpecialistFocus: VA, VAAR, VHA Procurement Manual, FAR-based acquisition... ...Develop acquisition strategies aligned with VA policy, VAAR, and VHA PM requirements.Draft,... ...: modifications, funding actions, REAs, claims, CPARS, and closeout.Ensure compliance with...SeniorPolicyClaimsContract work
$126k - $158k
...HEOR/RWE Senior Data ScientistADVI Health: Expert Advice. Clear Vision.Since... ...complex intersection of life sciences/healthcare innovation, economics, policy, and patient impact. Our aim is to... ...including Medicare and Medicaid claims to uncover insights that directly inform...SeniorPolicyClaimsTemporary workImmediate startWorldwide$90k
...Medtronic is a global leader in healthcare technology with a Mission to... ...exciting opportunity for a Senior Monitoring Sales Representative... ...receive a suspicious message claiming to be from Medtronic, do not... ...Opportunity It is the policy of Medtronic to provide equal...SeniorPolicyClaimsH1bWork at officeLocal areaImmediate startRemote workFlexible hours$144k - $329.1k
...opportunity We’re hiring an experienced agent Lead AI Software Architect that is an expert in designing and implementing AI memory... ...an engagement, project or year. Under our flexible vacation policy, you’ll decide how much vacation time you need based on your own...SeniorPolicyTemporary workSummer holidayFlexible hours$130k - $160k
...care. With human-centered, healthcare-relevant, and value-based... ...care. Requirements The Senior Quantitative Researcher, Alternative... ...model design documents and policy goals into operational... ...using Medicare and Medicaid claims, enrollment, and programmatic...SeniorPolicyClaimsFull timeRemote work$144k - $329.1k
...The opportunity We're hiring an experienced Lead AI Software Architect that to lead a team of domain architect experts in designing... ..., state management/persistence, execution environment control, policy definition and application, multiagent API and anomaly detection...SeniorPolicySummer holidayFlexible hours$75k - $80k
...(PPAF) seek a responsible and dedicated Senior Payroll Specialist. This job reports to the... ...the internal repository of payroll policies, procedures and payroll project design and... ...tax compliance. Responds to unemployment claims. Other duties as assigned Engagement Partner...SeniorPolicyClaimsLocal area- Senior Programmer Analyst ProSidian Seeks a Senior Programmer Analyst... ...critical issues related to healthcare and quality which are of... ..., legislative bodies, health policy makers and other health professionals... ...surveys, discharge and claims database. Other tasks may include...SeniorPolicyClaimsContract work
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