Medicare MACs Lead SME - CMS Operations & Policy
Peraton
Peraton is seeking a highly experienced Subject Matter Expert (SME) specializing in Medicare Administrative Contractors (MACs) to support mission‑critical CMS operations across the Medicare Fee‑For‑Service (FFS) ecosystem. As the nation’s leading mission capability integrator and trusted partner, Peraton relies on SMEs to provide authoritative knowledge on MAC functions and CMS interfacing. The role requires deep program operations experience, data‑driven analysis, and the ability to guide #J-18808-Ljbffr Peraton
$146k - $234k
...Subject Matter Expert (SME) specializing in Medicare Administrative Contractors (MACs) to support mission‑critical CMS operations across the Medicare Fee‑... ...ecosystem. As the nation’s leading mission capability... ...Background in Medicare policy, health care administration...OperationsCmsPolicyContract workFor contractorsLocal areaShift work$142.3k - $195.7k
...our caring communityA Lead Enterprise Salesforce Architect... ...client's process/operations issues, through needs... ...Personalization, AdTech, CMS and analytics.... ...of life for people with Medicare and Medicaid, families,... ...Opportunity EmployerIt is the policy of Humana not to discriminate...OperationsCmsPolicyFull timeTemporary workWork at officeRemote workWork from homeHome office$125k - $130k
...technology to deliver industry-leading digital solutions. Synechron’... ...experienced Senior Firewall SME / Team Lead to provide... ...and efficient network security operations. Key Responsibilities Provide... ...Switching NAT Security Policies and Access Controls...OperationsPolicyFull timeTemporary workRemote workFlexible hours- Credentialing Lead The Credentialing Lead is responsible... ...with NCQA, TJC, CMS, State regulations, organizational policies, and delegated credentialing... ...boards, OPMC, OMIG, OIG/SAM, Medicare OptOut) to ensure prompt... .... Leadership & Operational Oversight Serve as a key...OperationsCmsPolicyFull timeMonday to Friday
- ...Inc. (“Thalle”) is currently seeking a Lead Estimator. The Lead Estimator will report... ...coordinates with the Procurement Lead and Operations. Essential Duties and Responsibilities... ...escalating tension. Adheres to all company policies, safety requirements, and ethical...OperationsCmsPolicyTemporary workWork experience placementFor subcontractorWork at officeLocal areaAfternoon shift
$220k - $305k
...teams across the organisation, including operations, communications, subject matter experts,... ...and technical upload of content into the CMS as the final checkpoint before publication... ...legal requirements. See also Google's EEO Policy and EEO is the Law. If you have a...OperationsCmsPolicy- ...States The Opportunity A top 10 leading ENR contractor is seeking an accomplished... .... Combining strategic leadership with operational and commercial accountability, the successful... ...with the final role level and company policy. The Impact This is an opportunity...OperationsCmsPolicyFull timeContract workFor contractorsWork at officeLocal area
- ...Senior Financial Analytics Professional to manage data for day-to-day operations, strategic planning, and performance issues. You will lead data analysis, validation, and CMS reporting for Medicare Advantage Supplemental Benefits, owning data logic and supporting regulatory...OperationsCmsRemote job
- ...corporate clients on healthcare policy, strategy, and market analysis... .... Areas of focus include Medicare, Medicaid, commercial insurance... ...clinical compliance. Marwood operates at the intersection of Wall Street... ...with both UB-04 and CMS 1500 claims data, as well as understanding...OperationsCmsPolicyWork at officeLocal areaRemote work
- ...Eligibility Specialist (Membership Operations Specialist) plays a vital... ...payment reconciliation for Medicare Advantage members. This position... ...notices and transactions to CMS. Payment Reconciliation:... ...regulations, as well as internal policies and procedures. Perform other...OperationsCmsPolicyContract work
$73.8k - $218.8k
...expertise, we help our clients operate at the speed of life through... ...’s voice and purpose. We help leading brands create and deliver the... ...Oversee and serve as functional SME for integration points, workflows... ...approaches such as headless CMS and Edge Delivery Services (...OperationsCmsTemporary workLive inWork at officeLocal area$27.29 - $31.55 per hour
...Head Coach Community Manager across studio operations, client experience, sales, and coaching.... ...implementing company-wide strategies, policies, procedures, and overall maintenance... ...managing outreach and follow up for client leads within [solidcore]'s sales platform, phone...OperationsPolicyHourly payPermanent employmentFull timePart timeLocal areaFlexible hoursDay shiftAfternoon shift$151.6k - $208.4k
...hands-on, technically proficient Lead Product Manager to lead the... ...business units to map their operations end to end (service design),... ...quality of life for people with Medicare and Medicaid, families,... ...Opportunity EmployerIt is the policy of Humana not to discriminate...OperationsPolicyFull timeTemporary workWork at officeRemote workRelocationShift work3 days per week- ## Lead Financial AccountApply: New York: Full time: Posted 3 Days... ...including mortgage loans.* SME level cash flow understanding.... ...Financial Condition and Results of Operations (MD&A) in the 10-Q/K.*... ...reporting issues, trends, and policies to be applied to applicable transactions...OperationsPolicyFull timeWork at office
- ...critical in enabling onshore revenue cycle operations to optimize pro-fee billing and revenue... ..., and insurance denial trends for client policy and procedure improvement Maintainup to date... ..., Coding Auditor, QA Analyst, or Coding SME strongly preferred Experience with...OperationsCmsPolicyRemote workFlexible hours
- ...What Should You Expect? The Team Lead's primary role entails... ...escalation for clients and internal Operations Teams; Support Relationship... ...prioritization, resource planning, and SME support; Ensure compliance to... ...Equal Employment Opportunity policy, we do not discriminate on the...OperationsPolicyContract workWork experience placementWork at officeFlexible hours
- ...Business Analyst / Behavioral Health SME Location: USA Remote Employment Type... ...deep knowledge of Behavioral Health operations, end-to-end payer processes, healthcare... ...regulations, including MHPAEA, Medicare/Medicaid, HIPAA, CMS, and state-specific requirements Familiarity...OperationsCmsContract workRemote work
- ...stakeholders, conduct investigations, and help with auditing and policy governance. The ideal candidate has 5+ years in healthcare compliance, strong communication, and experience interpreting HIPAA, CMS, and federal/state laws. #J-18808-Ljbffr Meridian Street Capital...CmsPolicyRemote job
$140k - $200k
Team Lead, Android Core Product - New York, NY, USA Remote Remote... ...include its iOS app, Android App, Mac App, Chrome Extension, and Web... ...Equal Employment Opportunity policy,we do not discriminate on the... ...in a United States military operation for which an Armed Forces service...OperationsPolicyFor contractorsWork at officeRemote workShift workNight shift- ...approach. The Sr. Manager, Patient Experience will lead CAHPS administration, analyze feedback, and deliver actionable insights to partners and CMS programs. You will collaborate across Quality, Analytics, and operations to ensure accurate reporting, timely surveys, and...OperationsCms
$180k - $220k
...More than 900 of the world's leading financial institutions and fintechs... ...Marketing, and Product Operations teams to ensure customers have... ...filling documentation gaps with SME and tooling support, and deliver... ...PTO and flexible work policy Employee stock options Medical...OperationsPolicyInterim roleWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayFlexible hours3 days per week$82k - $111k
...trusted advisor for client operational representatives;... ...client strategic plan and leads tactical execution. Promotes policy adoption and acceleration... ...participates as an operational SME in department and corporate... ...experience, required. Knowledge of CMS guidelines and other...OperationsCmsPolicyImmediate startRemote work- ...with accuracy and urgency, safeguarding patient privacy under HIPAA and company policies. The role emphasizes quality, confidentiality, and timely response across complex records. The Lead SME will mentor colleagues, handle escalations, assist with onboarding, and...Policy
- ...tailored solutions that drive operational success, sustainability, and... ...determine compliance with Medicare coverage, coding, and payment... ...) or prior involvement with MAC/RCD/CMS program integrity.... ...Equal Employment Opportunity policy, we do not discriminate on the...OperationsCmsPolicyRemote jobContract workTemporary workFor contractors
$94.9k - $130.5k
...Program Integrity (PI) Contract Lead is an important member of the... ...involve resource allocation, operational approach, tactical execution,... ...documents such as contracts, policy and operations manuals High... ...programs to include VA, Medicare and/or TRICARE Previous experience...OperationsPolicyWeekly payOngoing contractFull timeContract workTemporary workWork at officeRemote workWork from homeHome office$86.7k - $151.7k
...seeking an experienced Global Web Publishing Lead to join the ASCS Global Websites team.... ...Publishing Lead, you will own publishing operations across the ASCS web ecosystem — driving... ...management and content management systems (CMS)- Experience in a multi-language...OperationsCmsFor contractorsWorldwideFlexible hours- CorVel Corporation seeks a Payment Integrity Analyst III - QA Analyst to lead the PPI team and conduct audits per CMS guidelines and client policy. The role requires strong clinical judgment, attention to detail, and expertise in revenue cycle processes. This remote position...CmsPolicyRemote job
- Intuit, via SelectTime, seeks a Lead Tax Processor and SME to own highly complex tax escalations and govern SOPs. You will mentor the team, drive compliance, and provide risk-informed recommendations in cross-functional settings. The role is remote with a minimum of 20...OperationsRemote work
- ...are seeking an experienced Healthcare Lead Business Analyst with strong payer?... ...US healthcare regulations (HIPAA, CMS, ACA) and payer operational guidelines. Participate in Agile/... ...Experience working with State Medicaid or Medicare programs Prior experience...OperationsCms
- Intuit, Inc. is seeking a Lead Tax Processor and SME for Payroll Tax Operations. This technical leadership role serves as the primary go-to resource for the team, owning the most complex escalations and governing SOPs and knowledge base content. You will coach staff, drive...OperationsPart timeFlexible hours
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