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Online Resumes with "Medicaid Medicare"
Business Analyst
SUMMARY * 10+ years of experience as a Business Analyst/Business System Analyst in industry domains including Banking, Health e, Financial, Insurance, and Retail. * Skilled Business Analyst in PMO environment who leads projects to successful completion and acts as liaison between business users and technical development teams to bridge gaps. * Strong understanding of financial valuation concepts and various capital market i...
Tags for this Online Resume: Microsoft Visio, VISIO, Integrate, Legacy, Management, Planning, Business Analysis, Business Analyst, Business Requirements, Data Mapping
Quality Assurance Specialist - 4 Years of Experience - Near 90245
Professional Summary * Experience and profound understanding of Software Development Life Cycle SDLC and Software Testing Life Cycle STLC, including the following: Requirements gathering, risk analysis, project planning, scheduling, testing, defect tracking, management, and reporting. * Expertise in various Testing methodologies like Functional Testing, Integration Testing, Regression Testing, System Testing, System Integra...
Tags for this Online Resume: Integrate, Quality Assurance Tester, Test, Applications, Integration Testing, Quality, Test Cases, Test Scripts, Documentation, Its
Business Analyst
SUMMARY * 10+ years of experience as a Business Analyst/Business System Analyst in industry domains including Banking, Health e, Financial, Insurance, and Retail. * Skilled Business Analyst in PMO environment who leads projects to successful completion and acts as liaison between business users and technical development teams to bridge gaps. * Strong understanding of financial valuation concepts and various capital market i...
Tags for this Online Resume: VISIO, Microsoft Visio, Business Analysis, Business Analyst, Business Requirements, Integrate, Legacy, Management, Planning, Structured Query Language
Marketing manager
KEY QUALIFICATIONS - OVER 21 YEARS EXPERIENCE IN MEDICARE, MEDICAID, AND MEDICARE-MEDICAID PLANS (MMP) Profit & Loss Accountability * Product Implementation / Mgt * Marketing & Communication Strategy * Product Strategy & Development * Business Development * Collateral / Campaign Development SUMMARY OF PROFESSIONAL EXPERIENCE CAPTIAL BLUECROSS HARRISBURG, PA 17050 SEPTEMBER 2015 - PRESENT DIRECTOR OF MEDICARE PRODUCT DEVELOP...
Tags for this Online Resume: Cms, Management, Market Research, Networking, Research, Pricing, Benefits, Marketing Management, Policies and Procedures, Product Development
Case Management Manager - 9 Years of Experience - Near 70441
Carrington Place of Baton Rouge (Social Service Director-assisting families and residents with different services and basic information on insurance coverage Medicaid and Medicare information) - December 31 2013 - Now
Tags for this Online Resume: Nursing, Therapy, Home Health, Insurance, Medicare, Novell Netware, Pharmaceutical Industry, Services
Learning & Development Stategist - 20 Years Experience
Strategic * Learning & Development SME on numerous service-design and systems change initiatives, leveraged Design Thinking to identify business opportunities and reframe legacy barriers to success. * Launched new service initiatives and established long-term consultative internal partnerships. * Managed project budget and team of designers and vendors implementing multiple innovation programs customized to identify new mar...
Tags for this Online Resume: Learning and Development, Training, Instructional Design, Organizational Development, Adult Learning, Training, Consulting, Layout, Legacy, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Visio, Microsoft Word
Business Analyst
Experienced with EDI files 834,835,270/271, 276/277 file formats * Mapped HIPAA 4010 and 5010 differences * Read and interpreted 997/999 acknowledgments * Facilitated the setup of new trading partners, including planning, project management, testing, documentation, and implementation. * Developed and maintained functional specifications for new / existing applications needed to maintain/enhance EDI processing and address th...
Tags for this Online Resume: EDI, Electronic Data Interchange, Health Insurance Portability And Accountability Act, Management, Software, Systems Analyst, Health Care Industry, VISIO, Agile, Audit
Manager/Director Provider Relations
Experience Summary * 5 years of experience in Medicaid Medicare Marketing * 17 years of Provider Relations, Network Development/Management and Contracting * 10 years Managerial Experience in Provider Relations & Business Development * Full Knowledge of CMS & NCQA Regulatory Guidelines. Completed Six Sigma Seminar. * Performed QAR and STAR data analysis & CQI projects initiatives.
Tags for this Online Resume: Complaints, Services, Management, Network Management, Networking, Referrals, Business Development, PEDIATRIC, Quality Assurance, Test
Application Support
SUMMARY: Detail orientated, hardworking, dedicated Professional with over 25 years of Health Care experience with FACETS, AMISYS 3000, AMISYS Advanced configuration and testing, troubleshooting Claims, 10 years of building products and benefits, and 5 years configuring pricing which includes 3 years of NetworX . Demonstrated strengths include strong analytical skills and complex problem solving capabilities: Works well with...
Tags for this Online Resume: FACETS, Call Center, Insurance, Test, Test Plans, Benefits, Pricing, Test Cases, Acceptance Testing, Business Requirements
Accountant
SUMMARY: Accounting professional with broad experience and knowledge in accounts receivable, accounts payable, and general ledger providing regular reports. Diverse performance in all areas of accounting. Independent/team player, detailed-oriented, multi-tasked, meet deadlines, self-motivated, accurate, dependable, adaptable, quick learner, ethical, loyal, communicative, enthusiastic, strong qualities in organizational skil...
Tags for this Online Resume: Accounts Payable, Credit Cards, Payroll, ADM, Benefits, Reconciliations, Quick Books, Quickbooks, Accounts Receivable, Bookkeeper
Software Sales Representative - 20 Years of Experience - Near 32034
SUMMARY Successful sales management and marketing professional with substantial start-up and new business development experience, over twenty-five years national healthcare experience serving top corporate clients, expertise in enterprise managed care information services and software, SaaS, EDI, outsourcing services (ITO, BPO, ITIS), business consulting services, Patient engagement and wellness, Plan Benefit Management, va...
Tags for this Online Resume: Consulting, Outsourcing, Health Care Industry, Services, Business Development, EDI, Electronic Data Interchange, Insurance, New Business Development, Sungard
Manager - 20 Years of Experience - Near 33647
An accomplished operations and account manager in the healthcare and insurance industries. * A diverse background that includes client and vendor services implementation and project management employee training claims and call center operations system migration and testing compliance and regulatory affairs and government managed care programs (Medicaid Medicare ACA)
Tags for this Online Resume: Insurance, Billing, Benefits, Program Manager, Root Cause Analysis, Cms, Medicare, Account Manager, Audit, Call Center
