Business Analysis

Business Analysis
Empresa:

(Confidencial)


Lugar:

San Juan


Área:

Otros

Business Analysis

Detalles de la oferta

Descripción del Empleo:
• Supports program policy data analysis. • Review of MMIS Operational and DSS reports.
• Review contract Service Level Agreements (SLAs) and Key Performance Indicators (KPIs).
• Research and analysis of Change Requests, Work Orders and Defects.
Requisitos:
• Bachelor's degree • Healthcare Industry background • Identifies aberrant billing practices
• Educates those who have improperly billed the Medicaid program
• Recovers overpayments, recommends sanctions for those who abusively bill Medicaid
• Assists in criminal investigations when appropriate
• Detects areas where Medicaid regulations and/or policy may be modified, administers
the provisions of the False Claims Acts
• Conducts provider training on fraud, waste, abuse, and improper payments, and
prevents fraud and abuse from occurring.
• Medical experience in hospital, clinic, mental health or pharmacy
• Experience with utilization review procedures and techniques
• Familiar with medical and surgical diagnoses codes and procedures codes
• Experience in statistical data collection and interpretation


Fuente: ClasificadosOnline


Área:

  • Otros / Otros

Requisitos

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