Medicaid (PPS) Provider Hospital Reimbursement Methodologies Analyst
Company: Humana
Location: Louisville
Posted on: November 19, 2023
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Job Description:
DescriptionThe Medicaid (PPS) Provider Hospital Reimbursement
Analyst also known as a Senior Business Intelligence Engineer will
be an integral part of the Pricer Business and System Support team
responsible for administering complex Medicaid provider
reimbursement methodologies. The associate will support existing
Medicaid business and expansion into new states. The business needs
of the team continue to evolve and grow, changing the composition
of the team as it expands to accommodate the increased
responsibilities.ResponsibilitiesResponsibilities: - The Senior
Business Intelligence Engineer will be primarily responsible for
implementation, maintenance and support of Medicaid provider
reimbursement for hospitals and facilities. - They will work
closely with IT, the pricing software vendor, CIS BSS, Medicaid
operations, claims operations, and other business teams involved in
the administration of Medicaid business at Humana. - The Senior
Business Intelligence Engineer will develop and maintain expertise
in Medicaid reimbursement methodologies rooted in complex grouping
concepts (EAPG, APR-DRG, MS-DRG, etc). - This role is within the
Integrated Network Payment Solutions (INPS) department which falls
under the Provider Process and Network Organization (PPNO).
The Senior Business Intelligence Engineer will be responsible
for:
---Preferred Qualifications
Location: Remote United States
As part of our hiring process for this opportunity, we will be
using an interviewing technology called Modern Hire to enhance our
hiring and decision-making ability. Modern Hire allows us to
quickly connect and gain valuable information from you pertaining
to your relevant skills and experience at a time that is best for
your schedule
To ensure Home or Hybrid Home/Office employees' ability to work
effectively, the self-provided internet service of Home or Hybrid
Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10
Mbps is recommended; wireless, wired cable or DSL connection is
suggestedSatellite, cellular and microwave connection can be used
only if approved by leadershipEmployees who live and work from Home
in the state of California, Illinois, Montana, or South Dakota will
be provided a bi-weekly payment for their internet expense.Humana
will provide Home or Hybrid Home/Office employees with telephone
equipment appropriate to meet the business requirements for their
position/job.Work from a dedicated space lacking ongoing
interruptions to protect member PHI / HIPAA informationScheduled
Weekly Hours40Pay RangeThe compensation range below reflects a good
faith estimate of starting base pay for full time (40 hours per
week) employment at the time of posting. The pay range may be
higher or lower based on geographic location and individual pay
decisions will vary based on demonstrated job related skills,
knowledge, experience, education, certifications, etc.$78,800 -
$108,500 per yearThis job is eligible for a bonus incentive plan.
This incentive opportunity is based upon company and/or individual
performance.Description of BenefitsHumana, Inc. and its affiliated
subsidiaries (collectively, "Humana") offers competitive benefits
that support whole-person well-being. Associate benefits are
designed to encourage personal wellness and smart healthcare
decisions for you and your family while also knowing your life
extends outside of work. Among our benefits, Humana provides
medical, dental and vision benefits, 401(k) retirement savings
plan, time off (including paid time off, company and personal
holidays, volunteer time off, paid parental and caregiver leave),
short-term and long-term disability, life insurance and many other
opportunities.
Keywords: Humana, Louisville , Medicaid (PPS) Provider Hospital Reimbursement Methodologies Analyst, Professions , Louisville, Kentucky
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