[Remote] Medicaid Provider Hospital Reimbursement Methodologies Analyst at Humana

The Medicaid Provider Hospital Reimbursement Methodologies Analyst will implement, maintain, and support Medicaid provider reimbursement for hospitals and facilities. Responsibilities include researching state-specific Medicaid reimbursement methodologies, developing expertise in complex groupers, and reviewing Medicaid RFPs and state contracts. The analyst will support new Medicaid pricer implementations by reviewing vendor specifications, identifying system changes, assisting with requirements development, and executing test plans. They will also perform ongoing maintenance, quality assurance, and compliance for Medicaid pricers, determine root causes of issues and develop solutions, work with IT and vendors to resolve problems, develop policies and procedures, identify automation opportunities, and research and resolve provider reimbursement inquiries.