ZipRecruiter

Log In

1

Medicare Program Analyst Jobs in Arkansas (NOW HIRING)

Pafford EMS

Cash Posting Analyst

Hope, AR · On-site

... from Medicare, Medicaid, commercial insurance carriers, healthcare facilities, attorneys, and ... Participate in staff meetings, training programs, and departmental projects. * Assist with ...

Nutex Health

Support audit preparation and documentation requests related to quality programs. * Analyze trends ... Experience with Medicare Advantage and/or Medicaid quality programs. * Experience working with ...

The Blossoms

MDS Coordinator

Little Rock, AR

$32.75 - $42/hr

Completion of the 100 day Medicare Part A and Managed Care Log * Completion of the Weekly Medicare ... Printing and Analysis of the Quality Measure/Quality Indicator Reports * Participation in the QI/QM ...

The Blossoms

MDS Coordinator

Little Rock, AR · On-site

$32.75 - $42/hr

Completion of the 100 day Medicare Part A and Managed Care Log * Completion of the Weekly Medicare ... Printing and Analysis of the Quality Measure/Quality Indicator Reports * Participation in the QI/QM ...

Unity Health

Radiology Coder, FT

Searcy, AR · On-site

$16.25 - $21.75/hr

... workshops, in-service programs, and updates from CMS, CPT, ICD-10-CM, HCPCS, Medicare ... Associate needs considerable initiative and judgment in collecting, analyzing, and coding radiology ...

next page

Showing results 1-20

All JobsMedicare Program Analyst JobsMedicare Program Analyst Jobs in Arkansas

Medicare Program Analyst information

What is a Medicare Program Analyst?

Medicare Program Analysts are professionals who evaluate, monitor, and help improve Medicare programs and policies. They analyze data related to Medicare services, assess program effectiveness, and recommend changes to ensure compliance with federal regulations. Their work often involves preparing reports, interpreting complex health care policies, and collaborating with other health care administrators and stakeholders. Medicare Program Analysts play a key role in ensuring Medicare programs are efficient and serve beneficiaries effectively.

How does a Medicare Program Analyst typically collaborate with other departments within a healthcare organization?

Medicare Program Analysts frequently work cross-functionally, partnering with compliance, finance, clinical, and IT teams to ensure Medicare programs are accurately implemented and maintained. They often serve as a bridge, translating regulatory requirements into actionable processes and communicating updates to relevant stakeholders. Regular meetings and project collaborations are common, requiring strong communication and teamwork skills. This collaborative environment helps ensure that all facets of the Medicare program operate efficiently and in compliance with federal guidelines.

What are the key skills and qualifications needed to thrive as a Medicare Program Analyst, and why are they important?

To thrive as a Medicare Program Analyst, a solid background in healthcare policy, data analysis, and program evaluation is essential, often supported by a degree in public health, health administration, or a related field. Familiarity with Medicare regulations, data analytics tools like SAS or SQL, and experience with claims processing systems are typically required. Strong analytical thinking, attention to detail, and effective communication are valuable soft skills for this role. These competencies are crucial for accurately interpreting program data, ensuring regulatory compliance, and supporting effective decision-making within Medicare programs.

What is the difference between Medicare Program Analyst vs Medicaid Analyst?

AspectMedicare Program AnalystMedicaid Analyst
Required CredentialsBachelor's degree in healthcare, public health, or related field; certifications like CPC or CMS certificationsBachelor's degree in healthcare administration, public health, or related; similar certifications often preferred
Work EnvironmentGovernment agencies, healthcare organizations, insurance companiesState and federal Medicaid agencies, healthcare providers
Employer & Industry UsagePrimarily in Medicare-focused roles within government and private sectorsPrimarily in Medicaid programs at state and federal levels

The Medicare Program Analyst and Medicaid Analyst roles share similar educational backgrounds and work environments, often involving government agencies and healthcare organizations. The main difference lies in their focus: Medicare Program Analysts specialize in Medicare policies and programs, while Medicaid Analysts focus on Medicaid services and regulations. Both roles require knowledge of healthcare policies and data analysis, but their specific responsibilities align with their respective programs.

Infographic showing various Medicare Program Analyst job openings in Arkansas as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.

Appeals Professional III (Licensed Clinician)

Little Rock, AR • On-site

St. George Tanaq Corporation
Business Management Consulting • 1 - 10 employees
Learn more about St. George Tanaq Corporationexternal

$57K - $77K/yr

Other

Re-posted 5 days ago

Job description

Appeals Professional III (Licensed Clinician)

Fully Remote-United States

Job Type

Full-time

Description

Overview

Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TSS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders.

About the Role

We are seeking an Appeals Professional III to support a contract with our federal client. The Appeals Professional III performs complex (senior-level) work. Provides dissatisfied parties with the opportunity to present documentation to demonstrate why an appeal should be allowed. Provides an independent second-level determination based on the documentation, facts, laws, regulations, and guidelines for Medicare Part C appeals. Works under general supervision, with moderate latitude for the use of initiative and independent judgment.

This is a remote position. Candidates must be based in the United States and able to work Eastern, Central, or Mountain Time Zone business hours.

Required: Active, unrestricted license in good standing as an RN, PT, RT, OT, or other qualifying licensed healthcare professional. Licenses with restrictions or encumbrances are not eligible.

Responsibilities

  • Reviews medical records/case files, writes reconsideration decision letters that are clear, concise, and impartial, and support the determination made, and documents the review.

  • Makes sound, independent decisions based on medical evidence in accordance with statutes, regulations, rulings, and policy.

  • Responds to and ensures that all appeal issues raised by the beneficiary/patient, representative, and provider/supplier have been addressed.

  • Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures.

  • Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision.

  • Stays abreast of changes in regulations, medical and healthcare practices, policies, and procedures.

  • Participates in case-specific verbal discussions.

  • Conducts reviews of appeals/disputes with multiple beneficiaries/services in one case.

  • Plans responses to statistical analysis challenges with assistance from statisticians.

  • Attends meetings and participates in workgroups at management's direction.

  • Conducts quality reviews, as needed.

  • Serves as a subject matter expert.

  • Mentors and/or trains staff.

  • May conduct quality reviews and audits.

  • Participates in special projects and performs other duties as assigned.

Requirements

Required Skills and Experience

  • Three (3) years of experience in medical dispute resolution, Medicare appeals, medical review, clinical work, or related healthcare roles.

  • Healthcare Professional with experience in Nursing, Physical Therapy, Respiratory Therapy, or Occupational Therapy experience.

  • Demonstrated experience writing or making medical necessity decisions.

  • Proficiency in research techniques, medical terminology, and analyzing and interpreting policies, along with knowledge of state and federal laws and regulations.

  • Must have experience and working knowledge of the Medicare program, including coverage and payment rules.

  • Experience with Medicare regulations, claims processing, and the medical review process, as well as applicable laws, rules, and regulations.

  • Prioritize and organize work tasks to handle multitasking and meet deadlines.

  • Ability to prepare correspondence and documents using correct spelling, grammar, and punctuation; proofreading and reviewing documents for clarity and consistency.

  • Practice logic and reasoning to identify problems, verify facts, and reach valid conclusions.

  • Experience in making decisions that support business objectives and goals.

  • Ability to identify and resolve problems or refer issues appropriately.

  • Communicate effectively verbally and in writing.

  • Adapt to the needs of internal and external customers.

  • Show integrity and ethical behavior, respect confidentiality, business ethics, and organizational standards.

  • Ensure compliance with company policies, procedures, and guidelines, including cybersecurity, regulatory, contractual, and accreditation entities.

  • Experience directly relevant to Medicare managed care appeals or utilization management activities, preferred.

  • Must have resided in the United States for a minimum of three (3) years out of the last five (5) years. This is a contractual requirement.

  • Must possess a valid driver's license with a clear and satisfactory driving record.

  • Ability to obtain and maintain public trust clearance and customer approval.

  • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Education and Training

  • Associate's degree or 60 or more credit hours towards a Bachelor's degree from an accredited college or university in healthcare or related discipline.

  • Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for an Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.)

Physical Requirements and Work Environment

  • Requires working in an office/cubicle environment; sitting, standing, walking, bending, twisting, and/or reaching.

  • Prolonged periods of sitting at a desk and working on a computer. May need to lift 25 pounds occasionally.

  • May require the ability to operate a motor vehicle and travel by motor vehicle and commercial airline. May require overnight travel. Travel may be less than 5% annually.

Who We Are

Tanaq Support Services (TSS) is a public health contractor, certified 8(a) business, owned by St. George Tanaq Corporation, an Alaska Native Corporation. (ANC). We listen to our stakeholders and leverage our science, technology, communication, and program expertise to understand and provide feedback as we develop solutions.

Our Commitment to Non-Discrimination

Tanaq is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to disability, status as a protected veteran or any other status protected by applicable federal, state, or local law. Tanaq complies with the Drug-free Workplace Act of 1988 and E-Verify.

If you are an individual with a disability and need assistance completing any part of the application process, please email accommodation@tanaq.com to request a reasonable accommodation. This email is for accommodation requests only and cannot be used to inquire about the status of applications.

Notice on Candidate AI Usage

Tanaq is committed to ensuring a fair and competitive interview process for all candidates based on their experience, skills and education. To ensure the integrity of the interview process, the use of artificial intelligence (AI) tools to generate or assist with responses during phone, in person and virtual interviews is not allowed. However, candidates who require a reasonable accommodation that may involve AI are required to contact us prior to their interview at accommodation@tanaq.com.

To apply and view all of our positions, visit:

https://recruiting.paylocity.com/recruiting/jobs/All/a4712c9f-f074-40e8-9a14-bee06660bd81/Tanaq-Support-Services-LLC (https://recruiting.paylocity.com/Recruiting/Jobs/Details/4047498)

Apply