- Highmark Health (Frankfort, KY)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... Evaluates various claims submitted by Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) on behalf of self-funded clients for compliance with… more
- Novant Health (NC)
- … Analyst II. The Pharmacy Business Analyst II use data to improve claims reconciliation, billing processes and inventory management processes for ... and best practices are considered during solution review. Understand management structure in Pharmacy and business architect of analyst teams at Novant Health.… more
- UCLA Health (Los Angeles, CA)
- …will provide analytical support for the day-to-day business operations of UCLA Ambulatory Pharmacy . You will work closely with frontline staff and pharmacy ... You will assist with AR reconciliation, insurance contracting, audit of weekly claims exceptions etc. In a fast-paced and high intensity environment, you must… more
- Mount Sinai Health System (New York, NY)
- …1. Analyzes data requests using information technology, enrollment, claims , pharmacy , clinical, contract, medical management, financial, administrative and ... **Job Description** The Data Science Analyst III is a...care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more
- Albany Medical Center (Albany, NY)
- …supervisory-level purchasing and inventory monitoring metrics and controls for all Albany Med pharmacy sites. The analyst will manage, monitor and report on key ... Department/Unit: Pharmacy Work Shift: Day (United States of America)...of America) Salary Range: $71,612.39 - $110,999.20 The 340B Analyst is responsible for advising, establishing, and helping to… more
- WMCHealth (Valhalla, NY)
- …accuracy and compliance. + Develop and refine claims qualification logic and data feeds for contract pharmacy relationships. + Assist in the implementation ... contract pharmacy relationships, including contract language, fee structures, and data setup, ensuring compliance with 340B requirements. + + Assess cost-saving… more
- Prime Therapeutics (Jackson, MS)
- …+ Recommend new and revised financial pricing strategies based on analysis of pharmacy claims data , average wholesale drug prices (AWP), health ... decision we make. **Job Posting Title** Sr. Market Pricing Analyst - REMOTE **Job Description** The Senior Market Pricing...+ Interpret financial performance reports to monitor performance against pharmacy claims data and identify… more
- The County of Los Angeles (Los Angeles, CA)
- …EHR modules including but not limited to: Registration, Scheduling, Lab, Radiology, and Pharmacy by conducting workflow data analysis, data mapping and ... PRINCIPAL INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3121047) Apply PRINCIPAL… more
- LA Care Health Plan (Los Angeles, CA)
- …and federal requirements and also LA Care contractual agreements. The position handles DMHC claims data submissions for LA Care and its Plan Partners and ... reports filing Collection, storage, maintenance and reporting of AB1455 Claims data by line of business submitted...Preferred Provider Groups (PPG), Specialty Health Plans (SHP) and Pharmacy Benefit Manager (PBM) including LA Care's Claims… more
- Centene Corporation (Olympia, WA)
- …all or some of the following areas: claims , provider data , member data , clinical data , HEDIS, pharmacy , external reporting + Extract, load, model, ... workplace flexibility. Remote Available. **Position Purpose:** Responsible for analytic data needs of the business unit. Handle complex ...data needs of the business unit. Handle complex data projects and acts as a lead for other… more
- The County of Los Angeles (Los Angeles, CA)
- …EHR modules including but not limited to: Registration, Scheduling, Lab, Radiology, and Pharmacy by conducting workflow data analysis, data mapping and ... SENIOR INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3124187) Apply SENIOR… more
- HCA Healthcare (Nashville, TN)
- …to update monthly reporting scorecard for performance guarantees. + Provide premium, claims , and administrative fee data to actuarial consultants to assist ... that invests in you as a Senior Benefits Financial Analyst ? At HCA Healthcare, you come first. HCA Healthcare...you will support employee benefits financial reporting, budgeting, and data management processes for the enterprise. You will establish… more
- Walgreens (Deerfield, IL)
- …through integration. May execute entire implementation for smaller projects. + Analyzes claims data , utilization and prescriber information from clients in order ... in development, facilitation, and execution of Client Implementations. The 340b Implementation Analyst will interact with Pharmacy Services, Pharmacy /Store… more
- MVP Health Care (Schenectady, NY)
- …working knowledge of health care data including but not limited to claim data , pharmacy data , clinical data , provider billing practices and ... Business Analytics, Lead Strategic Health Care Economics Analyst 625 State St, Schenectady, NY 12305, USA...methodologies and innovation programs. + Advanced knowledge of FACETS claims processing system and Provider billing and coding practices.… more
- Evolent (Washington, DC)
- …and articulating our value.** **Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations ... manner that fosters expertise and cooperation.** **Process and validate raw unadjudicated claims data .** **Use programming skills to explore, examine and… more
- Royal Electric (Sacramento, CA)
- …Required Skills & Abilities + Analytical skills required to assemble and interpret claims , metrics and loss data , and produce regular reports showing status ... Culture Short Story (https://www.royalelect.com/join-team-royal/) We are hiring for a Safety & Claims Administrator in Sacramento, CA or Long Beach, CA. Success in… more
- AmeriHealth Caritas (Philadelphia, PA)
- …integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. ... www.amerihealthcaritas.com We seek an experienced, passionate, and highly motivated WFM Business Analyst (BA) to join our Workforce Management Team. This consists of… more
- Prime Therapeutics (Montgomery, AL)
- …Management) or STARS experience + Experience conducting complex analysis on large sets of pharmacy , claims , medical, and/or financial data + Intermediate SAS ... Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides information, analyses, and consultation to internal and… more
- Evolent (Tallahassee, FL)
- …or engineering) - Preferred + Professional experience in healthcare analytics (eg medical and pharmacy claims data , membership data , or other healthcare ... Stay for the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a Senior Analyst… more
- CVS Health (Phoenix, AZ)
- …operations including the creation of new networks and the maintenance of existing pharmacy networks on adjudication systems. The Analyst position is responsible ... the client, CMS and government auditors. **Required Qualifications** - Data Management and familiarity of data sets...Microsoft Office Suite Experience **Preferred Qualifications** - Process of claims - Medical, Pharmacy , or PBM Experience… more