- Highlight Health (Philadelphia, PA)
- …hard-working individual to guide and optimize the most crucial department of our business - claims analysis and resolutions. In addition to an extensive background ... a mission-driven company that protects consumer rights and controls healthcare costs exclusively for self-funded employers and their stop...are looking for a health coverage large and complex claims analysis expert - an expert who has scrutinized… more
- RIT Solutions, Inc. (Glendale, CA)
- …1. SQL 2. C# 3. AWS 4. Any programming language Under limited supervision, the Business Systems Analyst supports IT goals and objectives by working closely with ... be working to help implement & test a new claims tracking system being built from the ground-up using...team environment. Primary Job Responsibilities: Must have prior DQ Business Systems Analyst experience and a proven… more
- Ahold Delhaize USA (Scarborough, ME)
- … providers, outside attorneys) customers. Financial Impact Administration Manage book of claims business (up to $ 2million) with authority to settle/negotiate ... Position Summary Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility… more
- Sentara Healthcare (Richmond, VA)
- City/State Richmond, VA Work Shift First (Days) Overview: The Senior Business Analyst is responsible for the implementation, analysis, and support of quality ... requirements, scope projects, conduct testing, and ensure the successful implementation of business solutions. The analyst provides subject matter expertise in… more
- OCHIN (Portland, OR)
- …Full-time Description MAKE A DIFFERENCE AT OCHIN Position Overview The Epic Resolute PB/PB Claims Application Analyst on our Install team supports the mission of ... team support model. Serve as internal advisor to other analyst as the lead working sessions with OCHIN members...of 2 years of build experience. Work history in Healthcare IT is required Bachelor's Degree preferred or a… more
- ShiftCode Analytics (Los Angeles, CA)
- We need a Business Analyst with Health Plan / Managed...experience for a 6+ month contract role for a Healthcare client in Los Angeles, CA. This role will be ... a US Citizen . Job Summary The Enterprise Portfolio Management Office Solutions Analyst is accountable for intake, execution, and managing the oversight of strategic… more
- MetroPlusHealth (New York, NY)
- …Qualifications Bachelor's degree required A minimum of 5 years' working experience within claims in the healthcare or insurance industry Extensive knowledge of ... About NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island… more
- Molina Healthcare (Long Beach, CA)
- Job Description Job Description Job Summary The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates Assists and collaborates...reporting for the assigned state Works in an agile business environment to derive meaningful information out of complex… more
- Serigor Inc. (Richmond, VA)
- Job Title: Business Analyst 4 (Hybrid) Location: Richmond, VA Duration: 12+ Months Responsibilities: Support the Electronic Health Records program. Posses ... family of standards including V@, Clinical Document Architecture, and Fast Healthcare Interoperability Resources. Supports the health IT Unit in the implementation… more
- Nationwide Mutual Insurance Company (Milwaukee, WI)
- …Benefits (Stop Loss), we empower self-funded employers to take control of their healthcare costs with confidence. Backed by the strength and stability of the ... brand, our stop loss solutions offer financial protection against catastrophic claims , helping businesses manage risk while supporting employee well-being. With… more
- Convey Health Solutions (Chicago, IL)
- …aggregation tools like Python (Jupyter), SQL, or SAS. 3+ years in analytics or business intelligence within the healthcare sector. Proficient in SQL for creating ... SUMMARY The Sr. Data Analyst will be responsible for utilizing technical and...and updating stored procedures. Familiarity with healthcare payer/provider claims , clinical, or quality data.… more
- Vital Care Infusion Services (Jacksonville, FL)
- Vital Care (www.vitalcare.com) is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute ... 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have… more
- CGS Administrators, LLC (Nashville, TN)
- …experience in SQL server, Power BI. Proficiency in Excel. Previous experience in healthcare , claims , prior authorization, supporting DME. What Blue Can Do for ... that allows us to build on a variety of business strengths. We deliver outstanding service to our customers....of the last five (5) years. This is a business requirement - government contracts, not an HR requirement.… more
- RxSense (Princeton, NJ)
- …Forbes' Top Startup Employers, Modern Healthcare 's Best Places to Work in Healthcare , and Inc's Best in Business and Best Workplaces. Position Summary : ... The Formulary Analyst plays a key role in the configuration, maintenance,...(PBM) 1+ year's of experience in formulary operations, pharmacy claims adjudication, or related healthcare analytics. Demonstrated… more
- Harbor, Inc. (Toledo, OH)
- …hours per week. Education/Experience/Other Requirements : Bachelors of Science in business administration, finance/accounting or other healthcare related area or ... Demonstrated understanding of grant reporting. Previous experience in a healthcare environment is desirable. Proficiency in Microsoft application suite, particularly… more
- Ballad Health (Johnson City, TN)
- JOB DESCRIPTION: The Senior Planning Analyst plays a key role in supporting enterprise strategy, service line growth, and business planning efforts across Ballad ... analytics, and decision-ready insights. Key Responsibilities: Enterprise Strategy & Business Planning: Lead the development of market, competitor, and organizational… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …improvements for Core back-Office systems including but not limited to: Core Healthcare Claims Processing Platform including Eligibility & Enrollment (Group, ... to support client configuration and ongoing auditing of system changes. Works with Technical Business Analyst and Programmer Analyst to support day to day… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... assess business impacts, and make recommendations through use of healthcare analytics, predictive modleing, etc. + Interact with various departments including;… more
- Molina Healthcare (Grand Island, NE)
- …combination of education and experience **Required Experience** + 5-7 years of business analysis experience with an emphasis in claims payment accuracy ... the Nebraska Health plan SLT by providing subject matter expertise on complex claims related issues and service recovery efforts.** Analyzes complex business … more
- Cognizant (St. Louis, MO)
- **QA Analyst Healthcare Domain - Payer & Claims Testing** This is a remote position open to any qualified applicant in the United States. We are seeking a ... highly skilled and motivated **QA Analyst Healthcare Domain - Payer & Claims Testing**...activities ensuring efficient workflow and communication. Conduct manual end-to-end business process assurance testing focusing on the Claims… more
