- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for ... and report outcome results on edits implemented. + Utilize data to examine large claims data...Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+… more
- Molina Healthcare (Bellevue, WA)
- …+ Locate and interpret regulatory and contractual requirements + Tailors existing reports or available data to meet the needs of the claims project + Evaluates ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Providence (Renton, WA)
- …insurance codes, regulations, and our department's policies and procedures + Secure monthly claims data reports and provide quality assurance recommendations to ... claims files for quality assurance purposes + Experience working with claims data analytics + Experience in project management + Experience creating… more
- The Cigna Group (Bloomfield, CT)
- …implementation/migration and/or claim adjudication engine enhancement experience + Knowledge of healthcare industry data standards and formats - X12, JSON, ... you have a high degree of technical expertise in claims systems? EviCore, a line of business within the...Group, is hiring a Claim Systems, Business Solutions Lead Analyst to provide focused support on implementations, expansions, and… more
- CenterLight Health System (NY)
- …returned monies and proper application of transaction by our TPA. + Perform in-depth claims analysis using multiple data sets, conduct root cause analysis, and ... JOB PURPOSE: The Claim Analyst will play a pivotal role in enhancing...managed care setting is strongly preferred. + Proficiency in data analytics, ie SAS, SQL. + Claims … more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Apr 19, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 60414 **Who we are** Teva ... journey of growth! **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid Drug...with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Apr 16, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 61400 **Who we are** ... a difference with. **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid Drug...with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and… more
- Molina Healthcare (Long Beach, CA)
- …_Designs and implements processes and solutions associated with a wide variety of data sets used for data /text mining, analysis, modeling, and predicting to ... by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with… more
- Centene Corporation (Austin, TX)
- …related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare . Project management experience ... healthcare (ie documenting business process, gathering requirements) or claims payment/analysis experience. Experience in benefits, pricing, contracting or … more
- Bloom Healthcare (Lakewood, CO)
- …seeking a Data Analyst , Value Based Care, to lead data analytics initiatives that support Bloom Healthcare 's population health strategies. This position ... Job Title: Data Analyst , Value Based Care Location:...Experience working with large healthcare datasets, including claims , eligibility, and encounter data + Demonstrated… more
- Molina Healthcare (Cedar Rapids, IA)
- …Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab ... analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst... Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data … more
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst... Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data … more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Senior Healthcare Data Analyst ** **(Location - Albany, NY)** **Summary:** The ... Data Analyst will work within the Division of ...reports in support of the intake and management of healthcare data . The ideal candidate will be… more
- HCA Healthcare (Nashville, TN)
- …and process documentation for both the department and for assigned projects. + Perform data analyst functions that generate knowledge via data mining, ... number growing to nearly 8,000 by 2028. The Research Analyst will assist in translating clinical needs into analytic...records, Medicare claims , or other health care claims data sets preferred. + SAS, RDBMS,… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Molina Healthcare (Augusta, GA)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- BGB Group (Kansas City, MO)
- …modeling, to forecast behaviors, outcomes, and trends. + Extract meaningful insights from healthcare claims data to inform strategies and enhance ... (http://www.bgbgroup.com/careers.html) Kansas City, MO BGB Group Data Analyst Our Agency BGB Group is a healthcare...R, SQL, or other advanced analytics tools; experience with claims data or healthcare datasets… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Senior Benefits Financial Analyst ? At HCA Healthcare , you come first. HCA Healthcare has committed ... members over the course of three years. **Benefits** HCA Healthcare , offers a total rewards package that supports the...monthly reporting scorecard for performance guarantees. + Provide premium, claims , and administrative fee data to actuarial… more
- Molina Healthcare (Everett, WA)
- …management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare data , including UM and CM data , claims , ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...executive decision-making + Mine and manage information from large data sources + Analyze claims and other… more
- AdventHealth (Altamonte Springs, FL)
- …close the most critical gaps in lowering the cost of care. The Analyst uses healthcare data ( claims , labs, EHR data ) analytics to gain insights into ... **Health Plan Data Analyst ** **Location:** Virtual **All the...utilizing analytical software tools and applications + Health Plan claims data knowledge This facility is an… more
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