- AmeriHealth Caritas Health Plan (Detroit, MI)
- …Network Management in dealings with provider agreements. The Contract Management Analyst will assist the Manager, Provider Network Management in administering the ... day-to-day business activities of developing, negotiating, and monitoring provider contract...or a related area or similar work experience Michigan Medicaid policies - state and federal managed health care… 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 ... on how to use reports related to Risk and Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. Assists with research, development, and completion of special… more
- Prime Therapeutics (Eagan, MN)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr. Business Systems Analyst **Job Description** The Sr. Business Systems ... are consistent with organization objectives by acting as the bridge between the business systems analyst team, business stakeholders, development team,… more
- Prime Therapeutics (Indianapolis, IN)
- …It fuels our passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst - ScriptMed - Remote **Job Description** The IT ... Business Systems Analyst is responsible for solving...from direct and indirect leadership **Preferred Qualifications** + Previous Pharmacy Benefit Management (PBM) or healthcare experience with understanding… more
- IQVIA (Milwaukee, WI)
- …Rebate Processing + Pharmacy Benefit Management + Managed Health Care + Medicaid Drug Rebate Program IQVIA is a leading global provider of clinical research ... build and enhance your interpersonal skills that are necessary to build effective business relationships with your clients. Those skills are pertinent because as an … more
- Molina Healthcare (Roswell, NM)
- … needs. Performs analysis across multiple states and lines of business (Medicare, Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- embecta (Parsippany, NJ)
- …needs of our diverse and global employees. The Pricing & Contracts Sr. Analyst will support the analytics, operations and contracting functions within US Sales ... Channels and Canada, as required. Primary responsibilities include providing business reporting, trend analysis, analytics, financial modeling for RFP's and contract… more
- Prime Therapeutics (Salt Lake City, UT)
- …change process + Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned ... passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated analytics to ... provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning, decision-making, goal setting, and effective… more
- Prime Therapeutics (Montgomery, AL)
- …on trend, benefit design and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid ). This role will also provide actuarial ... every decision we make. **Job Posting Title** Senior Actuarial Analyst - REMOTE **Job Description** The Senior Actuarial ...projections + Lead, perform, and review complex ad hoc pharmacy data mining and analyses to help investigate and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst II collaborates with stakeholders from across the organization to develop sophisticated analytics to provide ... information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning,...goal setting, and effective performance measurement. The Data Science Analyst II demonstrates sound and a more advanced understanding… more
- CVS Health (Phoenix, AZ)
- …and for Sales/Clients for all CVS Health adjudication platforms and lines of business (Medicare Part D, Commercial, Medicaid , etc.). Our Analysts make high ... multiple requests/priorities, and produce/develop custom reports for multiple lines of business and specific clients regarding retail pharmacy network… more
- Prime Therapeutics (Frankfort, KY)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The Compliance ... launch and beyond, focusing on balancing customer needs with business goals. + Consults with business areas...legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated… more
- Molina Healthcare (ID)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom ... on how to use reports related to Risk and Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. Assists with research, development, and completion of special… more
- Henry Ford Health System (Troy, MI)
- Reporting to the CDM Manager, the CDM Analyst is responsible for supporting and maintaining the Charge Description Master (CDM), including being responsible for the ... accuracy and completeness of the CDM. The CDM Analyst also supports the CDM Coordinator and Senior CDM...4. Serves as technical resource for assigned clinical or business departments throughout HFHS. Responsibility includes, but is not… more
- AmeriHealth Caritas (Detroit, MI)
- …Network Management in dealings with provider agreements. The Contract Management Analyst will assist the Manager, Provider Network Management in administering the ... day-to-day business activities of developing, negotiating, and monitoring provider contract...a related area or similar work experience + Michigan Medicaid policies - state and federal managed health care… more
- Queen's Health System (Honolulu, HI)
- …B. EXPERIENCE: * In addition to the educational requirement, three (3) years pharmacy operations, business operations or finance experience, preferably in a ... monitoring and routine auditing of virtual inventory accumulation, purchasing procedures, Medicaid billing procedures, patient eligibility, new areas of service, and… more
- Corewell Health (Grand Rapids, MI)
- …all types of health care fraud including member, employer group, agent, pharmacy , provider, etc. Investigates, collects and documents findings for management review. ... laws related to fraud, waste or abuse, Medicare and Medicaid regulations, etc. + Ability to work effectively with...vendors. Qualifications Required + Bachelor's Degree or equivalent Health, Business or statistics + 2 years of relevant experience… more
- Henry Ford Health System (Troy, MI)
- …system or process improvements. EDUCATION AND EXPERIENCE: + Bachelor's Degree in Business Administration, Healthcare, Finance, IT, or related field, or a minimum of ... interpersonal skills are required. + Knowledge of Medicare & Medicaid guidelines, and other third-party billing rules. + EPIC...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more
- Independent Health (Buffalo, NY)
- …negotiations on contracts with manufacturers on rebates for all lines of business , including, Medicare, Medicaid , Exchange, EGWP, self-funded, small group, State ... required, MBA degree preferred. + Two (2) years of healthcare/ pharmacy or PBM industry experience required. + Strong problem...and ability to work across several key lines of business . + Proven ability to negotiate win-win solutions, well… more
