- Highmark Health (Dover, DE)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Cognizant (Dover, DE)
- …the Configuration and IT organization and lead changes to such specifications (with senior business analyst oversight through peer reviews); Develop an informed ... knowledge of the business unit being supported, as well as an understanding of the IT organization's systems and capabilities in order to participate in project activities and research requests on an ongoing basis; Assist in obtaining consensus by facilitating… more
- Evolent (Dover, DE)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a ... the impact of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams… more
- Bank of America (Newark, DE)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Tampa, Florida; Jacksonville, Florida; Charlotte, North Carolina; Phoenix, Arizona **Job ... the production of product performance reports and updates for senior management LOB Specific Information **_This position is not...▪ Basic understanding of 1st and 3rd party fraud ( claims to charge-off timing, chargeback recovery rights, etc.) ▪… more
- Highmark Health (Dover, DE)
- …network structures (eg non standard tiering) and pricing methods in a senior operational role. Translates complex group and client information into system ... and scalability and reusability of benefit configurations. Develop and execute claims testing plan, scenarios, documentation and defect management to ensure minimal… more
- Evolent (Dover, DE)
- …SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Working on a strategic analytics team using data to identify ... more years of experience within a healthcare analytics role, working with Claims , Membership, or Authorization Data, and consulting both internal and external… more
- CVS Health (Dover, DE)
- …+ Applying advanced Excel modeling techniques to analyze large sets of pharmacy claims data and build forward looking financial forecasts and profit and loss (P&L) ... statements + Presenting financial analyses to Executive Leadership during Executive Underwriting Approval Calls and responding to financial questions in real-time + Supporting Underwriting Managers and Sr. Managers with ad-hoc financial analyses and client… more
- Evolent (Dover, DE)
- …to positively contribute to Evolent's broader mission. **Collaboration Opportunities:** The Senior Analyst , Performance Suite Analytics utilizes and develops ... and articulating our value.** **Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- Humana (Dover, DE)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more
- Evolent (Dover, DE)
- …the mission. Stay for the culture. **What You'll Be Doing:** Job Description Senior Analyst , Performance Analytics - **RBM Cardiac** product focus, utilizes and ... as well as Product Development efforts. **What You'll Be Doing:** + Analyse claims and authorization data to identify trends, calculate cost of care, and identify… more
- Citigroup (New Castle, DE)
- **Syndicated Loan Operations Intermediate Associate Analyst ** **Description:** The Syndicated Loan Operations Intermediate Associate Analyst develops and ... require interaction with other counterparties around positions and outstanding balances/ claims + Integrates a solid understanding of industry and business… more
- Citigroup (Wilmington, DE)
- The VP, Climate Risk and Portfolio Management Analyst will be aligned with the mortgage risk group with a focus on climate risk data analysis. This role will be ... climate risk data and analytics. + Prepare risk management presentations for senior management that include analytics on expected portfolio performance and areas of… more
- BlackRock (Wilmington, DE)
- **About this role** **GAAPS Analyst / Associate Private Markets Operations - Middle Office | Wilmington** **About BlackRock** Elevate your career by joining the ... candidate will require the skills to partner with Business leads, operations teams and senior leaders along with ICB, Legal, Tax, RQA and Compliance with regards to… more
- Highmark Health (Dover, DE)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Evolent (Dover, DE)
- …**What You'll Be Doing:** **What You'll Be Doing:** Evolent Health is looking for a Senior Product Owner, Client Data to be a key member of the Product team, focused ... the features into product releases. + Serve as a senior product owner on an Agile development team for...Degree + 2+ years' experience in healthcare, IT business analyst , and/or product management + Experience working with FHIR… more