- Guidehouse (Hanover, MD)
- …including resolution practices and audit strategies. + Experience applying advanced data analytics to healthcare claims , including anomaly detection, trend ... (eg, MPH, MHA, MBA, JD, or related). + 5 to 7+ years of experience in healthcare data analytics , consulting, or claims operations, preferably with a focus on… more
- Evolent (Annapolis, MD)
- …research, mathematics, economics) + At least 3-5 years of professional experience in claims -based healthcare analytics with a payer, provider, clinical ... and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding...vendor, managed care, or related healthcare consulting entity + Experience with managing … more
- Evolent (Annapolis, MD)
- …public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed ... or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Evolent (Annapolis, MD)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Analyst, Client Analytics ** Integrate and analyze claims and enrollment data from multiple sources ... we would want for our loved ones. The Client Analytics team offers candidates the opportunity to leverage data...when faced with challenges or tradeoffs. + Building and managing performance metrics and standard report production. + Identifying… more
- Humana (Annapolis, MD)
- …claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims utilizing revenue codes, CPT/HCPCS, ICD-10 diagnosis codes, DRG, ... reporting & analysis, reserving or trending) + Experience in managing large healthcare claim datasets and conducting...datasets and conducting trend analysis + Deep understanding of healthcare claims taxonomy (service categories, such as… more
- The Cigna Group (Baltimore, MD)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution. + Works to meet unit cost… more
- Baylor Scott & White Health (Annapolis, MD)
- …of work experience above the minimum qualification- EXPERIENCE + 2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , ... collaborating to resolve encounter data and process issues and managing policy and procedure documentation. + Oversee updates to...MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with Healthcare claims , enrollment and pharmacy data is… more
- CVS Health (Annapolis, MD)
- …some of the most challenging problems at the intersection of technology and healthcare . A&BC leverages advanced analytics , machine learning, modeling, and a ... transformational shift in how CVS Health leverages technology and analytics to become the leader in healthcare ...Strong verbal and written communication skills + Experience with claims /payor/ payment operations, healthcare technology, or… more
- Highmark Health (Annapolis, MD)
- …You will proactively identify opportunities to construct and leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , ... from concept to prototype. + ** Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or… more
- Norstella (Annapolis, MD)
- …relational databases, ensuring data accuracy and quality. *Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, ... technologies such as real-world data, machine learning and predictive analytics . As one of the largest global pharma intelligence...unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be… more
- Humana (Annapolis, MD)
- …team. The Encounter Data Management Professional will support encounter processing, analytics and research of encounter submission inventory. The Encounter Data ... Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of...PowerPoint) + Working knowledge of SQL **Demonstrated understanding of healthcare data exchange formats and industry standards (eg, CSV,… more
- Otsuka America Pharmaceutical Inc. (Annapolis, MD)
- …and ensuring that milestones are met. + Support strategy leads by managing the study operational execution of studies including protocol development, vendor ... functions involved in GVE (eg, Medical Affairs, Market Access, Data and Analytics ) and promote interaction between different departments to leverage expertise and… more
- Adecco US, Inc. (Washington, DC)
- …paying $ 60.10/hr. The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting specific drug (including Benefit ... Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on...as a strategic reimbursement advisor and primary liaison for healthcare providers, proactively identifying and resolving complex access and… more
- CareFirst (Owings Mills, MD)
- …ensuring alignment with enterprise objectives and product roadmaps. + Managing resource allocation, technical expertise, and career development for engineering ... to foster technical excellence and professional growth. + Provide Healthcare Payer domain expertise across key domains such as... Payer domain expertise across key domains such as Claims , Billing, Member, Provider, Broker, etc. + Mentor and… more
- Marriott (Bethesda, MD)
- …leveraging data and insights to inform program design and measurement strategy, managing vendor relationships to optimize service delivery and costs, and staying ... benefits leadership experience program with a history of progressive responsibility managing the benefits function within a large, global organization. +… more
- Evolent (Annapolis, MD)
- …Will Be Doing:** + **Strategic Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... Matter Expert (SME). + Take a proactive approach to managing the client and anticipating needs to ensure satisfaction...areas of sensitivity + 2 years of Account Management healthcare experience To ensure a secure hiring process we… more