• Claims Reporting / Data

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will provide ... routine and ad hoc analytics to drive impactful material, recommendations, and data driven decision making to support overall payment integrity and claim operations… more
    Commonwealth Care Alliance (06/15/25)
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  • Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst ... reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject...& Abilities (must have):** + Proficiency with Excel and reporting tools for data analysis. + Understanding… more
    Commonwealth Care Alliance (05/31/25)
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  • Senior Data and Reporting

    Humana (Boston, MA)
    …**Required Qualifications** + Bachelor's degree + 3 or more years of experience in data reporting + Current Advanced Microsoft Excel skills including ability to ... first** Humana's Gulf South Region is seeking a Senior Data and Reporting Professional that generates ad...insurance industry or health care sector with authorization or claims data + Ability to see trends… more
    Humana (06/14/25)
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  • Senior Financial Reporting Analyst

    Humana (Boston, MA)
    …caring community and help us put health first** The Senior Financial Reporting Professional/ Analyst prepares and distributes periodic financial statements for ... those directly employed by the organization. The Senior Finance Reporting Professional/ Analyst + Analyzes and forecasts... + Analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic… more
    Humana (05/29/25)
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  • Business Analyst , Community Benefits…

    Beth Israel Lahey Health (Charlestown, MA)
    …department, hospital and system operational and financial information systems, public health and claims data . * Independently identifies data needs and ... Relations (CBCR) Department at Beth Israel Lahey Health, the Business Analyst (" Analyst ") provides critical analytic and data support to the entire team. The… more
    Beth Israel Lahey Health (05/25/25)
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  • Facets System Analyst - Remote

    Cognizant (Boston, MA)
    …standards. You will use SQL for data analysis, troubleshooting, and reporting , and conduct testing to ensure accurate claims processing, collaborating with ... Together, we're improving everyday life. **Job Title** **: System Analyst ** **Location** **:** **Remote** **Job ID** **: SO# 00064395692**...and collaborate with QA teams. + Utilize SQL for data analysis and reporting . + Document configuration… more
    Cognizant (06/12/25)
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  • Payment Integrity: Reimbursement Policy Invoice…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …invoice reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices against plan enterprise warehouse claims ... Bring your true colors to blue. What We Need Reporting to the Associate Director of Professional Reimbursement Strategy,...and excel + Proficiency in working with and analyzing claims data + Strong written and verbal… more
    Blue Cross Blue Shield of Massachusetts (05/11/25)
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  • Senior Analyst , Healthcare Analytics…

    Evolent (Boston, MA)
    …insights and compelling narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization ... the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique… more
    Evolent (06/06/25)
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  • Sr. Market Pricing Analyst - REMOTE

    Prime Therapeutics (Boston, MA)
    …Recommend new and revised financial pricing strategies based on analysis of pharmacy claims data , average wholesale drug prices (AWP), health plan margin target ... markets + Interpret financial performance reports to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive… more
    Prime Therapeutics (05/22/25)
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  • Device and Non Monetary Fraud Lead Analyst

    Bank of America (Boston, MA)
    Device and Non Monetary Fraud Lead Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; New York, New York; Boston, Massachusetts; Charlotte, North Carolina; ... expand our capabilities, reduce customer friction, and make strategic investment decisions. Data related to customer profiles and online banking login events hold an… more
    Bank of America (05/30/25)
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  • Enrollment Analyst , hybrid

    Commonwealth Care Alliance (Boston, MA)
    …The department supports continuous improvement, including reports, operational workflows, gap and data analysis, and processes analysis. The Sr. Analyst reports ... self-starter and effective collaborator, showing strong interest in operations, data analysis, process improvement, strong technical/analytical and problem-solving skills,… more
    Commonwealth Care Alliance (06/10/25)
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  • EHR Applications Analyst 1-Willow

    Beth Israel Lahey Health (Charlestown, MA)
    …you're not just taking a job, you're making a difference in people's lives.** Reporting to the Executive Director of Epic Patient Financial Services - PB, the Senior ... Epic Operations Analyst serves as the preeminent Epic analytical resource tasked...back-end billing functions and workflows, charge generation and capture, claims generation and reconciliation, remittance posting processes, retro adjudication… more
    Beth Israel Lahey Health (05/17/25)
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  • Forecast Analyst - REMOTE

    Prime Therapeutics (Boston, MA)
    …Title** Forecast Analyst - REMOTE **Job Description** The Forecast Analyst is responsible for providing financial/ data modeling, forecasting, revenue ... Previous work experience with data analysis, large data sets and/or pharmacy claims ; creating moderately...peripheral vision, depth perception and ability to adjust focus ** Reporting Structure** + Reports to Manager, Principal or Director… more
    Prime Therapeutics (06/07/25)
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  • Analyst , Client Analytics

    Evolent (Boston, MA)
    …culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL ... programs. Import and load data from disparate sources to facilitate reporting for multiple health plans. Build new client relationships to understand analytical… more
    Evolent (05/29/25)
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  • Lead Commercial Performance Analyst

    Point32Health (Canton, MA)
    …**Job Summary** Reporting to the Director of Commercial Analytics and Reporting , the Lead Commercial Performance Analyst is responsible for the development ... familiarity with clinical, wellness and pharmacy metrics, good understanding of membership, claims , and pharmacy data preferred. **Compensation & Total Rewards… more
    Point32Health (06/03/25)
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  • Financial Management Analyst

    State of Massachusetts (Everett, MA)
    …accurate and timely in the awarding and disbursement of funds. Review and analyze data on nutrition reimbursement claims to ensure inclusion of the required ... would be expected to follow a hybrid model of reporting to work that combines two (2) in-office workdays...awarding and distribution of grant funds; Review and analyze data concerning various statewide child nutrition programs and prepare… more
    State of Massachusetts (04/15/25)
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  • Demand Forecasting Analyst

    Takeda Pharmaceuticals (Boston, MA)
    …business units for internal as well as cross-functional teams/stakeholders; Utilize secondary data sources such as IQVIA, Symphony claims , Metys, to track ... job opportunity: **JOB LOCATION:** Cambridge, MA **POSITION:** Demand Forecasting Analyst **POSITION DESCRIPTION** : Takeda Pharmaceuticals USA, Inc. is seeking… more
    Takeda Pharmaceuticals (06/07/25)
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  • Sr. Applied Stars and Quality Analytics…

    Prime Therapeutics (Boston, MA)
    …Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides information, analyses, and consultation to internal and ... or STARS experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Intermediate SAS or SQL coding… more
    Prime Therapeutics (05/24/25)
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  • Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    …techniques, business systems analysis, and reporting using a variety of reporting platforms, systems, sources, and data formats. They will collaborate with ... CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, initiatives,… more
    Commonwealth Care Alliance (05/23/25)
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