- Cognizant (Raleigh, NC)
- About the role As a ** Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end ... test strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality … more
- Prime Therapeutics (Raleigh, NC)
- …drives every decision we make. **Job Posting Title** Specialty & Home Delivery Program Claims Analyst - Remote **Job Description** The Specialty & Home Delivery ... Program Claims Analyst is responsible for serving as...processing or project lifecycle, or related roles in the healthcare or PBM industry + Must be eligible to… more
- Robert Half Accountemps (Raleigh, NC)
- Description We are looking for a detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. This long-term contract position is ideal ... high- quality results. Responsibilities: * Process and reconcile medical claims efficiently, ensuring all records are accurate and up-to-date. * Resubmit… more
- Prime Therapeutics (Raleigh, NC)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain with Health Plan administration experience of ... in-depth in healthcare payer domain within Group, member, Benefits & Claims Administration, Claims Payment & Vendor integration space. This person must… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role We are seeking an enthusiastic, results-oriented Enterprise Sr. Business Analyst /Product Specialist in the healthcare payer domain of Health Plan ... payer domain or Health Plan Administration (Benefits & Claims Administration, Vendor integration, Portals) and Healthcare ...Minimum 7 years of experience as a Senior Business Analyst or Product Specialist in healthcare payer… more
- Prime Therapeutics (Raleigh, NC)
- …analysis to include 1 year of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - REMOTE **Job Description** The Pricing Analyst maintains, provides… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain with Multi-employer Trust or Health Plan ... for client or product. The ideal candidate will have worked in-depth in healthcare payer domain in Multi-employer Trust (Hours & Eligibility management), Health Plan… more
- Prime Therapeutics (Raleigh, NC)
- …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... passion and drives every decision we make. **Job Posting Title** Data & Reporting Analyst - REMOTE **Job Description** The Data & Reporting Analyst is… more
- Norstella (Raleigh, NC)
- …(MD/DO), or a related field. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory data, in an academic ... Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States...In this role, you will leverage your expertise in ** healthcare data analytics** to extract meaningful insights from **real-world… more
- NTT DATA North America (Raleigh, NC)
- …+ Minimum of 5 years healthcare data analytics experience with understanding of claims , encounters, and quality measures + Minimum of 5 years hands on ... the right people on board, anything is possible. The quality , integrity, and commitment of our employees have been...strategy. NTT DATA Services currently seeks a **QA Data Analyst ** to join our team in **NC, Remote.** **Role… more
- CVS Health (Raleigh, NC)
- …Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including health insurance, PBM ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… more
- Highmark Health (Raleigh, NC)
- …Developers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, ... years in a relevant operational area (eg customer service, claims , enrollment and billing, etc.) to include 1 -...Insurance Industry + 1 - 3 years in the Healthcare Industry + 1 - 3 years in Lean/Six… more
- Public Consulting Group (Raleigh, NC)
- …Evaluation Consultant to join our team. This role involves analyzing large healthcare datasets and interpreting results of quality measures, supporting strategic ... analytical methodologies to ensure transparency and repeatability. + Develop and implement claims -based quality metrics to assess the performance of Medicaid… more
- Elevance Health (Durham, NC)
- …of committed clinicians and business leaders passionate about transforming American healthcare delivery. The **Senior Health Economist (** Advanced Analytics ... Analyst Senior) measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed story to… more
- TEKsystems (Raleigh, NC)
- …and systems. Qualifications: * Minimum of 5 years of experience working with healthcare software (eg, EHR/EMR systems, claims processing, provider portals). * ... Provider Relations Specialist plays a vital role in supporting the relationship between healthcare providers and the organization by serving as a primary point of… more
- Humana (Raleigh, NC)
- …and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... They will work closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the administration of Medicare business… more
- Highmark Health (Raleigh, NC)
- …Java Developer, DB2, Cogno, PEGA, Enterprise Architect(SCEA), Project Management, Certified Quality Analyst (CQA), Scrum Master Certification, Lean/Six Sigma ... complex applications that meet the service levels, system availability, performance and quality levels required by their customers. May mentor less experienced team… more
- Prime Therapeutics (Raleigh, NC)
- …information from research sources including the internet, trade publications, periodicals, analyst presentations, SEC filings, etc. + Support development of analytic ... 5 years of work experience in strategy, research or healthcare + Must be eligible to work in the...simultaneously **Preferred Qualifications** + Experience with large sets of claims data + In-depth knowledge of PBM industry +… more