- CVS Health (Woonsocket, RI)
- …Experience Transmission (CET Files) on behalf of our Clients and their vendors. The Claims Data Reporting Analyst will have primary responsibility and ... it all with heart, each and every day. **Position Summary** PBM Financial Operations Data Reporting is responsible for the implementation and ongoing support of … more
- 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
- BJs Wholesale Club (Marlborough, MA)
- …and ensures there is an efficient use of BJ's resources. Reviews open claims to ensure carrier/excess carrier reporting , determines compensability, scheduling of ... compensation training to educate clubs/internal partners. + Manages the data flow through a central Outlook inbox between risk,.... + Partners with Asset Prevention/Safety on team member claims trend information and any required OSHA reporting… more
- 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 plays ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible...& Abilities (must have):** + Proficiency with Excel and reporting tools for data analysis. + Understanding… more
- Beth Israel Lahey Health (Boston, MA)
- …you're not just taking a job, you're making a difference in people's lives.** Reporting to the Director of Revenue Cycle Operations, this position is responsible for ... planning, coordinating and managing HIPAA EDI activities including Claims , Remittance, as well as Provider Enrollment processing for Harvard Medical Faculty… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …of Field Technology will lead the design, optimization, and delivery of field sales reporting platforms and tools. This role is critical in ensuring that our field ... teams have seamless access to accurate, actionable data to drive performance. The role focuses on managing...Serve as the business lead for execution of field reporting and enablement systems within the assigned therapeutic area.… more
- Sumitomo Pharma (Boston, MA)
- …Master's) of relevant experience. + Experience in pharmaceutical commercial operations and data reporting strongly preferred. + Familiarity with sales operations ... + Partner cross-functionally with Sales, Market Access, Commercial Analytics, CRM and Data Strategy to align reporting solutions with business goals and… more
- Chiesi (Boston, MA)
- … data mining efforts to solve unmet medical needs; support the analysis of claims data to generate market insights + Identify and shape business challenges ... has an opening for a newly created role of Data Science Manager, reporting to the Head...Experience in biotech / pharmaceuticals preferred + Direct experience claims data analysis is a plus +… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …plan for the Medicare and Merged Market segments. The Director of Risk Adjustment Data and Analytics will oversee the reporting , analytics and management of risk ... Directory of Medicare Risk Adjustment and Analytics, the Director of Risk Adjustment Data and Analytics is responsible for developing and executing the analytic… more
- Humana (Boston, MA)
- …recognition of their service. The Associate Vice President (AVP) of Provider Data maintains responsibility for the timely update and accurate representation of ... information to ensure an up-to-date provider directory as well as appropriate claims adjudication impacting a multitude of downstream efforts to include (Referrals,… more
- CODAMETRIX (Boston, MA)
- …to clinical care. Overview The Vice President, Data Platforms is a member of the Data & Analytics team, reporting to the Senior Vice President, Data & ... stores, etc.) + Experience working with structured, semi-structured, and unstructured healthcare data (EHR, claims , clinical notes, HL7, FHIR) is highly… more
- Cardinal Health (Boston, MA)
- …and embeddings model. + Extensive knowledge of healthcare data , including clinical data , patient demographics, and claims data . Understanding of HIPAA ... **_What Data Science contributes to Cardinal Health_** The ...data platforms, the access, design and implementation of reporting /business intelligence solutions, and the application of advanced quantitative… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Bring your true colors to blue. What we need The Associate Director of Clinical Data Management will be a key leader in executing BCBSMA's data & analytics ... The successful candidate will be responsible for leading the clinical data management function, providing strategic direction, and ensuring the delivery of… more
- US Tech Solutions (Boston, MA)
- …code the technical specifications to operationalize the measures, and create the reporting and dashboards for the care team's needs. **Responsibilities:** + Extract ... data from various sources, including electronic health records (EHRs), claims databases, registries, and other clinical systems and develop the data pipeline… more
- Takeda Pharmaceuticals (Lexington, MA)
- …coordinating with data teams to ensure timeliness and accuracy of data updates, tracking product performance, providing analytical reporting , and optimizing ... Knowledge - experience working with internal and secondary data (IQVIA / Komodo / Symphony claims ,...secondary data (IQVIA / Komodo / Symphony claims , specialty pharmacy, 867, etc.) and integrating results into… more
- Takeda Pharmaceuticals (Lexington, MA)
- …business operations. This role involves tracking product performance, providing analytic reporting , and optimizing data analysis methodologies to identify trends ... + Data Knowledge - Experience working with internal and secondary data (867, specialty pharmacy, IQVIA/Komodo/Symphony claims , etc.) and integrating results… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Medical Expense Team, Segment Leaders, Enterprise Analytics Executive Team, Market Reporting Oversight Team, Pharmacy Leadership Committee, Data Access Layer ... well as BCBSMA Account Facing Value Proposition insights and reporting . The analytics vary in size and scope, and...includes the development and communication of market segment medical claims expense trends with the aim to provide insights… more
- 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
- Evolent (Boston, MA)
- …insights and compelling narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization ... product, and operational leaders to deliver client-specific insights and drive data -informed decision-making. Our team serves as strategic advisors, analysts, and… more
- Western Digital (Boston, MA)
- …safety and fire prevention + Emergency preparedness + Business recovery + Coordinate the reporting of property and cargo claims to insurers or against third ... enabling systems to make cities safer and more connected, to powering the data centers behind many of the world's biggest companies and hyperscale cloud providers,… more