- Cognizant (Springfield, IL)
- 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
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …The Business Analyst will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy and first-pass resolution rates. + Gather ... File Transfer Filters Careers Added Jul 21, 2025 Business Analyst - Claims Systems (26971) Chicago, IL...years relevant IT experience overall. + Experience in the Healthcare industry domain, including and especially Claims … more
- Evolent (Springfield, IL)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Prime Therapeutics (Springfield, IL)
- …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
- Elevance Health (Chicago, IL)
- …of committed clinicians and business leaders passionate about transforming American healthcare delivery. The **Advanced Analytics Analyst Senior** measures ... **Advanced Analytics Analyst Senior - Medical Economics** **Location:** Atlanta, GA;...financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed… more
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** The Analyst will support the research, clinical, quality improvement, and business data ... analysis needs of Rush University Medical Center. The Analyst will assist clinical faculty and Principal Investigators to identify and gather necessary data that… more
- Prime Therapeutics (Springfield, IL)
- …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst … more
- Highmark Health (Springfield, IL)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Prime Therapeutics (Springfield, IL)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- Option Care Health (Bannockburn, IL)
- …that attracts, hires and retains the best and brightest talent in healthcare . **Job Description Summary:** The Analyst , Compliance Auditing, Monitoring and ... advanced analytics techniques to analyze large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance… more
- Evolent (Springfield, IL)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value...health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- IBM (Chicago, IL)
- …including content creation, review and approval, digital asset management (DAM), claims management, and modular content * Implement client's E2E content supply ... for the end to end content lifecycle * Ensure quality of data best practices in Veeva PromoMats and...content creation, review and approval, digital asset management (DAM), claims management, and modular content * Consulting experience with… more
- CVS Health (IL)
- …accordance with company standards while meeting and exceeding accessibility, compliance, quality , and cost initiatives. Verifies contract compliance and adherence to ... metrics and training to ensure compliance with the company's regulatory, safety, quality , and confidentiality protocols and standards. + Ensures a high level of… more
- Evolent (Springfield, IL)
- …You Will Be Doing:** + **Strategic Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... monthly, quarterly, and annual client reporting. In addition to quality review and client Q & A reporting. +...areas of sensitivity + 2 years of Account Management healthcare experience To ensure a secure hiring process we… more
- Highmark Health (Springfield, IL)
- …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
- CVS Health (IL)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- CVS Health (Northbrook, IL)
- …do it all with heart, each and every day. **Position Summary** The Senior Analyst - Business Analytics will be a detail-oriented individual with strong data analysis ... regulations, review of compliance interpretation, writing business specifications, data quality review, data preparation and compliance to regulatory requirements.… more
- Spectrum Billing Solutions (Skokie, IL)
- Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and ... required timeframes for provider communications, enrollments, and follow-ups. + Maintain quality working relationships with internal and external customers. What we… more
- Public Consulting Group (Springfield, IL)
- …**Duties and Responsibilities** + Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages department providing ... Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory...Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets A Test Leader oversees the… more
- Highmark Health (Springfield, IL)
- …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