- 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 (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
- 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
- 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
- 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 ... the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique… more
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Fallon Health (Worcester, MA)
- …on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose** : The Risk Adjustment Analyst (RAA) will be a SME for the MassHealth risk adjustment model(s) and ... related data submission requirements. This role will be familiar with...streams relevant to the product line(s) and will develop reporting to enhance efficiency of Fallon's chart retrieval process.… more
- 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
- CVS Health (Boston, MA)
- …and subpoenas. + Handle and manage UCC liens. + Manage and responsible for data integrity on various reporting to leadership which includes monthly metrics ... each and every day. **Position Summary** The Corporate Services Analyst will provide legal support, support litigation management, and...reporting and monthly litigation reporting . + Collaborate with appropriate departments to obtain claim… more
- Verint Systems, Inc. (Boston, MA)
- …Learn more at www.verint.com . **Overview of Job Function:** The Benefits Analyst will be responsible for the day-to-day initiatives of all annual projects ... host open enrollment webinars and respond to employee questions + Ensure timely reporting of all federal and state compliance filings (including CMS, WSIB Annual… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …tailor solutions to support individual health needs and improve how people engage. Data is the cornerstone of our platform, connecting people and partners and ... collective impact on total healthcare. **About This Team** The Data & Technology Delivery Team serves as a key...to ensure stakeholder engagement and program success + Status Reporting : Project health (risks, issues, decisions ) + Communicate… more
- Highmark Health (Boston, MA)
- …+ 7 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 5 years of project ... Highmark Health **Job Description :** **JOB SUMMARY** This job creates data -driven insights which identify actionable opportunities through analytics and … more