- Molina Healthcare (Nampa, ID)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, ... analyses + Provide data driven analytics to Clinical COE, Finance, Claims , Medical Management, Network, and other departments to enable critical decision making… more
- Molina Healthcare (Nampa, ID)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- CVS Health (Boise, ID)
- …including Excel and Microsoft Word **Preferred Qualifications** -2-4 years experience as a medical assistant, office assistant or claim processor -ATV, HRP, or ... day. **Position Summary** -Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and… more
- Molina Healthcare (Nampa, ID)
- …SKILLS & ABILITIES:** + 1-3 years claims analysis experience + 5+ years medical claims processing experience across multiple states, markets, and claim ... **PREFERRED EXPERIENCE:** + 1-3 years claims analysis + 6+ years medical claims processing experience + Project management + Expert in Excel and PowerPoint… more
- Molina Healthcare (Nampa, ID)
- …sources. + Resource to staff for mentoring, coaching, and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Medical Economics Team activities and personnel. Provides technical expertise,… more
- Cognizant (Boise, ID)
- …IT organization and lead changes to such specifications (with senior business analyst oversight through peer reviews); Develop an informed knowledge of the business ... + 3+years Medicare/Medicaid regulatory healthcare experience + Knowledge of claim adjudication processes and Facets platform experience preferred + Experience… more
- Molina Healthcare (Nampa, ID)
- …the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements. + Create Business Requirements ... + Experience working with complex, often highly technical teams + Strong claims investigation experience within managed care + Background working with providers and… more
- R1 RCM (Boise, ID)
- …AI, intelligent automation, and workflow orchestration. As our R37 GenAI Lab Senior Process Analyst in the Perfect Claim pillar, you will play a key role ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...Analyst :** + Analyze and optimize current edits in claim scrubbers to improve claim processing accuracy… more
- WelbeHealth (Boise, ID)
- The Lead Data Analyst is an analytically heavy hands-on role, utilizing processed business information points as the basis to further define and build out metrics, ... provider and/or payer operations. + Minimum three years' of experience working with claims data and provider network data. + Preferred experience in Health Plan… more
- Evolent (Boise, ID)
- …contribute to Evolent's broader mission. **Collaboration Opportunities:** The Senior Analyst , Performance Suite Analytics utilizes and develops analytic tools to ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Business Development efforts. Working in… more
- Evolent (Boise, ID)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS, Specialty… more
- Molina Healthcare (Nampa, ID)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Evolent (Boise, ID)
- …internship + Experience with financial forecasting + Familiarity or experience with medical /pharmacy claims + Familiarity with PowerQuery/BI/VBA + Ability to ... more connected care journey. We are hiring an Actuarial Analyst to join our Actuarial Services Team. **What You'll...Actuarial Services Team. **What You'll Be Doing:** The Actuarial Analyst will inform decision making across the company and… more
- Evolent (Boise, ID)
- …Stay for the culture. **What You'll Be Doing:** Job Description Senior Analyst , Performance Analytics - **RBM Cardiac** product focus, utilizes and develops analytic ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Product Development efforts. **What You'll… more
- Molina Healthcare (Nampa, ID)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Economics, Math, or Computer Science **Preferred Experience** Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators: + Proactively… more
- Idaho Division of Human Resources (Boise, ID)
- Research Analyst Principal - MED Posting Begin Date: 2025/04/08 Posting End Date: 2025/05/18 Category: Research Sub Category: Business Work Type: Full Time Remote: ... Health and Welfare, Division of Medicaid has an exciting opportunity for aResearch Analyst Principalon our data analytics team. This position will support the data… more
- Humana (Boise, ID)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Molina Healthcare (Nampa, ID)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- Molina Healthcare (Nampa, ID)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and… more
- Highmark Health (Boise, ID)
- …and scalability and reusability of benefit configurations. Develop and execute claims testing plan, scenarios, documentation and defect management to ensure minimal ... strategy development for new strategic programs. + Research and analyze claims processing problems, perform initial problem identification and resolution activities,… more