- Cognizant (Trenton, NJ)
- 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 (Trenton, NJ)
- …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
- AIG (Jersey City, NJ)
- …and efficiency. How you will create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") ... Claims Complex Director - Healthcare Professional...analyst will investigate losses, orchestrate defense strategies for healthcare provider insureds, conduct independent assessments as to exposures… more
- Evolent (Trenton, NJ)
- …**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
- Robert Half Technology (Florham Park, NJ)
- Description A Senior Software Business Analyst is needed to play a crucial role in connecting business requirements to technical solutions. This role involves ... products, and tailored services to optimize patient outcomes and improve healthcare delivery. ** Qualified candidates should have experience with pharmacy insurance,… more
- Prime Therapeutics (Trenton, NJ)
- …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
- Terumo Medical Corporation (Somerset, NJ)
- Contract Analyst , Temp Date: Sep 22, 2025 Req ID: 5174 Location: Somerset, NJ, US, 08873 Company: Terumo Medical Corporation Department: Contracting and Analytics ... **Job Summary** The Temp Contract Analyst is responsible for administering specific assigned stages of...involve the sale of Terumo product, to ensure high quality contracts that are effective, equitable and compliant. The… more
- Evolent (Trenton, NJ)
- … quality reporting, and benchmarking + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and ... that fosters expertise and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding health plan cost &… more
- Prime Therapeutics (Trenton, NJ)
- …Posting Title** QA Analyst PBM Implementation - Remote **Job Description** The Quality Assurance (QA) Analyst performs complex quality reviews and serves ... GED is required + 2 years of experience within Claims Processing, Audit, Quality or Pharmacy +...Licensed Practical Nurse certification if working in Medicare + Healthcare , audit, and/or reporting and metrics environment experience +… more
- Terumo Medical Corporation (Somerset, NJ)
- …be bold, think outside the box, experiment, innovate and deliver what's next for quality healthcare . You will be part of a collaborative, respectful and ... develops, manufactures, and markets a complete, solutions-based portfolio of high- quality medical devices used in a broad range of...healthcare with heart_** **Job Summary** The Senior Tax Analyst , Indirect Tax will work with the Senior Tax… more
- CVS Health (Trenton, NJ)
- …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
- Evolent (Trenton, NJ)
- …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
- The Cigna Group (Jersey City, NJ)
- …go into the NYC office two times per month._** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and reports to ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- CVS Health (Trenton, NJ)
- …service orientation and attention to detail. **Preferred Qualifications** + Background in healthcare or claims processing experience. + Experience with Aetna ... technical expertise with strong communication and problem-solving skills to deliver high- quality support and drive continuous improvement. + Respond promptly and… more
- Evolent (Trenton, NJ)
- …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
- Virtua Health (Mount Laurel, NJ)
- …by US News and World Report, we've received multiple awards for quality , safety, and outstanding work environment.In addition to five hospitals, seven emergency ... Financial Services staff for reporting problems and denials on individual claims . Assist in researching coding issues, provide guidance and recommend solution… more
- Highmark Health (Trenton, NJ)
- …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
- Highmark Health (Trenton, NJ)
- …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 (Trenton, NJ)
- …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
- Norstella (Trenton, NJ)
- …manage a multi‑region product team and partner closely with Engineering, Content/ Analyst teams, Data Science, and Go‑to‑Market to deliver best‑in‑class forecasting, ... Integration** + Partner with Engineering and Data Science to incorporate RWD ( claims , lab, EMR) where it improves forecast accuracy and scenario planning. Champion… more