- 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
- 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 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
- 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 (Providence, RI)
- …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 opportunity… more
- Prime Therapeutics (Providence, RI)
- …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)
- Fraud Analytics and Innovation Lead Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; New York, New York; Boston, Massachusetts; Chandler, Arizona; ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Newark/Fraud-Analytics-and-Innovation-Lead- Analyst \_25028063) **Job Description:** At Bank of America, we are… more
- Fenway Health (Boston, MA)
- …creation of appeals, workflows, and edits based on recurring denials or underpayments. Data Reporting & Visualization + Build and maintain real-time dashboards ... Revenue Cycle Analyst Fully Remote * Boston, MA (http://maps.google.com/maps?q=126+Brookline+Ave+Boston+MA+USA+02215) * Finance Job Type Full-time Description … 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
- Evolent (Providence, RI)
- …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
- Point32Health (Canton, MA)
- …**Job Summary** Reporting to the Director of Commercial Analytics and Reporting , the Lead Commercial Performance Analyst is responsible for the development ... familiarity with clinical, wellness and pharmacy metrics, good understanding of membership, claims , and pharmacy data preferred. **Compensation & Total Rewards… 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 (Providence, RI)
- …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
- Cognizant (Providence, RI)
- …modern technologies to transform a variety of business operations. The **Encounters Analyst ** plays a critical role in ensuring the accurate and timely submission ... of healthcare encounter data to regulatory agencies. This **fully remote, US-based** position...training manuals, and knowledge management databases. **Stakeholder Engagement & Reporting ** + Respond to internal and external customer queries… more
- Verint Systems, Inc. (Providence, RI)
- …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. (Providence, RI)
- …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 (Providence, RI)
- …and complexity + Coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + Project leadership in ... :** Highmark Health **Job Description :** **JOB SUMMARY** This role creates data -driven insights to identify actionable opportunities aligned to the Quadruple Aim of… 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