- Molina Healthcare (West Valley City, UT)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Evolent (Salt Lake City, UT)
- …Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems ... interactions fostering expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **Qualifications… more
- Molina Healthcare (West Valley City, UT)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Evolent (Salt Lake City, UT)
- …skills + Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical ... You'll Be Doing:** Evolent Health is looking for a Senior Product Owner to be a key member of...key member of the Product team, focused on client data integrations. This individual will play a critical role… more
- Humana (Salt Lake City, UT)
- …community and help us put health first** Humana's Gulf South Region is seeking a Senior Data and Reporting Professional that generates ad hoc reports and regular ... or data warehouse queries and scripts. The Senior Data and Reporting Professional: + Integrates...insurance industry or health care sector with authorization or claims data + Ability to see trends… more
- Cardinal Health (Salt Lake City, UT)
- …and enhance the overall healthcare experience. We are seeking a highly motivated and experienced Senior Data Scientist to join our team as a thought leader and ... data to solve complex business problems on large data sets, integrating multiple systems . At Cardinal...Extensive knowledge of healthcare data , including clinical data , patient demographics, and claims data… more
- Datavant (Salt Lake City, UT)
- …designing, developing, and maintaining robust data pipelines for healthcare data including prescriptions, medical claims , MAO4, patient demographics, and ... with the other engineering teams to troubleshoot issues with API's and data exchanges between multiple systems . **What You Need to Succeed** + 5+ years Data … more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- **Position Summary** The Senior Manager of Field Technology will lead the design, optimization, and delivery of field sales reporting platforms and tools. This role ... in ensuring that our field teams have seamless access to accurate, actionable data to drive performance. The role focuses on managing field-facing technology … more
- Evolent (Salt Lake City, UT)
- …SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data * Using analytical tools to integrate various data ... care data including medical, pharmacy and ancillary claims data , membership data , clinical...feasible given data limitations * Understanding of data systems and the critical thinking skills… more
- Highmark Health (Salt Lake City, UT)
- …overall business targets or assigned volume of new applications or RFP's.Utilize various systems and tools to obtain necessary data and accurately complete and ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of… more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- …- Interacts effectively with internal/external functional business units to gather data and develop documentation required for on-time submissions. - Works closely ... (Word, Excel, PowerPoint, Outlook) and familiarity with electronic document management systems (EDMS). **Competencies** See OPDC Competencies Chart (Level X) **P**… more
- Highmark Health (Salt Lake City, UT)
- …years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider data + 3 years of project ... office periodically for scheduled business meetings.** This job creates data -driven insights which identify actionable opportunities and/or create analytics and… more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- …of the Quality Systems and Risks will be reported periodically to Senior Management through the Management Review process to ensure alignment with Company policy ... the R&D audit program, engage with regulatory authorities, and maintain clinical data integrity. The leader will be responsible for providing a compelling vision… more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- …Content Enablement -this leader ensures that insights, content, tools, training, and systems are aligned to business priorities and delivered with excellence. This ... therapeutic-area specific Brand Analytics & Insights, Payer and Field Analytics, Data Enablement, and Forecasting. + Deliver timely, actionable insights and decision… more
- Highmark Health (Salt Lake City, UT)
- …overall business targets/or assigned volume of new applications or RFP's.Utilizes various systems and tools to obtain necessary data and accurately complete ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses… more
- Waystar (Lehi, UT)
- …the leading Healthcare Revenue Cycle Management (RCM) technology company, is seeking a seasoned Senior Data Engineer to support and evolve our Data Licensing ... insights to customers. You will work with complex healthcare data from multiple source systems and ensure...accuracy and quality. **Preferred:** + Experience working with healthcare data and understanding RCM processes ( claims , billing,… more
- Highmark Health (Salt Lake City, UT)
- …utilization and care management solutions, patient-focused digital products, and clinical data exchange capabilities, as well as outsourced technology and BPO ... competitive pricing strategies for our diverse portfolio SaaS, Platform, Modular, Data and AI-based healthcare technology products and services, covering the Payor… more
- R1 RCM (Salt Lake City, UT)
- …hospitals and systems to review and test Medicare bad debt claims for Medicare reimbursement. **Responsibilities:** + Analyze and interpret patient accounts for ... management services which transform and solve challenges across health systems , hospitals and physician practices. Our mission is to...ready for their review prior to submitting to the manager/ senior manager. Working as a part of the Government… more