- Molina Healthcare (New York, NY)
- …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
- Capital One (New York, NY)
- Sr . Distinguished Engineer - Fraud Technology (Remote-Eligible) As a Sr . Distinguished Engineer at Capital One, you will be a part of a community of technical ... on our customers' lives. We are looking for a Senior Distinguished Engineer to define, architect and drive the...Define and drive technical strategy and roadmap for our systems and platforms that power Fraud defenses and Fraud… more
- Molina Healthcare (New York, NY)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Two95 International Inc. (New York, NY)
- …SOW will meet their needs * Lead the discovery of the client's EMR/EHR and/or claims data environment so we can efficiently and effectively navigate and do the ... Job Title: Sr . Analytics Consultant Job type : Remote Work...analyses * Lead the analytical-interrogation of their EMR/EHR and/or claims data to perform data … more
- Terumo Medical Corporation (Somerset, NJ)
- …plans, and provides training and re-training to associates, as needed. + Leverages data analytics tools and create reports for senior management to create ... Sr . Compliance Manager - Monitoring & Transparency Date:...& Medicaid Services (CMS). Performs analytics on CMS available data and provides meaningful insights to senior … more
- Acxiom (New York, NY)
- …and segment longitudinal healthcare provider and HIPAA compliant patient's health claims data to optimize targeted engagement strategies. **Audience Portfolio ... a highly analytical and detail-oriented **Healthcare & Media Strategy Sr . Analyst** to inform Acxiom Health Product in developing...Public Health. 5 - 7 years advanced analytics and data experience in healthcare systems , health-tech or… more
- Molina Healthcare (New York, NY)
- …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst, Healthcare Analytics role will be responsible...I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + Data… more
- Elevance Health (Woodbridge, NJ)
- **Clinical Quality Management Analyst Sr . Behavioral Health** **Location:** 111 Wood Ave. S, Iselin, NJ 08830 **Office Requirement:** This role requires associates ... locations may be considered. The **Behavioral Health Clinical Quality Analyst Sr .** is responsible for developing and conducting more complex behavioral health… more
- Cushman & Wakefield (New York, NY)
- **Job Title** Sr . Facilities Manager **Job Description Summary** This position has managerial oversight of multiple facilities, an entire campus, or a portfolio of ... Facilities Manager and/or Assistant Facilities Manager reporting into it. The Senior Facilities Manager has the overall responsibility for overseeing the… more
- Molina Healthcare (New York, NY)
- … systems to support executive decision-making + Mine and manage information from large data sources + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...reports, and improvement opportunities based on analyses + Provide data driven analytics to Clinical COE, Finance, Claims… more
- Molina Healthcare (New York, NY)
- … systems to support executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical… more
- Molina Healthcare (New York, NY)
- … 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
- BD (Becton, Dickinson and Company) (Franklin Lakes, NJ)
- …strategic advisor to the EVP & Chief Information Officer and other senior leaders. Additionally, this individual will partner in developing functional capability ... client market spaces including external talent trends, culture, reward systems , and organization models + Works on complex issues...Works on complex issues where analysis of situations or data requires an in-depth knowledge of the team and… more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current Molina employees: If you… more
- MetLife (New York, NY)
- …and possess in-depth knowledge of plan designs, benefit features and how claims are paid * Strong understanding of industry marketplace and legal developments. ... all levels of the organization * Ability to analyze data to influence and execute on renewal decisions *...computer navigation skills and ability to work in multiple systems simultaneously (Microsoft suite, different company platforms) * Strong… more
- Axis (New York, NY)
- …volume of tasks efficiently * Proactively asks questions to ensure proper handling of claims * Willingness to learn new systems and processes in a fast-paced ... for candidates taking part in the selection process. Reinsurance Senior Claim Specialist - Job Description Job Family Grouping:...Claim Specialist - Job Description Job Family Grouping: Reinsurance Claims Job Family: Claims Location: New York… more
- Axis (New York, NY)
- …+ Background in designing, developing, and implementing IT systems within claims operations. + Solid understanding of data analysis, budgeting, and business ... Claims Value Stream Lead will collaborate closely with Claims senior leadership to translate their needs...learn and share knowledge. + **Making Disciplined Decisions:** Use data and analytics to form plans and actions, exercising… more
- Axis (New York, NY)
- …specialty insurers + A good working knowledge of the workstreams, workflows, processes, and claims systems , in aP&C claims organization, for both North ... multiple departments. The Product Owner would focus on managing and enhancing claims -related products, systems , and processes. Their role involves translating… more
- City of New York (New York, NY)
- …to contracting with government and/or insurance companies. - Experience guiding insurance claims data analysis - Experience in Management Service Organizations, ... impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care organizations.… more
- City of New York (New York, NY)
- … data warehousing services to constituent divisions of the Finance Office. The Senior Systems Analyst will perform technical and analytical work that will ... seeking an Associate Staff Analyst to function as the Senior Systems Analyst within Management & Policy...and qualitative analysis of special projects from ORMD and senior executive staff. Manage large amounts of data… more