- Molina Healthcare (Warren, MI)
- …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
- Molina Healthcare (Warren, MI)
- …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
- Molina Healthcare (Warren, MI)
- …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
- Molina Healthcare (Warren, MI)
- …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
- Molina Healthcare (Warren, MI)
- …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...(including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future… more
- Molina Healthcare (Warren, MI)
- … 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 (Warren, MI)
- … 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 (Warren, MI)
- … 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
- Molina Healthcare (Warren, MI)
- **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
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Senior Data Analytics Lead, you report to the Vice ... simultaneously. **Here's what you will experience working as our Senior Data Analytics Lead:** + Work with... analysis role working with large healthcare datasets (preferably claims data ) and a familiarity with the… more
- Walgreens (Farmington Hills, MI)
- …with Company policies and procedures. + Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Assists ... and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- General Motors (Warren, MI)
- **Job Description** ** Senior Product Manager, Low Voltage Architecture** **Hybrid:** This role is categorized as hybrid. This means the successful candidate is ... GM vehicles. From mechatronic infrastructure to OnStar connected services, and infotainment systems to autonomous driving - we are creating complete and compelling… more
- Trinity Health (Livonia, MI)
- …healthcare industry. 3. Collects, analyzes and summarizes market, financial, clinical and claims data from publicly available and internal sources as appropriate ... capital and operating budget process; e. Identifying trends or patterns in complex claims data . 5. Develops and communicates ongoing assessment of healthcare… more
- Integra Partners (Troy, MI)
- …of healthcare claims processing, billing, adjudication, EDI, clinical information systems , big data , and other such systems . Business/Operational ... next steps required. Working closely with the CEO and senior leadership team, the CIO is responsible for maintaining...for the organization. Create a Scalable, Compliant, and Secure Data and IT Infrastructure The CIO will be responsible… more
- Sedgwick (Detroit, MI)
- …and productivity; to provide strategic planning; to assure security and integrity of data systems ; and to manage vendors and evaluate third party and ... to support efficient technology for internal and customer use; serves as a senior management liaison with other departments within and beyond the Systems … more
- Sedgwick (Detroit, MI)
- …Attends regular client implementation meetings to gather and interpret critical data necessary for success. + Prepares essential documentation including overpayment ... reports, meeting minutes, and project plans. Provides regular updates to senior management and stakeholders. + Facilitates communication between clients and internal… more
- Sedgwick (Southfield, MI)
- …(WFM) team and their work for a high-volume contact center. + Leverage data analytics and workforce tools to enhance reporting, drive operational improvements, and ... occupancy, shrinkage, and adherence. + Present reports and insights to senior leadership, providing recommendations for improving contact center efficiency and… more
- Trinity Health (Pontiac, MI)
- …Mission, Vision, and Values in behaviors, practices, supports and endorses senior leadership decisions, goals, objectives, and strategies. Assists the General ... EVS programs. Coordinates within the RHM: + Implementation of core program systems (Cleaning Practices and protocols, auditing tools, competencies, etc.) + Staff… more