- UTMB Health (Galveston, TX)
- Reimbursement Analyst ( Medicare /Medicaid), Partial Remote/Local - Government Reimbursement **Galveston, Texas, United States** Business, Managerial & Finance ... Accounting, Business, or related field. and a minimum of three years of Medicare and Medicaid Cost Report or related experience. An equivalent combination of… more
- Centene Corporation (Providence, RI)
- …healthcare to improve outcomes, advance quality, and promote equity. The Analyst , Value-Based Payment Initiatives (VBP) will support the expansion and performance ... of Medicare -focused VBP arrangements across New York, including ...terms, and generating insights to guide strategic decision-making. The Analyst will work closely with the VBP Manager, Director,… more
- CVS Health (Tallahassee, FL)
- …And we do it all with heart, each and every day. **Position Summary** Aetna Medicare Product Tools & Technology is seeking a Technical Business Analyst to join ... our exciting team. We build and support internal Medicare related applications that allow our business users to...to complete crucial business processes for Aetna. The Business Analyst plays a role in business problem solving and… more
- Humana (St. Paul, MN)
- …of our caring community and help us put health first** We are seeking an Actuarial Analyst 2 to join our Medicare Dental & Vision forecasting team. The Actuarial ... and independent determination of the appropriate courses of action. The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and… more
- ERP International (Laurel, MD)
- …( www.erpinternational.com ) is currently seeking Full-Time **Policy & Regulatory** ** Analyst ** to support of the **CMS Division of Enterprise Architecture** in ... requirements affect CMS business processes, IT systems, organizational roles, data standards, and governance frameworks. + Maintain comprehensive regulatory… more
- Molina Healthcare (Green Bay, WI)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data (SQL and advanced Excel functions) from internal and external sources to ... Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis… more
- Molina Healthcare (Fort Worth, TX)
- …on 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 to business and system requirements of customers as it pertains to… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Master Data Management Analyst I** The MDM Analyst within the ... as well as Integrations from/to Source/Target systems across multiple data domains. The MDM Analyst will utilize...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Bloom Healthcare (Lakewood, CO)
- Job Title: Data Analyst , Value Based Care Location: Denver, Colorado; Hybrid About Bloom: Bloom Healthcare is a pioneering and employee-owned primary care and ... place to work. Job Summary: We are seeking a Data Analyst , Value Based Care, to lead...document these findings to support BI-centric solutions, particularly with Medicare Advantage, ACO, and claims data . +… more
- LA Care Health Plan (Los Angeles, CA)
- Clinical Data Analyst III (HEDIS, Tableau, SQL) Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Clinical Data Analyst III supports Healthcare metrics, quality and process improvement… more
- Commonwealth Care Alliance (Boston, MA)
- …TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical ... ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also...and report outcome results on edits implemented. + Utilize data to examine large claims data sets… more
- Methodist Health System (Dallas, TX)
- …:** 5 days **Work Shift :** **Job Description :** Your Job: The SR REIMBURSEMENT( MEDICARE ) ANALYST will assist the Manager of Regulatory Compliance, the Manager ... * CPA Preferred * Position requires extensive knowledge of governmental programs ( Medicare and Medicaid). * Good written and oral communication skills. * Good… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency SUNY System Administration Title Healthcare Data Analyst Occupational Category No Preference Salary Grade NS Bargaining Unit PSNU - ... 353 Broadway City Albany State NY Zip Code 12246 Duties Description The Healthcare Data Analyst will conduct analyses and synthesize findings essential to the… more
- UCLA Health (Los Angeles, CA)
- …As a member of the Medicare Advantage Operations team, Business Data Analyst is instrumental in independently developing the detailed requirements ... requirements are understood and implemented consistent with the Business Data Analyst 's vision + perform testing, design...+ Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or… more
- Trinity Health (Columbus, OH)
- …financial analysis, audit, provider relations and more. **Position Purpose:** Pharmacy/Clinical Service Data Analyst is responsible for data collection, ... Shift **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare… more
- Zelis (TX)
- …you are. Position Overview We are seeking a detail-oriented and technically skilled analyst to support healthcare claims repricing and data validation efforts. ... (joins, CTEs, subqueries) to extract, manipulate, and audit claim data . + Evaluate pricing scenarios based on Medicare... data . + Evaluate pricing scenarios based on Medicare , Medicaid, and commercial reimbursement rules. + Apply working… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated ... sound strategic planning, decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The HIIM Data Integrity Analyst is responsible for ensuring the accuracy, completeness, and integrity of medical records by reviewing, indexing, ... Medicare Conditions of Participation, and other regulatory requirements. The HIIM Data Integrity Analyst assigns deficiencies to providers, verifies document… more
- Convey Health Solutions (Chicago, IL)
- Job Description SUMMARY The Data Analyst will be responsible for utilizing technical and industry knowledge to accelerate analytic insights and new feature ... desired deliverables will be vital to success. Collaborating within a team, the analyst will engage with engineers, QA, Data Scientists, and Product teams… more
- Prime Therapeutics (Lansing, MI)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Health Data Analyst - Remote **Job Description** The Health Data Analyst ... and consultative work such as analyzing and interpreting client pharmacy benefit data , trends and reports and partnering with analytics team to deliver… more