- Independent Living Systems (Miami, FL)
- …Certification such as Certified Business Analysis Professional (CBAP) or Certified Healthcare Business Analyst (CHBA). Experience with Electronic Health ... field. At least 4 years of experience as a Business Analyst within the healthcare ...and implement practitioner, hospital, and ancillary contracts into the claims system, including amendments and claims testing.… more
- JS Perkins Consulting (Falls Church, VA)
- …Here is the Role: JS Perkins Consulting (JSPC) is seeking to hire a Budget Analyst to support the Defense Health Agency (DHA) Office of General Counsel (OGC) in its ... improve financial oversight and increase collections through the Medical Affirmative Claims (MAC) and Third-Party Collections (TPC) programs. This role will provide… more
- Molina Healthcare (KY)
- …**Job Summary** **Job Summary** Responsible for comprehensive contract review and target claims audit review. This includes but not limited to deep dive, contract ... review and targeted claims audits related to accurate and timely implementations and...validate data stored on databases and ensure adherence to business and system requirements of stakeholders as it pertains… more
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …Global NavigationEmployee Login (http://www2.lrs.com) File Transfer Filters Careers Added Jul 21, 2025 Business Analyst - Claims Systems (26971) Chicago, IL ... need to talk! LRS Consulting Services is seeking a Business Analyst for a long-term, hybrid onsite... will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy and… more
- Molina Healthcare (Grand Island, NE)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Savers | Value Village (Bellevue, WA)
- **Description** Job Title: Claims Analyst (Remote, USA) Pay Range: $52,014 - $73,860 Savers Benefits Geographic & job eligibility rules may apply Healthcare ... + To work in a purpose-driven company, with a business model that people love for our impact on...supplement our offerings. What you'll be working on: The Claims Analyst supports Saver's risk mitigation strategy… more
- Catholic Health (Buffalo, NY)
- …EDUCATION + Bachelors: minimum two (2) year of job experience in a computer science, business or healthcare field + Associates: minimum four (4) years of job ... technology method of transformation. Supports the organizations Revenue Cycle claims and remittance process. Identifies and implements EPIC and/or...experience in a computer science, business or healthcare field + High School… more
- Molina Healthcare (NY)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... adjustment to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience… more
- Molina Healthcare (Grand Island, NE)
- …advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and ... trends to provide analytic support for finance, pricing and actuarial functions. + Healthcare Analyst I experience desired. + PowerBI, Excel, Power Pivot, VBA,… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (Cincinnati, OH)
- …a critical role in supporting clinical and operational initiatives by translating healthcare business needs into technical solutions. This role works closely ... solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. *… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (MI)
- …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... numbers, assess business impacts, and make recommendations through use of healthcare analytics, etc. + Analysis of trends in medical costs to provide analytic… more
- Molina Healthcare (Provo, UT)
- **Job Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and...+ At least 6 years of experience as a Business Analyst or Program Manager in a… more
- Molina Healthcare (Layton, UT)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Evolent (Helena, MT)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Catholic Health (Buffalo, NY)
- …Exempt from Overtime: Exempt: Yes Work Schedule: Days Hours: 8-4 Summary: The Healthcare Analyst III will be responsible for compiling, formatting, maintaining ... our quality and utilization objectives and NCQA accreditation requirements. Additionally, the Healthcare Analyst III will be responsible for the administration… more
- Molina Healthcare (Caldwell, ID)
- …and/or detects violation of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the Business ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- Beth Israel Lahey Health (Wakefield, MA)
- …including but not limited to:** + Understands the medical and pharmacy claims adjudication circle terminology, healthcare quality and EHR terminology and ... the reporting documentation repository. + Collaborates with the Medical Director(s) and business associates (eg, healthcare plan, PBM, consultants) to define the… more
- Elevance Health (Chicago, IL)
- **Senior Healthcare Economics Analyst - Cost of Care** **Location:** Chicago, IL (preferred). This role requires associates to be in-office 1 - 2 days per week, ... is not eligible for current or future visa sponsorship._ The **Senior Healthcare Economics Analyst ** creates statistical models to predict, classify, quantify,… more
