- Highlight Health (Philadelphia, PA)
- …Health is a mission-driven company that protects consumer rights and controls healthcare costs exclusively for self-funded employers and their stop loss carriers. We ... are looking for a health coverage large and complex claims analysis expert - an expert who has scrutinized...engineers new ways to protect consumer rights and control healthcare costs for self-funded employers. Nearly every American has… more
- Ahold Delhaize USA (Scarborough, ME)
- …Position Summary Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility ... claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, … more
- OCHIN (Portland, OR)
- …Full-time Description MAKE A DIFFERENCE AT OCHIN Position Overview The Epic Resolute PB/PB Claims Application Analyst on our Install team supports the mission of ... team support model. Serve as internal advisor to other analyst as the lead working sessions with OCHIN members...of 2 years of build experience. Work history in Healthcare IT is required Bachelor's Degree preferred or a… more
- Sentara Healthcare (Richmond, VA)
- City/State Richmond, VA Work Shift First (Days) Overview: The Senior Business Analyst is responsible for the implementation, analysis, and support of quality ... conduct testing, and ensure the successful implementation of business solutions. The analyst provides subject matter expertise in operational areas such as claims… more
- Molina Healthcare (Long Beach, CA)
- Job Description Job Description Job Summary The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... Develops custom health plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates Assists and collaborates with the national Risk… more
- RIT Solutions, Inc. (Glendale, CA)
- …role? The contractor will be working to help implement & test a new claims tracking system being built from the ground-up using proprietary technology. They will ... the MUST HAVE technologies for this position? 1. Expert knowledge of industry-standard healthcare EDI formats (eg, 837s, 835, 999, etc.) 2. Expert knowledge of flat… more
- Nationwide Mutual Insurance Company (Milwaukee, WI)
- …Benefits (Stop Loss), we empower self-funded employers to take control of their healthcare costs with confidence. Backed by the strength and stability of the ... brand, our stop loss solutions offer financial protection against catastrophic claims , helping businesses manage risk while supporting employee well-being. With… more
- RxSense (Princeton, NJ)
- …healthcare (PBM) 1+ year's of experience in formulary operations, pharmacy claims adjudication, or related healthcare analytics. Demonstrated expertise in ... RxSense is a leading healthcare technology company delivering innovative solutions for pharmacy...Business and Best Workplaces. Position Summary : The Formulary Analyst plays a key role in the configuration, maintenance,… more
- MetroPlusHealth (New York, NY)
- …Qualifications Bachelor's degree required A minimum of 5 years' working experience within claims in the healthcare or insurance industry Extensive knowledge of ... About NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island… more
- ShiftCode Analytics (Los Angeles, CA)
- We need a Business Analyst with Health Plan / Managed Care experience for a 6+ month contract role for a Healthcare client in Los Angeles, CA. This role will be ... a US Citizen . Job Summary The Enterprise Portfolio Management Office Solutions Analyst is accountable for intake, execution, and managing the oversight of strategic… more
- Convey Health Solutions (Chicago, IL)
- …Proficient in SQL for creating and updating stored procedures. Familiarity with healthcare payer/provider claims , clinical, or quality data. Risk Adjustment ... SUMMARY The Sr. Data Analyst will be responsible for utilizing technical and...Economics, Finance, Marketing Analytics, MIS, Computer Science, Engineering, or Healthcare Analytics with proven experience exhibiting data and analytic… more
- RIT Solutions, Inc. (Atlanta, GA)
- Sr. Data Analyst (Mainframe, healthcare data) | TELECOMMUTE Eden Prairie, MN - Remote Interview Process: 1 round via video. Will be very technical. TOP ... TSO. What will set candidates apart: T echnical mainframe knowledge in healthcare environment. Required: Five (5) years-experience working in a mainframe environment… more
- Vital Care Infusion Services (Jacksonville, FL)
- …1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have ... and growth opportunities. Employee Referral Program Job Summary: The Pharmacy Audit Analyst is responsible for supporting the Vital Care pharmacy network with… more
- Ballad Health (Johnson City, TN)
- JOB DESCRIPTION: The Senior Planning Analyst plays a key role in supporting enterprise strategy, service line growth, and business planning efforts across Ballad ... Serve as subject matter expert in using market analytics tools (eg, Sg2, claims -based datasets) and provide market share data and insights. Regulatory & Reporting… more
- Serigor Inc. (Richmond, VA)
- Job Title: Business Analyst 4 (Hybrid) Location: Richmond, VA Duration: 12+ Months Responsibilities: Support the Electronic Health Records program. Posses experience ... family of standards including V@, Clinical Document Architecture, and Fast Healthcare Interoperability Resources. Supports the health IT Unit in the implementation… more
- Harbor, Inc. (Toledo, OH)
- …: Bachelors of Science in business administration, finance/accounting or other healthcare related area or an equivalent combination of education and experience. ... Demonstrated understanding of grant reporting. Previous experience in a healthcare environment is desirable. Proficiency in Microsoft application suite, particularly… more
- CGS Administrators, LLC (Nashville, TN)
- …experience in SQL server, Power BI. Proficiency in Excel. Previous experience in healthcare , claims , prior authorization, supporting DME. What Blue Can Do for ... You: Our comprehensive benefits package includes: 401(k) retirement savings plan with company match. Subsidized health plans and free vision coverage. Life insurance. Paid annual leave - the longer you work here, the more you earn. Nine paid holidays. On-site… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …improvements for Core back-Office systems including but not limited to: Core Healthcare Claims Processing Platform including Eligibility & Enrollment (Group, ... with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be responsible for… more
- American Family Care (Montgomery, AL)
- …Care, we're not just treating patients - we're revolutionizing how people access healthcare . As the nation's leading urgent care provider with over 200 clinics ... coverage, explain costs clearly to patients, and ensure clean claims will be your most valuable contribution. What You'll...warmth and professionalism that makes AFC stand out in healthcare Own the Front Desk Flow: Process payments, schedule… more
- County of Los Angeles, CA (Los Angeles, CA)
- …level of Custodian Supervisor** *Institutions are defined as but not limited to healthcare facilities, schools, or gyms. **Experience at the level of the County of ... a candidate's original application record. DEPARTMENT CONTACT: Andrew Munoz, Exam Analyst Phone: ### E-mail: ADA COORDINATOR PHONE: ### CALIFORNIA RELAY SERVICES… more
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