- Robert Half Accountemps (Raleigh, NC)
- Description We are looking for a detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. This long-term contract position is ... ideal for someone with extensive experience in medical claims processing and a strong ability to manage repetitive clerical tasks effectively. The role requires… more
- Cognizant (Raleigh, NC)
- About the role As a **Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end test ... strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality Engineering team and… more
- Baylor Scott & White Health (Raleigh, NC)
- …2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with ... + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight...outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …professional and ancillary claims . + Minimum 3 years in auditing of claims adjudication. + Working knowledge of medical terminologies and coding a plus ... About The Role Brighton Health Plan Solutions is seeking a Senior Quality Analyst , who will oversee contract and benefit configuration to ensure accurate claims … more
- Motion Recruitment Partners (Garner, NC)
- Senior Data Analyst / HEDIS Garner, North Carolina **100% Remote** Contract $60/hr - $70/hr Our client is looking for a Senior Data Analyst to support the team ... cases + Strong understanding of HEDIS measures and how claims and clinical data work to inform those measures...respective payers **You will receive the following benefits:** + Medical Insurance - Four medical plans to… more
- Norstella (Raleigh, NC)
- Analyst II, RWD Delivery Support & Education Company: Norstella Location: Remote, United States Date Posted: Sep 22, 2025 Employment Type: Full Time Job ID: R-1510 ... UK, The Netherlands, Japan, China and India. **The Role: Analyst II, RWD Delivery Support & Education** The ...sciences companies. * Understanding of RWD, including lab, EMR, claims , and SDoH data assets * Ability to work… more
- Evolent (Raleigh, NC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** Senior Analyst , Client Analytics The Client Analytics team provides a unique opportunity to ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS,… more
- City of Durham (Durham, NC)
- Business Services Analyst , Sr. Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/5114446) Apply Business Services Analyst , Sr. Salary ... - $84,000 Hours/Schedule/Shift: 8:00am - 5:00pm The Sr. Business Services Analyst is devoted to providing advanced-journey level management analysis and oversight;… more
- Evolent (Raleigh, NC)
- …Stay for the culture. **What You'll Be Doing:** Job Description The Analyst , Performance Analytics - **RBM Cardiac** product focus, utilizes and develops analytic ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Product Development efforts. **What You'll… more
- CVS Health (Raleigh, NC)
- …R, Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… more
- Vontier (Raleigh, NC)
- …preferred locations for this opportunity. **Job Overview** The Quality Data Analyst Intern will support the Gilbarco Veeder-Root Quality organization by conducting ... analysis efforts by providing data-driven insights into failure trends and warranty claims . * Assist in documenting quality data processes, ensuring consistency, and… more
- CVS Health (Raleigh, NC)
- …position is to collaborate with non-par providers to negotiate the pricing of medical and facility claims to obtain the highest possible success rates, ... resulting in savings for both the member and Aetna. As a Negotiator Analyst , you will: + Communicate with providers via phone, fax and/or email as set forth under… more
- CVS Health (Raleigh, NC)
- …do it all with heart, each and every day. **Position Summary** The Senior Analyst , Plan Sponsor will be responsible for functioning as an Account Management and Plan ... cases (1,000 life). **Key Responsibilities** + Researches, and resolves eligibility and claims inquiries for an assigned book of business. + Consults with… more
- Evolent (Raleigh, NC)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from ... innovative analytics solutions that drive decision-making for clients by performing medical economics analyses to determine cost and utilization drivers. Showcase… more
- Evolent (Raleigh, NC)
- …team at Evolent. This individual will be primarily focused on distilling medical economics insights from product strategy analyses and translating them to complex ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- WTW (Raleigh, NC)
- …Risk, including adjustments for model limitations, near-term climate conditions, and claims experience. + Working with clients, jointly with other Willis commercial ... following (eligibility requirements apply): + **Health and Welfare Benefits:** Medical (including prescription coverage), Dental, Vision, Health Savings Account,… more
- Elevance Health (Durham, NC)
- …healthcare analytics, and/or financial services highly preferred. + Comprehensive understanding of medical claims data. + Intermediate to Advanced expertise with ... American healthcare delivery. The **Senior Health Economist (** Advanced Analytics Analyst Senior) measures financial performance of core Carelon products leveraging… more
- CVS Health (Raleigh, NC)
- …**Position Summary** We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance ... investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate...findings to non-technical audiences. + 2+ years experience interpreting medical claim data + Advanced experience in SQL &… more
- Norstella (Raleigh, NC)
- …manage a multi‑region product team and partner closely with Engineering, Content/ Analyst teams, Data Science, and Go‑to‑Market to deliver best‑in‑class forecasting, ... Integration** + Partner with Engineering and Data Science to incorporate RWD ( claims , lab, EMR) where it improves forecast accuracy and scenario planning. Champion… more
- Humana (Raleigh, NC)
- …and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more