- Cognizant (Hartford, CT)
- 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 … more
- Evolent (Hartford, CT)
- …**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
- The Cigna Group (Bloomfield, CT)
- …In this critical role, you'll help ensure the integrity, consistency, and quality of healthcare data across the organization. You'll work cross-functionally ... testing to ensure accuracy of BI deliverables + Query and analyze large-scale healthcare datasets (eg, claims , pharmacy, patient data) using SQL and other… more
- The Cigna Group (Bloomfield, CT)
- …In this critical role, you'll help ensure the integrity, consistency, and quality of healthcare data across the organization. You'll work cross-functionally ... data governance policies, standards, and procedures. + Query and analyze large-scale healthcare datasets (eg, claims , pharmacy, patient data) using SQL and… more
- CVS Health (CT)
- …we do it all with heart, each and every day. **Position Summary** A Quality Assurance Senior Analyst reviews business requirements and translates them into ... both documentation and hands-on experience. **Preferred Qualifications** + Background in healthcare or claims processing experience. + Experience with Aetna… more
- Prime Therapeutics (Hartford, CT)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Fair Haven Community Health Care (New Haven, CT)
- …clean, and reconcile data across EHR, population health tools, 340B program, and payer/ claims . + Define and implement data quality checks, lineage, and ... choices. As we grow and are able to bring high- quality health care to more areas that need access,...of ability to pay. Job purpose The Senior Data Analyst turns clinical, operational, and financial data into insights… more
- CVS Health (CT)
- …in all RFI-related activities. In addition to core responsibilities, the Senior RFI Analyst will support **Training** , ** Quality ** , and Program Integrity ... And we do it all with heart, each and every day. The **Senior RFI Analyst ** within the Special Investigations Unit (SIU) plays a key role in supporting fraud, waste,… more
- The Cigna Group (Bloomfield, CT)
- …with local healthcare providers-physicians, hospitals, clinics, and other healthcare facilities-to help deliver high- quality , cost-effective healthcare . ... and negotiate contracts, initiate new agreements, and contribute to building strong healthcare provider networks. **As a Network Contracting Analyst , you will:**… more
- Prime Therapeutics (Hartford, CT)
- …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst … more
- Highmark Health (Hartford, CT)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Prime Therapeutics (Hartford, CT)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- Evolent (Hartford, CT)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value...health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Insight Global (Hartford, CT)
- Job Description healthcare insurance provider is seeking a versatile Data Engineer/Data Analyst to support organizational reporting and accreditation efforts, ... specifically around HEDIS accreditation. This role involves translating Quality Assurance (QA) requirements into clear business rules and technical specifications,… more
- CVS Health (CT)
- …service orientation and attention to detail. **Preferred Qualifications** + Background in healthcare or claims processing experience. + Experience with Aetna ... technical expertise with strong communication and problem-solving skills to deliver high- quality support and drive continuous improvement. + Respond promptly and… more
- CVS Health (CT)
- …accordance with company standards while meeting and exceeding accessibility, compliance, quality , and cost initiatives. Verifies contract compliance and adherence to ... metrics and training to ensure compliance with the company's regulatory, safety, quality , and confidentiality protocols and standards. + Ensures a high level of… more
- Evolent (Hartford, CT)
- …You Will Be Doing:** + **Strategic Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... monthly, quarterly, and annual client reporting. In addition to quality review and client Q & A reporting. +...areas of sensitivity + 2 years of Account Management healthcare experience To ensure a secure hiring process we… more
- Highmark Health (Hartford, CT)
- …Developers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, ... years in a relevant operational area (eg customer service, claims , enrollment and billing, etc.) to include 1 -...Insurance Industry + 1 - 3 years in the Healthcare Industry + 1 - 3 years in Lean/Six… more
- CVS Health (CT)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- CVS Health (Hartford, CT)
- …do it all with heart, each and every day. **Position Summary** The Senior Analyst - Business Analytics will be a detail-oriented individual with strong data analysis ... regulations, review of compliance interpretation, writing business specifications, data quality review, data preparation and compliance to regulatory requirements.… more