- Insight Global (Woonsocket, RI)
- Job Description Job Description: CVS Health is seeking a dynamic and detail-oriented Business Analyst to join our team and support strategic initiatives that ... drive innovation and improve healthcare outcomes. As a Business Analyst , you will collaborate with cross-functional teams to analyze business processes,… 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 ... that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and… more
- Cognizant (Providence, RI)
- …and IT organization and lead changes to such specifications (with senior business analyst oversight through peer reviews); Develop an informed knowledge ... you on our team. **Purpose:** This position is responsible for working with business partners within one business function to align technology solutions with… more
- State of Massachusetts (Boston, MA)
- …and districts, as well as individuals, corporations and not-for-profit organizations that do business with the government. The Office is led by the Inspector General ... Care Division * In 2023, Inspector General Jeffrey Shapiro shifted the review of Medicaid (MassHealth) and the Health Safety Net (HSN) programs to the newly created… more
- Public Consulting Group (Providence, RI)
- …public sector. To learn more, visit www.publicconsultinggroup.com . The Education Data Analyst works as part of a deadline-oriented, fast-paced team consisting of ... systems, data warehousing, federal reporting, and other programs. The Analyst will be responsible for reviewing, formatting, importing/exporting, transforming,… more
- Prime Therapeutics (Providence, RI)
- …change process + Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned ... passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible… more
- Humana (Providence, RI)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to… more
- Humana (Providence, RI)
- …and help us put health first** The Senior Financial Reporting Professional/ Analyst prepares and distributes periodic financial statements for users other than those ... directly employed by the organization. The Senior Finance Reporting Professional/ Analyst + Analyzes and forecasts financial, economic, and other data to provide… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** Job Description The Senior Compliance Analyst ... role is dedicated to the government program compliance in the Medicare, Medicaid , and the Affordable Care Act (ACA) spaces. **Responsibilities** + Executes… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** **Description:** The ... Senior Compliance Analyst assists in the implementation of Prime's compliance programs...which may include. validating compliance gap closures throughout the business , partnering to facilitate company-wide Compliance Risk Assessment, and… more
- Elevance Health (Smithfield, RI)
- …a strong, clinical-first lens to deliver member-centered, lasting pharmacy care. The **Test Analyst ( Business Analyst III)** will be responsible for serving ... **Test Analyst - Pharmacy Benefit Management (PBM)** **Location:** This...as the liaison between the business and IT in translating complex business … more
- Prime Therapeutics (Providence, RI)
- …on trend, benefit design and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid ). This role will also provide actuarial ... every decision we make. **Job Posting Title** Senior Actuarial Analyst - REMOTE **Job Description** The Senior Actuarial ...or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 3 years of experience… more
- Prime Therapeutics (Providence, RI)
- …on trend, benefit design and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid ). **Responsibilities** + Build, support, and ... drives every decision we make. **Job Posting Title** Actuarial Analyst - REMOTE **Job Description** The Actuarial Analyst...or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 1 year of experience… more
- Humana (Providence, RI)
- …of our caring community and help us put health first** The Market Finance Analyst / Professional 2 collects, analyzes and reports on various market data to connect ... financial outcomes with operational effectiveness. The Market Finance Analyst / Professional 2 + Data and reporting + Works the Actuary, MRA, Corporate Finance,… more
- Evolent (Providence, RI)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... **Clinical Rules Management, Analyst ** Seeking a detail-oriented **Clinical Rules Management, Analyst...work experience + Good understanding of specialty benefit management business + Project management skills to keep up with… more
- Prime Therapeutics (Providence, RI)
- …passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior Compliance Analyst assists in ... across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance. +… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Intelligence Compliance Analyst ... governance across the organization to validate requirements are met and that business operations are aligned with expectations of applicable regulatory guidance +… more
- Cognizant (Providence, RI)
- **About the role** As a QNXT Config Analyst , you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... on decision making for right configuration by working with Business team **Work model:** Remote We strive to provide...functionality. + Have worked with QCS. + Familiarity with Medicaid and Medicare programs are minimum requirements, as well… more
- Cognizant (Providence, RI)
- …is one of the world's leading professional services companies, transforming clients' business , operating, and technology models for the digital era. Our unique ... Together, we're improving everyday life. **Job Title** **: Sr QNXT Config Analyst ** **Location** **:** **Remote** **Job ID** **: SO# 00062828461** **Role and… more
- Humana (Providence, RI)
- …other end-user information portals or resources + May create reports based on business requests and understanding of needs and changes to operational processes **Use ... root cause(s) of any trend (positive and negative) + Ability to interview business owners to define the need/problem/desire of a request and understand how best… more