- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will provide ... routine and ad hoc analytics to drive impactful material, recommendations, and data driven decision making to support overall payment integrity and claim operations… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst ... reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject...& Abilities (must have):** + Proficiency with Excel and reporting tools for data analysis. + Understanding… more
- Humana (Providence, RI)
- …**Required Qualifications** + Bachelor's degree + 3 or more years of experience in data reporting + Current Advanced Microsoft Excel skills including ability to ... first** Humana's Gulf South Region is seeking a Senior Data and Reporting Professional that generates ad...insurance industry or health care sector with authorization or claims data + Ability to see trends… more
- Humana (Providence, RI)
- …caring community and help us put health first** The Senior Financial Reporting Professional/ Analyst prepares and distributes periodic financial statements for ... those directly employed by the organization. The Senior Finance Reporting Professional/ Analyst + Analyzes and forecasts... + Analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic… more
- Sedgwick (Providence, RI)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Data Analyst **PRIMARY PURPOSE OF THE ROLE:** To create comprehensive ... reporting and analysis of statistical data ; to...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Cognizant (Providence, RI)
- …standards. You will use SQL for data analysis, troubleshooting, and reporting , and conduct testing to ensure accurate claims processing, collaborating with ... Together, we're improving everyday life. **Job Title** **: System Analyst ** **Location** **:** **Remote** **Job ID** **: SO# 00064395692**...and collaborate with QA teams. + Utilize SQL for data analysis and reporting . + Document configuration… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …invoice reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices against plan enterprise warehouse claims ... Bring your true colors to blue. What We Need Reporting to the Associate Director of Professional Reimbursement Strategy,...and excel + Proficiency in working with and analyzing claims data + Strong written and verbal… more
- Evolent (Providence, RI)
- …insights and compelling narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization ... the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique… more
- Prime Therapeutics (Providence, RI)
- …Recommend new and revised financial pricing strategies based on analysis of pharmacy claims data , average wholesale drug prices (AWP), health plan margin target ... markets + Interpret financial performance reports to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive… more
- Bank of America (Boston, MA)
- Device and Non Monetary Fraud Lead Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; New York, New York; Boston, Massachusetts; Charlotte, North Carolina; ... expand our capabilities, reduce customer friction, and make strategic investment decisions. Data related to customer profiles and online banking login events hold an… more
- Commonwealth Care Alliance (Boston, MA)
- …The department supports continuous improvement, including reports, operational workflows, gap and data analysis, and processes analysis. The Sr. Analyst reports ... self-starter and effective collaborator, showing strong interest in operations, data analysis, process improvement, strong technical/analytical and problem-solving skills,… more
- Prime Therapeutics (Providence, RI)
- …Title** Forecast Analyst - REMOTE **Job Description** The Forecast Analyst is responsible for providing financial/ data modeling, forecasting, revenue ... Previous work experience with data analysis, large data sets and/or pharmacy claims ; creating moderately...peripheral vision, depth perception and ability to adjust focus ** Reporting Structure** + Reports to Manager, Principal or Director… more
- Evolent (Providence, RI)
- …culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL ... programs. Import and load data from disparate sources to facilitate reporting for multiple health plans. Build new client relationships to understand analytical… more
- Point32Health (Canton, MA)
- …**Job Summary** Reporting to the Director of Commercial Analytics and Reporting , the Lead Commercial Performance Analyst is responsible for the development ... familiarity with clinical, wellness and pharmacy metrics, good understanding of membership, claims , and pharmacy data preferred. **Compensation & Total Rewards… more
- Takeda Pharmaceuticals (Boston, MA)
- …business units for internal as well as cross-functional teams/stakeholders; Utilize secondary data sources such as IQVIA, Symphony claims , Metys, to track ... job opportunity: **JOB LOCATION:** Cambridge, MA **POSITION:** Demand Forecasting Analyst **POSITION DESCRIPTION** : Takeda Pharmaceuticals USA, Inc. is seeking… more
- Prime Therapeutics (Providence, RI)
- …Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides information, analyses, and consultation to internal and ... or STARS experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Intermediate SAS or SQL coding… more
- Cognizant (Providence, RI)
- …and reliable data handling. . Provide expert guidance on Facets claims processing to improve accuracy and reduce processing time. . Collaborate with stakeholders ... configurations for better performance. . Utilize MS Excel for data analysis and reporting providing insights to...data model management. . Demonstrate proficiency in Facets claims provider plan product membership and group modules. .… more
- Commonwealth Care Alliance (Boston, MA)
- …techniques, business systems analysis, and reporting using a variety of reporting platforms, systems, sources, and data formats. They will collaborate with ... CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, initiatives,… more
- CVS Health (Providence, RI)
- …and subpoenas. + Handle and manage UCC liens. + Manage and responsible for data integrity on various reporting to leadership which includes monthly metrics ... each and every day. **Position Summary** The Corporate Services Analyst will provide legal support, support litigation management, and...reporting and monthly litigation reporting . + Collaborate with appropriate departments to obtain claim… more
- Verint Systems, Inc. (Providence, RI)
- …Learn more at www.verint.com . **Overview of Job Function:** The Benefits Analyst will be responsible for the day-to-day initiatives of all annual projects ... host open enrollment webinars and respond to employee questions + Ensure timely reporting of all federal and state compliance filings (including CMS, WSIB Annual… more