- Molina Healthcare (Layton, UT)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Molina Healthcare (Layton, UT)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Molina Healthcare (Layton, UT)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr . Analyst, Network Strategy, Pricing & Analytics guides...(including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future… more
- Molina Healthcare (Layton, UT)
- … systems to support executive decision-making + Mine and manage information from large data sources + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...reports, and improvement opportunities based on analyses + Provide data driven analytics to Clinical COE, Finance, Claims… more
- Evolent (Salt Lake City, UT)
- …manner that fosters expertise and cooperation.** **Process and validate raw unadjudicated claims data .** **Use programming skills to explore, examine and ... **Familiarity with value-based care and utilization management- Preferred.** **Understanding of data systems and the critical thinking skills to solve… more
- Evolent (Salt Lake City, UT)
- …care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical thinking skills to solve new ... activities as well as Product Development efforts. **What You'll Be Doing:** + Analyse claims and authorization data to identify trends, calculate cost of care,… more
- Molina Healthcare (Layton, UT)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Molina Healthcare (Layton, UT)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current Molina employees: If you… more
- Intermountain Health (Salt Lake City, UT)
- …in support of Intermountain Health's key strategy of Expanding Proactive Care. As a Data Analyst-Technical- Senior , you will act in a more senior capacity, ... to strategic initiatives, clinical standards, and operational goals through data insights. Reporting to senior leaders in...or economics and four years of relevant experience performing data analysis. + SQL + Insurance claims … more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- **Position Summary** The Senior Manager of Field Technology will lead the design, optimization, and delivery of field sales reporting platforms and tools. This role ... in ensuring that our field teams have seamless access to accurate, actionable data to drive performance. The role focuses on managing field-facing technology … more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- …Under the direction of the Director/Associate Director of Clinical Management, the Senior Clinical Study Manager is responsible for the oversight and management of ... assigned trial(s), as assigned.** **Participates in ongoing review of clinical trial data focusing on data integrity, trending and consistency.** **Supports… more
- Highmark Health (Salt Lake City, UT)
- …overall business targets or assigned volume of new applications or RFP's.Utilize various systems and tools to obtain necessary data and accurately complete and ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of… more
- Otsuka America Pharmaceutical Inc. (Salt Lake City, UT)
- …- Interacts effectively with internal/external functional business units to gather data and develop documentation required for on-time submissions. - Works closely ... (Word, Excel, PowerPoint, Outlook) and familiarity with electronic document management systems (EDMS). **Competencies** See OPDC Competencies Chart (Level X) **P**… more
- Fujifilm (Salt Lake City, UT)
- **Position Overview** The accomplished Senior Corporate Compliance Specialist will support FUJIFILM's Corporate Compliance Program's operations to ensure high ... and implementation of new or updated polices, procedures, or systems to address new risk areas or to improve...action plans, and prepare related reports. + Manage transparency data collection, validation, and reporting process to ensure compliance… more
- Highmark Health (Salt Lake City, UT)
- …years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider data + 3 years of project ... times per year for scheduled business meetings.** This job creates data -driven insights which identify actionable opportunities and/or create analytics and reporting… more
- HUB International (Sandy, UT)
- …and carrier representatives and update EPIC agency management system. + Ensure the accuracy of data in those systems + Travel on company business as required + ... Account Manager to join our growing team! As the Senior Account Manager, your primarily focuses will be servicing...resolve. + Negotiate with underwriters and carriers + Troubleshoot claims and billing issues + Be responsible for overall… more
- Air National Guard Units (Salt Lake City, UT)
- …adequate landing areas. Maintains a thorough knowledge of the aircraft systems and procedures under normal, instrument, and emergency conditions. Maintains mission ... DA Form 759, DA Form 1059, Air Military Career Data Brief or FAA certification on the brief for...provide transcripts or other documentation to support your Educational claims . To receive credit for Education, you must provide… more
- R1 RCM (Salt Lake City, UT)
- …II Job Summary: * The Billing Representative is engaged in the tracking of claims through the billing process, to identify problem areas, and to determine a course ... of action to resolve aging claims . Follows all policies and procedures as outlined by...regulations and according to HIPAA regulations. Position reports to: Senior Manager, Account Resolution Responsibilities: * Responsible for working… more
- Lincoln Financial (Salt Lake City, UT)
- …operational resources & technology. You will also function as a partner to senior leaders and internal/external stakeholders to advise on new & enhanced processes & ... quality and process improvements to enhance the customer experience. Provides senior leadership with a summary of research; makes and executes recommendations… more
- Highmark Health (Salt Lake City, UT)
- …overall business targets/or assigned volume of new applications or RFP's.Utilizes various systems and tools to obtain necessary data and accurately complete ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses… more