- CVS Health (Cumberland, RI)
- …Experience Transmission (CET Files) on behalf of our Clients and their vendors. The Claims Data Reporting Analyst will have primary responsibility and ... it all with heart, each and every day. **Position Summary** PBM Financial Operations Data Reporting is responsible for the implementation and ongoing support of … more
- 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
- BJs Wholesale Club (Marlborough, MA)
- …and ensures there is an efficient use of BJ's resources. Reviews open claims to ensure carrier/excess carrier reporting , determines compensability, scheduling of ... compensation training to educate clubs/internal partners. + Manages the data flow through a central Outlook inbox between risk,.... + Partners with Asset Prevention/Safety on team member claims trend information and any required OSHA reporting… 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 plays ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible...& Abilities (must have):** + Proficiency with Excel and reporting tools for data analysis. + Understanding… more
- Beth Israel Lahey Health (Boston, MA)
- …you're not just taking a job, you're making a difference in people's lives.** Reporting to the Director of Revenue Cycle Operations, this position is responsible for ... planning, coordinating and managing HIPAA EDI activities including Claims , Remittance, as well as Provider Enrollment processing for Harvard Medical Faculty… more
- Guardian Life (Boston, MA)
- …daily, weekly, and monthly reports on team productivity 1) for operational reporting and monitoring purposes; 2) to identify trends and training opportunities; and ... process improvement ideas to revise workflows and procedures. + Support claims initiatives by encouraging/providing relevant feedback and being an effective change… more
- Sumitomo Pharma (Boston, MA)
- …Master's) of relevant experience. + Experience in pharmaceutical commercial operations and data reporting strongly preferred. + Familiarity with sales operations ... + Partner cross-functionally with Sales, Market Access, Commercial Analytics, CRM and Data Strategy to align reporting solutions with business goals and… more
- Chiesi (Boston, MA)
- … data mining efforts to solve unmet medical needs; support the analysis of claims data to generate market insights + Identify and shape business challenges ... has an opening for a newly created role of Data Science Manager, reporting to the Head...Experience in biotech / pharmaceuticals preferred + Direct experience claims data analysis is a plus +… more
- Commonwealth Care Alliance (Boston, MA)
- 011260 CCA-Revenue Cycle Management **Position Summary:** Reporting to the Director of Encounter Data Management within the Revenue Cycle Department, the Risk ... align with HCC revenue projections and CMS methodologies. + Maintain and enhance reporting infrastructure to track data quality, submission errors, and risk… more
- Pfizer (Cambridge, MA)
- …trends, and product performance. + **Secondary Data Analysis** : Leverage multiple external data sources (eg, claims data , specialty pharmacy data , ... to support business-critical decisions for Elrexfio. The Senior Manager will manage various data assets, including claims , sales, and specialty pharmacy data… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …for the Medicare and Merged Market segments. The Associate Director of Risk Adjustment Data and Analytics will oversee the reporting , analytics and management of ... of Medicare Risk Adjustment and Analytics, the Associate Director of Risk Adjustment Data and Analytics is responsible for developing and executing the analytic plan… more
- Lyric (Boston, MA)
- …clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets. ... By leveraging advanced coding, analytic reporting , and predictive modeling, the Clinical Data Analyst - Staff uncovers actionable insights that drive innovation… more
- Wondr Health (Boston, MA)
- … data modeling, and serverless best practices to support analytics, operations, reporting , and data science use cases. **ESSENTIAL FUNCTIONS** **:** + Design, ... for analytics and reporting use. + Build and maintain an AWS-based data lake and Redshift-based data warehouse infrastructure. + Identify opportunities to… more
- CODAMETRIX (Boston, MA)
- …to clinical care. Overview The Vice President, Data Platforms is a member of the Data & Analytics team, reporting to the Senior Vice President, Data & ... stores, etc.) + Experience working with structured, semi-structured, and unstructured healthcare data (EHR, claims , clinical notes, HL7, FHIR) is highly… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Bring your true colors to blue. What we need The Associate Director of Clinical Data Management will be a key leader in executing BCBSMA's data & analytics ... The successful candidate will be responsible for leading the clinical data management function, providing strategic direction, and ensuring the delivery of… more
- US Tech Solutions (Boston, MA)
- …code the technical specifications to operationalize the measures, and create the reporting and dashboards for the care team's needs. **Responsibilities:** + Extract ... data from various sources, including electronic health records (EHRs), claims databases, registries, and other clinical systems and develop the data pipeline… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Medical Expense Team, Segment Leaders, Enterprise Analytics Executive Team, Market Reporting Oversight Team, Pharmacy Leadership Committee, Data Access Layer ... well as BCBSMA Account Facing Value Proposition insights and reporting . The analytics vary in size and scope, and...includes the development and communication of market segment medical claims expense trends with the aim to provide insights… 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
- Beth Israel Lahey Health (Wakefield, MA)
- …Assures, by data testing, the quality and accuracy of BILHPN's claims and EMR data . Responsible for developing reports for upper-level management ... and preparing monthly reporting packages. Compiles medical, pharmacy and EHR related information...in using Power BI or Tableau. + Knowledge of claims -based health care data , including medical terminology… more
- Evolent (Boston, MA)
- …insights and compelling narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization ... product, and operational leaders to deliver client-specific insights and drive data -informed decision-making. Our team serves as strategic advisors, analysts, and… more