- Molina Healthcare (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst, Healthcare Analytics role will be responsible...I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + Data… more
- Molina Healthcare (Phoenix, AZ)
- …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 (Phoenix, AZ)
- … 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
- Molina Healthcare (Phoenix, AZ)
- … 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...evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical… more
- Evolent (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …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 (Phoenix, AZ)
- … 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 (Phoenix, AZ)
- **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
- Highmark Health (Phoenix, AZ)
- …evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for ... disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services)… more
- Wells Fargo (Chandler, AZ)
- …empowered to grow. Join us! **About this role:** Wells Fargo is seeking a Senior Lead Control Management Officer within Fraud Claims Management. Fraud Claims ... financial crimes, operational risk, audit, legal, credit risk, market risk, IT systems security, and business process management + Provide vision, direction, and… more
- Wells Fargo (Chandler, AZ)
- …and automations via Crontab and/or Visual Basic + Experience in big data extractions, manipulations, and analytics across multiple platforms/ systems + Predictive ... **About this role:** Wells Fargo is seeking a Senior Lead Analytics Consultant within Consumer & Small...Small Business Banking (CSBB) Operations for the Fraud and Claims Management (FCM) Payment Card Claim Analytics team. Detection… more
- Otsuka America Pharmaceutical Inc. (Phoenix, AZ)
- **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
- DriveTime (Tempe, AZ)
- …which provides quality warranty and ancillary products, and a customer-friendly claims process. SilverRock offers a variety of ancillary products and administrative ... contracts, products, and warranties, and over $300 million in claims . **That's Nice, But What's the Job?** **_This is...eligible for hire at this time._** In long, our Senior Analyst, Strategic Analytics are responsible for: + Innovate… more
- Bank of America (Phoenix, AZ)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Tampa, Florida; Jacksonville, Florida; Charlotte, North Carolina; Phoenix, Arizona **Job ... customer experience. Key responsibilities include utilizing a variety of systems , such as Excel, SAS, SQL, Tableau, and other...such as Excel, SAS, SQL, Tableau, and other relational data bases, to provide analytical support on strategies, ensure… more
- Otsuka America Pharmaceutical Inc. (Phoenix, AZ)
- …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
- Walgreens (Phoenix, AZ)
- …with Company policies and procedures. + Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Assists ... and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Scottsdale, AZ)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Highmark Health (Phoenix, AZ)
- …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