- Molina Healthcare (Sterling Heights, MI)
- …Operations teams + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...Molina. Identifies the root cause of processing errors through research and analysis, coordinates and engages with appropriate departments,… more
- Molina Healthcare (Sterling Heights, MI)
- …around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research , analysis and modeling of complex healthcare claims data, ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...provides insights needed to support strategic investment decisions + Research and develop reports and analyses for senior management… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- R1 RCM (Detroit, MI)
- …intelligent automation, and workflow orchestration. **Position Summary** A payer analyst role involves understanding basic concepts of hospital/physician billing ... guidelines, the ability to analyze, formulate, and initiate actions to resolve claims /issues, and the overall escalation of claim issues with payors when necessary.… more
- Molina Healthcare (Sterling Heights, MI)
- …ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, ... for Patient Liability and Medicaid processes. **KEY RESPONSIBILITIES** + Perform research and analysis for inquiries and requests, utilizing technical tools as… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL… more
- Trinity Health (Livonia, MI)
- …Term Disability, Military Leave, Family Medical Leave and Workers' Compensation claims with internal areas of expertise and external vendors.Acts independently to ... judgment to make decisions based on insufficient or unclear data. Conducts appropriate research to ensure data is complete and to respond to problems and unresolved… more