- MetroPlusHealth (New York, NY)
- …degree required; Bachelor's degree preferredMinimum of 4 years of experience performing claims quality audits in a managed care settingExpertise in both ... to building strong relationships with its members and providers.Position OverviewClaims Quality Auditor is responsible for reviewing claims to determine… more
- MetroPlusHealth (New York, NY)
- …you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and ... its members and providers.Position OverviewThe Medical Payments and Fee Schedules Analyst will lead the analysis, development, and implementation of payment rates… more
- Axis (Short Hills, NJ)
- …is available upon request for candidates taking part in the selection process. ** Claims Business Analyst ** **How does this role contribute to our collective ... success?** We are seeking a Claims Business Analyst to join our Business...+ Analytical and detail-oriented with a focus on delivering high- quality outcomes. + Strong facilitation skills and the ability… more
- Molina Healthcare (Yonkers, NY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... business requirements. Lead and participate in audit initiatives, develop quality control framework, and collaborate cross-functionally to drive continuous… more
- AIG (Jersey City, NJ)
- …How you will create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims ... Claims Complex Director - Healthcare Professional Liability (HPL)...determinations, investigations, and trial and resolution strategies. + The analyst will investigate losses, orchestrate defense strategies for healthcare… more
- Mount Sinai Health System (New York, NY)
- …Sinai is one of the largest US health systems with a strong reputation for quality of care and research. We have over 38,000 employees working together to provide ... billions of dollars in high- quality care each year for millions of patients. We...System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible for tracking, trending,… more
- Molina Healthcare (Yonkers, NY)
- **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops ... educate users on how to use reports. * Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and… more
- Molina Healthcare (Yonkers, NY)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... educate users on how to use reports. + Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics...Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated analytics to ... goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding...care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more
- Mount Sinai Health System (New York, NY)
- …occasionally at 150 E 42nd Street Corporate Offices** The Data Science Analyst II collaborates with stakeholders from across the organization to develop ... goal setting, and effective performance measurement. The Data Science Analyst II demonstrates sound and a more advanced understanding...care EMR such as Epic/Clarity, eCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III serves as a senior member of the Pharmacy Analytics team, advancing Mount Sinai's mission through high-impact data ... deliver data products that inform strategic decisions across the Health System. The Analyst plays a key role in developing interactive dashboards and optimizing SQL… more
- UIC Government Services and the Bowhead Family of Companies (Dover, NJ)
- **Overview** Foreign Military Sales Program Analyst : Bowhead is looking for a Foreign Military Sales Program Analyst to support the PM CCS contract at Picatinny, ... NJ. The Foreign Military Sales Program Analyst will support and manage the partner nation cooperation...Experience working in different types of database systems. + Quality customer service experience; meet customer's needs with a… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTATIVE STAFF ANALYST CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... maintains the operation of the Office of Audit and Quality Assurance (OAQA), Office of Compliance & Support (OAS),...Office of Revenue is recruiting for (1) Admin Staff Analyst NM III to function as a(n) Executive Director,… more
- Molina Healthcare (New York, NY)
- …+ Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Mount Sinai Health System (New York, NY)
- …Sinai is one of the largest US health systems with a strong reputation for quality of care and research. We have over 38,000 employees working together to provide ... billions of dollars in high- quality care each year for millions of patients. We...Sinai Health System. MSHP seeks a **Senior Contract Manager Analyst ** will play a critical role in testing, coding,… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The **Senior Analyst , Utilization Management** plays a critical role in supporting clinical and operational ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient… more
- Molina Healthcare (Yonkers, NY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application upgrades and… more
- VaynerMedia (New York, NY)
- Overall Purpose: We are seeking a Social Commerce Analyst focused on affiliate management to run day-to-day activation for multiple client brands in a fast-paced, ... to hit performance goals + Write clear, one-page briefs that include hooks, claims guardrails, required assets, CTAs, and timelines to improve first-pass approvals +… more
- City of New York (New York, NY)
- …for all medically related issues for medical management of workers' compensation claims . Responsibilities include: Consult managerial and legal staff in regards to ... to the claimant's work injury and assist with medical case management of claims . Review and process high value and complicated in-patient billing. Coordinate with… more
- Robert Half Technology (Florham Park, NJ)
- Description A Senior Software Business Analyst is needed to play a crucial role in connecting business requirements to technical solutions. This role involves ... candidates should have experience with pharmacy insurance, medical insurance, and claims processing ** Key Responsibilities: + Collect and translate business… more
