- Molina Healthcare (Grand Island, NE)
- …accurate and timely implementation and maintenance of critical information on 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 to business and system requirements of customers as it pertains to contracting,… 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 ... dashboards. * Produce provider scorecards related to Payment Integrity initiatives and lead internal and external provider meetings to review results and trends. *… more
- Tucson Electric Power (Tucson, AZ)
- **Benefits Analyst - I, II, Senior or Lead ** Company **Tucson Electric Power** Location **Tucson, AZ** Requisition ID **6015** **About Us** UNS Energy ... employees,here (https://youtu.be/hpknvJPLuoc) andhere (https://youtu.be/7BECywu-Re4) . **Job Description - Benefits Analyst - I, II, Senior or Lead ** **Position… more
- Amazon (New York, NY)
- …management through innovative software solutions. We're seeking an experienced application analyst to lead the architecture, configuration, and management of ... 95 distinct insurance programs. The solutions developed and maintained by the Application Analyst cover the full claims lifecycle, encompassing processes such as… more
- Magellan Health Services (Albuquerque, NM)
- …and concepts to a varied audience of users. General Job Information Title Lead Clinical Analyst Grade 27 Work Experience - Required Analytics/Informatics, ... MatLab or other analytic tools. Experience working with healthcare medical claims , normalized and denormalized data structures; and will have experience manipulating… more
- Trinity Health (Albany, NY)
- …Type:** Full time **Shift:** Day Shift **Description:** **TITLE** Risk Analyst /Specialist **DEPARTMENT:** Clinical Quality & Safety **REPORTS TO:** Risk Manager ... being faithful to who we say we are. **POSITION SUMMARY** The Risk Analyst is primarily responsible for supporting non-clinical risk management activities in both… more
- Prime Therapeutics (Eagan, MN)
- …and assumptions to define additional resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments ... Provide work plan and detailed estimate based on scope; lead scope management, prioritization and drive scope trade off...within project + Educate and advance business systems analyst practice within the Claims IT team… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …area/out of network non-par claims . In the course of this work, the Analyst will be required to work closely with others to assemble and produce documentation ... with sound and ethical procedures, objectives and controls, a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan… more
- CVS Health (Springfield, IL)
- …care and how provider reimbursement policies relate to the control of medical claims costs. + Full comprehension of provider contracts and the potential impact the ... regulatory /legislative environment has on reimbursement strategies. + An understanding...differentiating between inpatient and outpatient services, facility and professional claims , and impacts from population dynamics. + Underwriting, sales,… more
- AIG (San Francisco, CA)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within a world-class ... claims function. Make your mark in Claims ...determinations, investigations, and trial and resolution strategies. + The analyst will investigate losses, orchestrate defense strategies for healthcare… more
- The Hartford (King Of Prussia, PA)
- Sr Product Analyst - EM08FEProduct Analyst - EM08AE We're determined to make a difference and are proud to be an insurance company that goes well beyond ... diverse individuals? If so, then the Personal Insurance Product Analyst role may be a great fit for you....initiatives. In addition to working closely with the Region Lead and his/her team of Product Managers and other… more
- Prime Therapeutics (Jackson, MS)
- …passion and drives every decision we make. **Job Posting Title** Sr. Market Pricing Analyst - REMOTE **Job Description** The Senior Market Pricing Analyst serves ... of new or enhanced financial pricing strategies. This position will also lead complex financial pricing analyses and provide consultation and analytic insight to… more
- Vanguard (Malvern, PA)
- …that supports each other and celebrates team members' successes! As a Legal Analyst , you will leverage your analytical and communication skills to support the ... the business, under supervision by legal counsel, to provide advice on regulatory and legal developments related to Vanguard's business activities and investment… more
- TEKsystems (Los Angeles, CA)
- …workflows and ensuring accurate data submission, particularly around Encounter and Claims processes. Key Responsibilities * Develop and document clinical and ... operational workflows tailored to PACE. * Lead build, testing, and deployment activities in Epic Tapestry, especially for Encounter and Claims modules. *… more
- System One (Dayton, OH)
- Job Title: Pricing and Reimbursement Analyst Location: Dayton, Ohio Type: Contract Compensation: Contractor Work Model: Remote Title: Pricing and Reimbursement ... Analyst ALTA is supporting an 8-month contract opportunity working...configured into the system. + Extensive knowledge of end-to-end claims lifecycle, from intake and encounter submission to adjudication… more
- UIC Government Services and the Bowhead Family of Companies (Aberdeen, MD)
- **Overview** Program Analyst , Executive (PEOC3N): Bowhead seeks an Executive Program Analyst (PA) to provide support to the Project Manager, Tactical Network ... by four-star level senior executive leadership. The PA will lead efforts in support of Army and Joint Requirement...for submission to USG decision makers to meet statutory, regulatory , and policy mandates. + Position will require the… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Risk Management Analyst ** **FT Days- M-F onsite** **Mission Statement:** We, St Peter's Health ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more
- Elevance Health (Woodbridge, NJ)
- **Clinical Quality Management Analyst Sr. Behavioral Health** **Location:** 111 Wood Ave. S, Iselin, NJ 08830 **Office Requirement:** This role requires associates ... Alternate locations may be considered. The **Behavioral Health Clinical Quality Analyst Sr.** is responsible for developing and conducting more complex behavioral… more
- Corewell Health (Grand Rapids, MI)
- …issues whenever possible. Ensure compliance with all mandated, legislative, regulatory and accreditation requirements. Assist customers and staff throughout the ... State and Federal decisions are properly implemented. Assist the Lead , Supervisor and/or Manager in coordinating activities and in...plan to ensure all activities are completed by the regulatory time line, gather all relevant information for the… more
- UCLA Health (Los Angeles, CA)
- Description The Business Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison between business units, IT teams, and ... and driving system enhancements to improve efficiency and compliance. The analyst will also support testing, report generation, and documentation efforts related… more