- The Cigna Group (Bloomfield, CT)
- … solutions ? Do you have a high degree of technical expertise in claims systems ? EviCore, a line of business within the Cigna Group, is hiring a Claim ... Systems , Business Solutions Lead Analyst...Systems , Business Solutions Lead Analyst to provide focused...work closely with external clients, internal stakeholders, project managers, claims systems , claims product and… more
- Highmark Health (Hartford, CT)
- …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
- Cognizant (Hartford, CT)
- …This position is responsible for working with business partners within one business function to align technology solutions with business strategies; ... partners to elicit, analyze, communicate, and validate requirements for changes to business processes, policies, and information systems ; Assist in the analysis… more
- Prime Therapeutics (Hartford, CT)
- …It fuels our passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst - ScriptMed - Remote **Job Description** The IT ... Business Systems Analyst is responsible for solving...of security implications of domain + Experience in Prime claims systems + Proficiency in Visio, Microsoft… more
- The Cigna Group (Bloomfield, CT)
- …Contracting & contract negotiations. In-depth understanding of managed care business processes, data, systems , reimbursement methodology, case-mix adjustment, ... As a **National Competitive Business Analytics Senior Advisor** , this highly technical...focus is to deliver robust competitive unit cost data solutions & insights to be leveraged in negotiations, with… more
- The Hartford (Hartford, CT)
- …along with business acumen to translate complex technical topics into business solutions . + Strong verbal/written communication skills; Must be able to ... Data Science & AI organization, ensuring the integration of cutting-edge AI solutions to optimize business processes and enhance decision-making. This role… more
- NTT America, Inc. (Hartford, CT)
- …process improvements. + Under guidance, reviews and edits requirements, specifications, business processes, and recommendations related to proposed solutions . ... attention to detail and accuracy. + Ability to identify solutions in sprawling data sets and the business...data protection and privacy laws. + Experience with Medicaid/Medicare systems processing, including Claims , Provider, and Member… more
- The Cigna Group (Bloomfield, CT)
- …group presentation + Understanding of managed care business processes, data, systems , and applications for claims payment, enrollment, benefit design, and ... through analysis of healthcare provider contracts, analysis of high performing network solutions , analysis of medical expense reports, data drill downs of trend… more
- Norstella (Hartford, CT)
- …view on proper design and implementation of studies using NorstellaLinQ real world data solutions of claims , lab, and/or EHR. Proficient speaking to and working ... we can offer an even wider breadth of expertise, cutting-edge data solutions and expert advisory services alongside advanced technologies such as real-world data,… more
- Otsuka America Pharmaceutical Inc. (Hartford, CT)
- …management, medical, patient access and market access to engage local healthcare systems and identify opportunities to improve the patient experience. Through this ... Science Liaison (MSL), contributes to the development of the ecosystem strategic business plan and identifies key stakeholders that are vital to the ecosystem.… more
- NASCO (Hartford, CT)
- …judgment, discretion and analysis in coordinating, developing and designing computerized information systems solutions for business problems to meet ... where you'll be pivotal in analyzing and implementing innovative solutions that drive our business forward. In...moderate to complex technical challenges, enhancing data management and claims processing systems for NASCO and its… more
- Public Consulting Group (Hartford, CT)
- …+ Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + ... program integrity functions. + Time study and cost allocation systems to support Health and Human service agency cost...solutions that meet or exceed user expectations and business goals is foundational to serving in this role.… more
- Zurich NA (Hartford, CT)
- … claims office staff for insureds and other parties calling to report claims . + Identify appropriate business or marketing reps for agents seeking ... staff for insureds and other parties calling to report claims . + Identify appropriate business or marketing...+ Proven ability to multitask across multiple applications and systems + Comfortable working with various platforms and multiple… more
- Otsuka America Pharmaceutical Inc. (Hartford, CT)
- …metrics and generating monthly reports. + Manage user administration of subscribed systems and tools and monitor usage. + Support various department projects and ... the implementation of the most up-to-date language technologies and solutions , and process improvement. **Qualifications** Required + Minimum bachelor's degree… more
- Otsuka America Pharmaceutical Inc. (Hartford, CT)
- …to extend congress reach and engagement, including virtual and hybrid congress solutions + Develop and execute strategic plans for pre-congress, on-site, and ... **Metrics and Analytics** + Establish KPIs for congress activities and implement systems to track and analyze performance + Conduct post-congress analysis to assess… more
- Evolent (Hartford, CT)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... opportunity to support the evolution of value-based care across all lines of business by collaborating directly with our health plan partners. We are advocates for… more
- CVS Health (Hartford, CT)
- …are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital ... Investigates to prevent payment of fraudulent, abusive, or otherwise improperly billed claims submitted by providers, members, and others - Facilitates the recovery… more
- Highmark Health (Hartford, CT)
- …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 ... lower level HMIG Underwriters. **ESSENTIAL RESPONSIBILITIES** + Responsible for a book of business of renewing accounts and writing new business at profitable… more
- Highmark Health (Hartford, CT)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... policies and protocols. **ESSENTIAL RESPONSIBILITIES** + Responsible for a book of business of renewing accounts and writing new business at profitable… more
- Molina Healthcare (Hartford, CT)
- …this role must reside in the state of CT **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor ... Enrollment team . Partners with the vendor to analyze business and vendor performance problems and issues using data...using data from internal and external sources to provide solutions to the decision-makers supporting the vendor and the… more