- CVS Health (Woonsocket, RI)
- …Experience Transmission (CET Files) on behalf of our Clients and their vendors. The Claims Data Reporting Analyst will have primary responsibility and ... it all with heart, each and every day. **Position Summary** PBM Financial Operations Data Reporting is responsible for the implementation and ongoing support of … more
- BJs Wholesale Club (Marlborough, MA)
- …and ensures there is an efficient use of BJ's resources. Reviews open claims to ensure carrier/excess carrier reporting , determines compensability, scheduling of ... compensation training to educate clubs/internal partners. + Manages the data flow through a central Outlook inbox between risk,.... + Partners with Asset Prevention/Safety on team member claims trend information and any required OSHA reporting… more
- Guardian Life (Providence, RI)
- …daily, weekly, and monthly reports on team productivity 1) for operational reporting and monitoring purposes; 2) to identify trends and training opportunities; and ... process improvement ideas to revise workflows and procedures. + Support claims initiatives by encouraging/providing relevant feedback and being an effective change… more
- Sumitomo Pharma (Providence, RI)
- …Master's) of relevant experience. + Experience in pharmaceutical commercial operations and data reporting strongly preferred. + Familiarity with sales operations ... + Partner cross-functionally with Sales, Market Access, Commercial Analytics, CRM and Data Strategy to align reporting solutions with business goals and… more
- Lyric (Providence, RI)
- …clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets. ... By leveraging advanced coding, analytic reporting , and predictive modeling, the Clinical Data Analyst - Staff uncovers actionable insights that drive innovation… more
- Wondr Health (Providence, RI)
- … data modeling, and serverless best practices to support analytics, operations, reporting , and data science use cases. **ESSENTIAL FUNCTIONS** **:** + Design, ... for analytics and reporting use. + Build and maintain an AWS-based data lake and Redshift-based data warehouse infrastructure. + Identify opportunities to… more
- Evolent (Providence, RI)
- …insights and compelling narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization ... product, and operational leaders to deliver client-specific insights and drive data -informed decision-making. Our team serves as strategic advisors, analysts, and… more
- Western Digital (Providence, RI)
- …safety and fire prevention + Emergency preparedness + Business recovery + Coordinate the reporting of property and cargo claims to insurers or against third ... enabling systems to make cities safer and more connected, to powering the data centers behind many of the world's biggest companies and hyperscale cloud providers,… more
- Allied Universal (Foxborough, MA)
- …knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for prosecution. ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …effective communication with all relevant parties to resolve problems quickly and efficiently. ** Reporting & Data Analysis:** + Collect and analyze operational ... and communications + Leverage trade customer contracts, by analyzing and monitoring data to maintain optimal inventory levels. + Responsible for creating and… more
- Prime Therapeutics (Providence, RI)
- …Recommend new and revised financial pricing strategies based on analysis of pharmacy claims data , average wholesale drug prices (AWP), health plan margin target ... markets + Interpret financial performance reports to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive… more
- Evolent (Providence, RI)
- …Leading a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical) to explain potential upside/downside risks of a given ... new products and strategy innovations into existing analytical models and reporting frameworks + Developing analytical models and synthesizing complex analyses into… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …to ensure field teams have access to standardized dashboards and data -driven insights, supporting execution excellence and performance tracking. The Director will ... of contacts for ad hoc analytics requests, ensuring field teams have the right data to make informed decisions, but will not be creating these reports themselves or… more
- Evolent (Providence, RI)
- …for the culture. **What You'll Be Doing:** **Analyst, Client Analytics** Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL ... programs. Import and load data from disparate sources to facilitate reporting for multiple health plans. Build new client relationships to understand analytical… more
- Cytel (Providence, RI)
- …or platforms. + Supporting statistical programming to generate innovative means of data standardization, visualization, and reporting of observational data . ... of study protocols and analysis plans leveraging large RWD sources ( Claims and/or EHR) + Liaise with data vendors to obtain relevant data extracts for… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …pharmacology** activities related to study design, protocol development, study execution, data interpretation and study reporting .Conduct or oversee **PK and ... regulatory submissions. You will lead study design, execution and reporting of **clinical pharmacology** and studies. You will contribute...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Humana (Providence, RI)
- …other BH needs (ADHD, eating disorders, etc.) * Within Medicare, these members have claims cost over 2x of members without BH needs * Within Medicaid, these members ... have claims costs over 7x of members without BH needs...Medicaid. The team will consist of 3-5 BH experts reporting into the BH leader. They will also have… more
- Highmark Health (Providence, RI)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... and industry regulatory changes and assess their potential impact on Claims Operations, Customer Service and other operational areas processes and collaborate… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …tailor solutions to support individual health needs and improve how people engage. Data is the cornerstone of our platform, connecting people and partners and ... collective impact on total healthcare. **About This Team** The Data & Technology Delivery Team serves as a key...to ensure stakeholder engagement and program success + Status Reporting : Project health (risks, issues, decisions ) + Communicate… more
- Datavant (Providence, RI)
- …practices and SDLC. + **Technical Acumen:** Comfortable working with large datasets, EHR data , claims data , and HCC-based analytics. Familiarity with query ... Datavant is a data platform company and the world's leader in...to improve coding accuracy, efficiency, and transparency through advanced reporting , dashboards, and analytics features. + Stay informed on… more