- 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 ... routine and ad hoc analytics to drive impactful material, recommendations, and data driven decision making to support overall payment integrity and claim operations… more
- Lyric (Boston, MA)
- …leveraging advanced coding, analytic reporting , and predictive modeling, the Clinical Data Analyst - Staff uncovers actionable insights that drive innovation ... not available for this position. **Job Summary:** The Clinical Data Analyst - Staff plays a pivotal...experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and… more
- Center For Health Information And Analysis (Boston, MA)
- …to work with an extensive range of health care enrollment, spending, quality, and claims data . You will be at the forefront of executing analyses, utilizing ... share content expertise, and provide technical oversight within our dynamic Health Informatics and Reporting team. As a Health Policy Analyst at CHIA, you will… more
- Beth Israel Lahey Health (Charlestown, MA)
- …department, hospital and system operational and financial information systems, public health and claims data . * Independently identifies data needs and ... Relations (CBCR) Department at Beth Israel Lahey Health, the Business Analyst (" Analyst ") provides critical analytic and data support to the entire team. The… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst ... reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject...& Abilities (must have):** + Proficiency with Excel and reporting tools for data analysis. + Understanding… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …invoice reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices against plan enterprise warehouse claims ... Bring your true colors to blue. What We Need Reporting to the Associate Director of Professional Reimbursement Strategy,...and excel + Proficiency in working with and analyzing claims data + Strong written and verbal… more
- Highmark Health (Boston, MA)
- …for PCPs, specialists, facilities, post-acute providers, and ancillary providers. + Interprets raw claims , provider, quality, and member data to build data ... technical workflows, develop and submit technical business requirements and validate data generated by recurring analytic engine processes. Performs data … more
- Evolent (Boston, MA)
- …insights and compelling narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization ... the mission. Stay for the culture. **What You'll Be Doing:** Senior Analyst , Healthcare Analytics Consultant The Client Analytics team provides a unique opportunity… more
- Prime Therapeutics (Boston, MA)
- …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
- Beth Israel Lahey Health (Wakefield, MA)
- …Assures, by data testing, the quality and accuracy of BILHPN's claims and EMR data . Responsible for developing reports for upper-level management ... supervision of the Manager, Clinical Analytics, the Health Care Analyst is responsible for providing high quality analyses that...in using Power BI or Tableau. + Knowledge of claims -based health care data , including medical terminology… more
- Bank of America (Boston, MA)
- Fraud Analytics and Innovation Lead Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; New York, New York; Boston, Massachusetts; Chandler, Arizona; ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Newark/Fraud-Analytics-and-Innovation-Lead- Analyst \_25028063) **Job Description:** At Bank of America, we are… more
- Commonwealth Care Alliance (Boston, MA)
- …The department supports continuous improvement, including reports, operational workflows, gap and data analysis, and processes analysis. The Sr. Analyst reports ... self-starter and effective collaborator, showing strong interest in operations, data analysis, process improvement, strong technical/analytical and problem-solving skills,… more
- Beth Israel Lahey Health (Charlestown, MA)
- …you're not just taking a job, you're making a difference in people's lives.** Reporting to the Executive Director of Epic Patient Financial Services - PB, the Senior ... Epic Operations Analyst serves as the preeminent Epic analytical resource tasked...back-end billing functions and workflows, charge generation and capture, claims generation and reconciliation, remittance posting processes, retro adjudication… more
- Evolent (Boston, MA)
- …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
- Point32Health (Canton, MA)
- …**Job Summary** Reporting to the Director of Commercial Analytics and Reporting , the Lead Commercial Performance Analyst is responsible for the development ... familiarity with clinical, wellness and pharmacy metrics, good understanding of membership, claims , and pharmacy data preferred. **Compensation & Total Rewards… more
- Takeda Pharmaceuticals (Boston, MA)
- …business units for internal as well as cross-functional teams/stakeholders; Utilize secondary data sources such as IQVIA, Symphony claims , Metys, to track ... job opportunity: **JOB LOCATION:** Cambridge, MA **POSITION:** Demand Forecasting Analyst **POSITION DESCRIPTION** : Takeda Pharmaceuticals USA, Inc. is seeking… more
- Highmark Health (Boston, MA)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Prime Therapeutics (Boston, MA)
- …Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides information, analyses, and consultation to internal and ... or STARS experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Intermediate SAS or SQL coding… more
- Commonwealth Care Alliance (Boston, MA)
- …techniques, business systems analysis, and reporting using a variety of reporting platforms, systems, sources, and data formats. They will collaborate with ... CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, initiatives,… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …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