- Publix (Lakeland, FL)
- **31050BR** **Position Title:** Pharmacy Quality Related Event Analyst , Customer Claims - Risk Mgmt **Department:** Risk Management **Location:** Lakeland, ... if an event should be escalated to a Customer Claims Unit (CCU) adjuster, + data entry... system and QRE database, and + referring asserted pharmacy claims to CCU adjusters by early… more
- State of Michigan (Lansing, MI)
- … quality oversight ( data warehouse). This individual is responsible for analyzing pharmacy claims data to evaluate the quality, accuracy, and ... is the analyst responsible for the Department's pharmacy and rebate data interfaces and ...data warehouse). This individual is responsible for analyzing pharmacy claims data to evaluate… more
- The Cigna Group (Bloomfield, CT)
- …facing communication and presentation skills, strongly preferred + Knowledge of industry standard claims data types (837, 835, 277, 999) and editing rules (ICD, ... of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst . This **highly...data file mapping (such as provider, member, auths, claims , etc.) + Design solutions for billing rule, benefits… more
- Prime Therapeutics (Columbus, OH)
- …+ Recommend new and revised financial pricing programs based on analysis of pharmacy claims data , average wholesale drug prices (AWP), and ... every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job...+ Develop financial pricing models to monitor performance against pharmacy claims data and identify… more
- ProMedica Health System (Toledo, OH)
- …procedures are in place 13. Work as a liaison between departments to provide data requests. 14. Assist as a pharmacy department inventory control specialist in ... within contract pharmacies and hospital outpatient programs. Works closely with system pharmacy team, 340B lead, supply chain, compliance, legal, epic ( pharmacy )… more
- CareOregon (Portland, OR)
- …or Public Health + Experience with at least one healthcare data domain (eg, medical claims , pharmacy claims , dental claims , clinical data , etc.) ... Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Data Science Analyst II Exemption Status Exempt... products to facilitate production of insights from healthcare claims , enrollment, and other related data . The… more
- Mount Sinai Health System (New York, NY)
- …1. Analyzes data requests using information technology, enrollment, claims , pharmacy , clinical, contract, medical management, financial, administrative and ... **Job Description** The Data Science Analyst III is a...care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more
- AssistRx (Orlando, FL)
- … data that will be presented to internal teams, clients and partners. The Data Analyst leads the onboarding of electronic data trading partners and ... The Data Quality Analyst is responsible for...quality issues. Successful applicants will have experience with Excel Pharmacy Claims experience is a huge plus… more
- Prime Therapeutics (Eagan, MN)
- …and assists with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to ... including data extraction, storage, manipulation, processing and analysis + Analyze claims data of varying complexity to identify and mitigate financial… more
- Medical Mutual of Ohio (OH)
- …sources. . Track record of success with analyzing clinical, claims , pharmacy , program and other administrative data . . Intermediate to advanced knowledge ... . Significant track record of success with analyzing clinical, claims , pharmacy , program and other administrative data . . Advanced knowledge of health… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …RAC requests, coding reviews, and denials + Ensure accuracy and integrity of charge data prior to billing interface and claims submission + Utilize a ... services, home health care services, durable medical equipment, rehabilitative therapies, and pharmacy reviews from finance and/or claims department + Prepare… more
- Walgreens (Deerfield, IL)
- …Benefit Manager, Benefit Consultancy, or Managed Care company. + Experience working with pharmacy data at a retail pharmacy , Pharmaceutical Benefit Manager, ... **Job Summary** _Primarily responsible for reporting financial information related to claims , premiums and allocations to the Accounting and Finance stakeholders… more
- The Cigna Group (Franklin, TN)
- …preferred. Requirements + 5 - 7+ years' experience with systems analysis, data analysis and requirements gathering in Healthcare Industry + Thorough understanding of ... how to interpret customer data and business needs and translate them into technical...standard working experience within healthcare that includes ANSI 837 Claims (Institutional, Dental, Professional), 835 (Claim Payment/Remittance), 834 (Benefit… more
- The County of Los Angeles (Los Angeles, CA)
- …EHR modules including but not limited to: Registration, Scheduling, Lab, Radiology, and Pharmacy by conducting workflow data analysis, data mapping and ... SENIOR INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3124187) Apply SENIOR… more
- Adecco US, Inc. (Teaneck, NJ)
- …essential. Responsibilities: - Oversee the operational processes required for onboarding Specialty Pharmacy Data . - Comprehend data aggregation and ... _Preferred:_ - 5-10 years of experience. - Managed Markets Insight & Technology (MMIT) data proficiency. - Specialty Pharmacy & Distributor data experience.… more
- ManpowerGroup (Westlake, OH)
- …Management Team. **What's Needed?** + Previous experience working with PBM or pharmacy claims processing. + 5+ years' healthcare experience with providers ... in the healthcare industry is seeking a Business Systems Analyst to join their team. As a Business Systems...**Pay Range:** Competitive **What's the Job?** + Responsible for data analysis and data translation between proprietary… more
- Prime Therapeutics (Columbus, OH)
- … Benefit Management) experience + Experience conducting complex analysis on large sets of pharmacy , claims , medical, and/or financial data + Basic to ... Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, analyses, and consultation to internal and… more
- The Cigna Group (Seattle, WA)
- …contractual requirements. **ESSENTIAL FUNCTIONS** + Perform efficient and effective network pharmacy claims audits to produce results consistent with ... professional input to complex Quality Assurance/Audit assignments/projects to identify pharmacy audit risks. Works autonomously, only requiring "expert" level… more
- Insight Global (Woonsocket, RI)
- …includes the financial and analytical data flows for membership, premium, medical claims , pharmacy claims , and providers for both Medicare and IFP ... Job Description Insight Global is seeking Business Support Analyst to join a large health insurance client...a Medicare or Medicaid space or environment Experience analyzing data : data trends and tracking of … more
- Henry Ford Health System (Troy, MI)
- …+ Conduct analysis associated with medical cost containment initiatives. Analyze medical and pharmacy claims to identify early signs of trends or other issues ... GENERAL SUMMARY: As a Senior Medical Economics Analyst , your primary objective will be to identify,...exceed customer requirements and expectations. + Knowledge of medical claims data and managed care membership … more
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