- Molina Healthcare (AZ)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- BlueCross BlueShield of North Carolina (NC)
- …a passion for Medicare Advantage? Join our dynamic team as a Senior Actuarial Analyst , where you'll leverage your expertise in mathematics, probability, ... statistics, and business principles to support our rating/pricing, valuation, healthcare economics,...reserves for new and existing insurance plans. + Support senior analysts and actuaries as needed. + Retrieve and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Competitive Intelligence Analyst Sr .-Lead_ **Location:** _OH-Brooklyn_ **Requisition ID:** ... and help our members achieve their best possible health and quality of life. ** Sr . Competitive Intelligence Analyst ** **Plays a pivotal role in driving our… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …finance experience . Certified Public Accounting (CPA) preferred Sr . Financial Analyst . Bachelor's degree in Business , Accounting, Finance, or a ... departments, ensuring financial processes are efficient and aligned with company goals. Sr Financial Analyst Responsible for analyzing financial trends, creating… more
- CommonSpirit Health (Phoenix, AZ)
- …happen both inside our hospitals and out in the community. **Responsibilities** The ** Senior Reimbursement Analyst i** s responsible for providing cost report ... , Medicaid and other State and Federal regulations. The Sr . Reimbursement Analyst interacts with customers and...Analyst also assists in the improvement of internal business processes and meeting future reimbursement service needs. The… more
- Commonwealth Care Alliance (Boston, MA)
- …. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing prospective claims auditing ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Prime Therapeutics (Columbus, OH)
- …drives every decision we make. **Job Posting Title** Compliance Analyst Sr --Medical Pharmacy Specialty- REMOTE **Job Description** The Senior Compliance ... the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance +… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Sr Business Applications Analyst will identify business requirements and solutions related to the support of the specific ... business area for implementation of a packaged system software....in related field. **Preferred Skills** + Experience working in Medicare and/or Medicaid + Knowledgeable of regulations specific to… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Sr . Compliance Analyst (Regulatory Intelligence and Assessment) - Remote **Job ... Description** The Senior Compliance Analyst assists in the implementation...organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory… more
- Providence (OR)
- …retain the best people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible ... and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare Advantage… more
- Insight Global (Houston, TX)
- Job Description Insight Global is looking for an IT Business Analyst for a healthcare client. This IT Healthcare Business Analyst will be responsible for ... Minimum of 5 years of experience in healthcare IT business analysis, with a focus on Medicare ,...IT business analysis, with a focus on Medicare , Medicaid, and Marketplace. Proven experience in analyzing and… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... key business issues related to cost, utilization and revenue for...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Columbus, OH)
- …Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare /MMP. + 3+ Years of experience ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...Reporting modules related to Quality/HEDIS for Medicaid, Marketplace and Medicare /MMP. + Analysis and reporting related to Managed care… more
- Healthfirst (NY)
- …is achieving desired results. + Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and their owner hospital performance. ... Member Per Month (PMPM) and revenue. + Basic understanding of Medicaid and Medicare programs or other healthcare plans. + Self-motivated, creative problem solver who… more
- Elevance Health (Norfolk, VA)
- **Risk Adjustment Advanced Analyst Senior ** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles ... of one of our Elevance Health PulsePoint locations.** The **Risk Adjustment Advanced Analyst Senior ** is responsible for creating statistical models to predict,… more
- Point32Health (Canton, MA)
- …and complex information into key insights. The individual will work effectively across business areas and often lead collaborative projects. They will need to follow ... complex business processes, consider options when problems arise, and identify...auditing firm. + Understanding of claims systems, provider information, Medicaid/ Medicare , and/or experience working with large data sets preferred.… more
- Healthfirst (NY)
- …and maintain monthly competitive reports + Prepare ad-hoc reporting as required by senior management and external partners + Support team in creation of models to ... communication skills with the ability to translate data to business insights (in other words, you are an analytic...system or a health insurance company + Knowledge of Medicare and Medicaid programs, health care, and managed care… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …and purpose of the job. Reporting to the Director of Physician Revenue Cycle, the Senior Revenue Cycle Analyst ( Sr . RCA) is both a transformational leader ... and an analyst . The Sr . RCA has an in-depth...Children?s Healthcare Alliance (PCHA) and hospital revenue cycle. The Senior Revenue Cycle Analyst will collaborate with… more
- BeneLynk (Detroit, MI)
- …in conjunction with BeneLynk's Manager of Business Analysis, Quality Assurance, the Sr . Business Analyst - Quality Assurance, and the Engineering (ENG) ... they deserve. Currently BeneLynk serves clients representing 12 million Medicare /Medicaid lives in every state in the USA. The...of Business Analysis, Quality Assurance and the Sr . Business Analyst - Quality… more
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