- Healthfirst (AZ)
- … business rules within the claims processing system. + Identify claims configuration and contract implementation defects and improve departmental performance ... are adequately implemented based on technical planning documents. + Ensure post implementation accuracy of claims configuration implementations and mass claim… more
- Healthfirst (AZ)
- …the development and configuration of new business, member benefits and products, claims editing, reference data and their enhancements including claims ... enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier… more
- Molina Healthcare (AZ)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and ... reports. As the senior level team member, this role leads efforts to ensure the claims teams and other departments have access to quality claims data through… more
- Evolent (Phoenix, AZ)
- …be doing** : This individual will spearhead the requirements management for implementation projects across our client and Evolent organizations. By driving Evolent's ... + 5-8+ years of IT and / or business experience in an HMO / PPO Claims , Medicaid, Medicare and / or managed care healthcare environment + Knowledge of the Affordable… more
- Intermountain Health (Phoenix, AZ)
- **Job Description:** As a Business Systems Analyst , you will work closely with the business areas to identify and understand their needs and requirements. The major ... to major projects. Requirements may be specific to healthcare insurance products, claims , sales activities or other service-related processes; all in support of… more
- Lincoln Financial Group (Phoenix, AZ)
- …73933 **Role at a Glance** Lincoln National Corporation seeks an Analyst , Application Development in Radnor, PA to consult/analyze and deliver assignments/projects ... for Group Protection IT Claims of application development responsibility. Act as a resource...and existing programs to determine requirements, solution, test and implementation plans. Create Group Protection systems, tools and functionality,… more
- Randstad US (Phoenix, AZ)
- escalation analyst . + phoenix , arizona + posted december 2, 2024 **job details** summary + $19 - $24 per hour + temp to perm + associate degree + category office ... and administrative support occupations + referenceAB_4671380 job details The Escalation Analyst will assist in the development of improved processes and best… more
- CVS Health (Scottsdale, AZ)
- …health care more personal, convenient and affordable. CVS Health is seeking a Sr. Analyst , Medical Economics to join our team! The Sr. Analyst participates on ... development of provider fee schedules. + Responsible for the development and implementation of key medical economics business efforts eg medical cost initiatives,… more
- Molina Healthcare (AZ)
- **JOB DESCRIPTION** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains ... critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each… more
- Molina Healthcare (Chandler, AZ)
- …DESCRIPTION** **Job Summary** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they...execution of some test plans. + Participates in the implementation and conversion of new and existing health plans.… more
- HealthEdge Software Inc (Phoenix, AZ)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...and maintaining detailed documentation to support the building and implementation of proprietary healthcare edits, including specifications, test plans,… more
- Molina Healthcare (Tucson, AZ)
- **JOB DESCRIPTION** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains ... critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each… more
- CVS Health (Phoenix, AZ)
- …setup essential for online viewing and processing related to Customer Service, Claims , Enrollment, Billing and Reporting in support of internal and external ... plans rather than standard offerings. + Develops and executes implementation strategy consistent with client expectations; Ensures strategy is administered… more
- Molina Healthcare (AZ)
- …stages of project development including research, design, programming, testing and implementation to ensures the released product meets the intended functional and ... operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business… more
- Prime Therapeutics (Phoenix, AZ)
- …in the project management, programming, testing and documentation aspects of the analyst responsibilities to drive the highest level of performance and meet or ... reporting requirements and testing of new reporting development prior to implementation to Production. + Participates in initiatives or projects that support… more