- Nuvance Health (Danbury, CT)
- *Description* Summary: The Managed Care Analyst compiles, validates, and analyzes utilization and reimbursement data to aid in contract negotiations for all ... In addition to gathering volume data and modeling of current reimbursement, the Managed Care Analyst determines the need for methodology changes and proposes… more
- Molina Healthcare (Yonkers, NY)
- …with Python and QNXT is preferred. + Experience working in a Healthcare / Managed care environment specifically with Provider data is preferred. + Excellent ... **Job Description** **Job Summary** The Sr. Analyst , Advanced Provider Data Management is responsible for...improvement, and developing solutions to optimize performance. The Sr. Analyst often acts as a liaison between the business… more
- Molina Healthcare (Yonkers, NY)
- …facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (Yonkers, NY)
- …Target/Ranking Engine for all line of businesses. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and related financial ... **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports...cleaning of data. + 3-5 Years of experience in Managed Care Organization executing similar techno functional… more
- Molina Healthcare (Yonkers, NY)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... **Job Description** **Job Summary** The Sr. Analyst , Quality Analytics and Performance Improvement role will...cleaning of data. + 5+ Years of experience in Managed Care Organization executing similar techno functional… more
- Molina Healthcare (Yonkers, NY)
- …similar, with experience in one or more of these programs.** + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, practices, ... including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business Analysis Professional… more
- Nuvance Health (Danbury, CT)
- …ie, registration. 6. Follows through with education of rules and regulations in the managed care system, as well as, State & Federal guidelines. 7. Adjusts ... account balances to specific account needs; ie, capitated labs. 8. Maintains Contract Management reporting (ie, payment errors, carve out billings ) and updates any information as needed or requested by supervisor. 9. Applies cash received to appropriate… more
- Nuvance Health (Danbury, CT)
- …ie, registration. 6. Follows through with education of rules and regulations in the managed care system, as well as, State & Federal guidelines. 7. Adjusts ... account balances to specific account needs; ie, capitated labs. 8. Maintains Contract Management reporting (ie, payment errors, carve out billings ) and updates any information as needed or requested by supervisor. 9. Applies cash received to appropriate… more
- Molina Healthcare (Yonkers, NY)
- …in Business, Finance, Economics, or related fields **Preferred Experience** + Previous managed care or healthcare experience + Previous experience with ... Marketplace / Individual and Family Plans + Proficiency in Microsoft suite, especially PowerPoint and Excel + Strong analytical skills and proficiency in data analysis tools and techniques + Excellent written and verbal communication skills + Attention to… more
- Molina Healthcare (Yonkers, NY)
- …and experience **Required Experience** + 3-5 Years of business analysis + 4+ years managed care experience + Demonstrates familiarity in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 1-3 years formal training in Business Analysis and/or Systems Analysis… more
- Molina Healthcare (Yonkers, NY)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 3-5 years of formal training in Project Management + Experience… more
- Molina Healthcare (Yonkers, NY)
- …with Python and QNXT is preferred. + Experience working in a Healthcare / Managed care environment specifically with Provider data is preferred. * Experience ... **Job Description** **Job Summary** The Lead Analyst , Advanced Provider Data Management is responsible for...ability to mentor and support other analysts. The Lead Analyst often acts as a liaison between the business… more
- WMCHealth (Valhalla, NY)
- …Provider Solutions Inc. City/State: Valhalla, NY Category: Finance/Info Systems Department: Managed Care -WMC Health Union: No Position: Full Time Hours: ... Qualifications/Requirements: Experience: Minimum of 5 years experience as an analyst , required. Education: Bachelor's degree in finance or accounting, required.… more