- Humana (Boston, MA)
- …level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional , you will play a pivotal role in ... and take the lead on building solutions that make a difference! The Senior Pharmacy Claims Professional analyzes and answers inquiries regarding… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Senior Pharmacy Claims Professional adjudicates pharmacy claims and ... process pharmacy claims for payment. The Senior Pharmacy Claims Professional work assignments involve moderately complex to complex issues where… more
- Elevance Health (Woburn, MA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . **How will you make an impact:** + Claim… more
- Humana (Boston, MA)
- …Benefit Manager, Pharmacy , or Healthcare data, in particular drug utilization, claims , costs and forecasting + Experience with techniques that can improve our ... help us put health first** Humana is seeking a Senior Economist to lead the development and management of...in applying econometric techniques to real-world problems, with either professional work experience or publication history + Ability to… more
- Deloitte (Boston, MA)
- Life Sciences Market Access Senior Manager An evolving customer and regulatory landscape, mounting pipeline of next-gen assets and portfolio pressures, and ... + Lead team in development of quantitative and/or qualitative analysis (eg, claims data analysis, market research data) to drive meaningful insights for our… more
- Takeda Pharmaceuticals (Lexington, MA)
- …with an inclusive & supportive team to analyze data, including complicated medical claims and pharmacy prescription datasets, while partnering closely with key ... and/or Databricks. Knowledgeable mentors will provide guidance as you gain professional hands-on experience. You will develop critical thinking and problem solving… more
- Elevance Health (Woburn, MA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
- WTW (Boston, MA)
- …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims ... audit services. Product based solutions such as our pharmacy purchasing coalition round out our broad-based suite of...data and create client deliverables drafts for review by senior colleagues. **Love your work.** You will partner with… more
- RELX INC (Cambridge, MA)
- Senior Director-Product ManagementAre you a thought leader and innovator seeking a new opportunity? Would you like to lead a team to solve complex business problems? ... Team leads the strategy and development of Healthcare solutions, leveraging provider, claims , and consumer data to provide insights for Healthcare Payer, Provider,… more
- Commonwealth Care Alliance (Boston, MA)
- …and long term services and supports. Works closely with delegated entities, pharmacy , dental and other vendors to assure integration, oversight, and efficiency of ... management functions with network strategy, vendor relationship management and claims processing. Works closely with provider relations on resolving provider… more