- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Feb 20, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 60414 **Who we are** Teva ... us on our journey of growth! **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes… more
- VNS Health (Manhattan, NY)
- OverviewWorks directly with management on highly visible projects to understand business needs and challenges of managed care payors and to develop innovative ... requirements, performs analysis, designs new or enhanced systems to meet operational, business , and clinical needs. Collaborates with Business Unit and/or… more
- Molina Healthcare (New York, NY)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare data, including ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...data, claims , enrollment, ect. + Knowledge of healthcare financial terms (eg, PMPM, revenue) and different standard… more
- Molina Healthcare (New York, NY)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... **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… more
- Molina Healthcare (New York, NY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …and implementation. Essential Qualifications + Minimum 6-7 years of experience as a business analyst in healthcare payer industry. + Expertise and ... Role We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with...business issues & requirements into technical solutions. + Healthcare Insurance Payer in one of more of the… more
- VNS Health (Manhattan, NY)
- …technical expert and principal designer of information systems for the managed healthcare business . Collaborates with senior level management to understand ... OverviewFunctions at the most senior level Business Systems Analyst role. Works directly...wellness programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for… more
- BGB Group (New York, NY)
- …to forecast behaviors, outcomes, and trends. + Extract meaningful insights from healthcare claims data to inform strategies and enhance decision-making. + ... all jobs) (http://www.bgbgroup.com/careers.html) New York, NY BGB Group Data Analyst Our Agency BGB Group is a healthcare...R, SQL, or other advanced analytics tools; experience with claims data or healthcare datasets is highly… more
- Centene Corporation (New York, NY)
- …and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to ... clinical outcomes. + Interpret and analyze data from multiple sources including claims , provider, member, and encounters data. Identify and assess the business… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing, and healthcare reimbursement models. ? Experience in ... of patients. We are accelerating a transition to a business model focused on population health management - our...System. MSHP seeks a Senior Contract Compliance (Hospital Billing) Analyst who will primarily be responsible for tracking, trending,… more
- CVS Health (New York, NY)
- …effective solutions related to the adjudication and processing of pharmacy and medical claims and newly expanded healthcare services. Create and ensure custom ... unit, as needed. + Development of billing/vendor solutions that enable business growth/new healthcare services, working cross-functionally to prioritize,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Data Science Analyst III - Digital and Technology Partners - Remote - Req#3024403** The Data Science Analyst III is a senior role, ... develop sophisticated analytics to provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning,… more
- Haleon (Warren, NJ)
- Haleon is a science-led global healthcare company with a clear purpose to deliver better everyday health with humanity. Our leading brands are built on trusted ... growing and more relevant than ever. We define consumer healthcare as consisting of Oral Health, VMS and Over-the-Counter...and Other. Haleon is committed to being a responsible business by making everyday health more inclusive, reducing our… more
- Hackensack Meridian Health (Tinton Falls, NJ)
- …experience in Revenue Cycle Operations + Minimum two years experience in a healthcare billing office or health insurance claims environment; familiar with common ... keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change....serve as a leader of positive change. The Billing Analyst is responsible for analysis of the Medical Center's… more
- Terumo Medical Corporation (Somerset, NJ)
- Contract Analyst Date: Feb 26, 2025 Req ID: 4443 Location: Somerset, NJ, US, 08873 Company: Terumo Medical Corporation Department: Contracting and Analytics **Job ... Summary** The Contract Analyst is responsible for administering specific assigned stages of...purchase agreements in accordance with TMCs approved templates and business standards. 2. Responsible for drafting and/or reviewing contract… more
- AIG (Parsippany, NJ)
- …expertise to assist with pricing reserving the Lexington Casualty and Professional Lines business . The Senior Actuarial Analyst will be responsible for reviewing ... Senior Actuarial Analyst , Lexington Casualty At AIG, we are reimagining...major insurance operating companies, globally. We collaborate with Finance, Claims , Operations, Marketing and Risk Management, among other functions.… more
- VNS Health (Manhattan, NY)
- …trend reporting for cost avoidance and recovery initiatives. Co-ordinate with business to align with payment recoveries disseminating findings for affordability ... initiatives. Conducts analysis of claims and payment data across health plans in support...wellness programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for… more
- VNS Health (Manhattan, NY)
- OverviewConducts analysis of claims and payment data across health plans in support of ensuring payment integrity and cost containment. Identifies anomalous ... with vendor's contracted rates. Reconciles and validates underlying analytic data claims , and utilization management systems. Tests the integrity of utilization and… more
- Elevance Health (Woodbridge, NJ)
- …a strong, clinical-first lens to deliver member-centered, lasting pharmacy care. The **Test Analyst ( Business Analyst III)** will be responsible for serving ... **Test Analyst - Pharmacy Benefit Management (PBM)** **Location:** Alternate...as the liaison between the business and IT in translating complex business … more