- HomeSafe Alliance (Washington, DC)
- **Title:** Lead IT Business Process Analyst (Deltek/Costpoint) **_HomeSafe Alliance_** is the single global household goods movement manager of over 300,000 ... better than the last. **_About the Role:_** As the Lead IT Business process analyst , you will...Create Custom tables and views for non-native functionality (ie, Claims ) and develop custom logic in Costpoint + Integrate… more
- Prime Therapeutics (Washington, DC)
- …our passion and drives every decision we make. **Job Posting Title** Lead Business Analyst -REMOTE/Configuration exp preferred **Job Description Summary** Serves ... as liaison between departmental team business owners, end users, IT, Claims and Clinical departments. Responds to ad hoc requests for support, reports and analysis.… more
- Windstream Communications (Washington, DC)
- …involves managing Third-Party Auto and General Liability Physical Damage and Bodily Injury Claims . The analyst will assist in internal investigations and support ... of infinite possibilities! ** ** The Risk Management Liability Analyst will act as a crucial liaison between Windstream...Casualty claims handling as an adjuster or claims Team Lead or Supervisor experience. +… more
- Evolent Health (Washington, DC)
- …+ 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 ... Care Act, HMO and managed care principles including Medicaid and Medicare regulation + Extensive experience with the System Design Life Cycle (SDLC) + Experience with EDI X12 structure and syntax rules; chiefly with 834 files + Superior root cause analysis… more
- UIC Government Services and the Bowhead Family of Companies (Washington, DC)
- **Overview** USER SECURITY/GMT HELP DESK ANALYST (BDOS) Bowhead is seeking an User Security/GMT Help Desk Analyst to support our Department of State contract in ... Washington, DC. The User Security/GMT Help Desk Analyst will be responsible for establishing, updating and deactivating...security experience. + Ability to work alongside the Team Lead and Government Project Manager (GPM) to solve complex… more
- Amentum (Washington, DC)
- …This involves monitoring various claim statuses or queues and identifying claims assignable within the Special Master's guidance. + Determine individual team ... data to provide daily determination entry numbers to the Lead Project Manager. + Work with Claim Review Team...on weekly Eligibility-Only claim review assignments to SMO's for claims produced for approval. + Update SharePoint site as… more
- Johns Hopkins University (Middle River, MD)
- …+ Manage Optum Claims manager. + Work Epic Charging tickets. + Lead CPA Process Improvement Projects. + Lead Epic upgrade efforts. + Project ... specifications and process improvement recommendations. + Work with Epic Lancaster analyst and at times Epic Verona to work through Epic operational… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Regulatory Compliance Analyst will conduct independent analysis for complicated, high level regulatory inquiries ... to CareFirst indemnity business, ensuring that all appropriate materials, related claims , contracts, payment vouchers are included. Develop a summary/assessment of… more
- Evolent Health (Washington, DC)
- …culture. **What You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst , you will have the opportunity to shape the technical aspects and design of ... Doing:** Evolent Health is looking for a Senior Product Analyst to be a key member of the Product...teams, product, and engineer through forums (bringing all POs, Lead engineers, and stakeholder into a consistent forum to… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk adjustment ... methodology, risk score calculation, ACA enrollment, premiums, medical and pharmacy claims , and provider data. Incumbent is responsible for performing complex… more
- Prime Therapeutics (Washington, DC)
- …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Regulatory Compliants & Inquires) - Remote **Job Description** The Regulatory ... Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs...in the implementation of Prime's compliance programs and may lead some initiatives within their designated areas and partners… more
- Elevance Health (Hanover, MD)
- **Provider Contract/Cost of Care Analyst Sr.** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live ... miles of one of Elevance's Pulse Point locations. **The Provider Contract/Cost of Care Analyst Sr.** is responsible for analytical support to the Cost of Care and/or… more
- Elevance Health (Hanover, MD)
- **Actuarial Analyst III** **Location:** Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that ... onsite will be discussed as part of the hiring process. The **Actuarial Analyst III** completes very diverse and complicated projects and performs very complex… more
- Prime Therapeutics (Washington, DC)
- …fuels our passion and drives every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is ... and update appropriate stakeholders of changes or new requirements + Take the lead on any new business issues and opportunities generated by Government and/or… more
- Prime Therapeutics (Washington, DC)
- …and drives every decision we make. **Job Posting Title** Sr IT Analyst **Job Description Summary** This position will analyze, evaluate and redesign business, ... to execute on strategies to solve complex and open-ended business problems. + Lead prototyping of potential solutions. + Perform implementation reviews. + Lead … more
- CareFirst (Baltimore, MD)
- …and meetings with stakeholders. + Research benefit coverage and claims related inquiries escalated from internal member/enrollee facing departments including ... pharmacy overrides, high dollar pharmacy claims reviews and more. Follows up with member in...assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:**… more
- Prime Therapeutics (Washington, DC)
- …Title** Network Economic Financial Consultant **Job Description** The Principal Pricing Analyst leads complex analyses, financial modeling, and reporting to create ... management, profit drivers and the organization's financial value statement + Lead the development of financial analytic pricing methodologies, models, reports and… more