- Molina Healthcare (Madison, WI)
- JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. *… more
- Highmark Health (Madison, WI)
- …and claims staff regarding the final adjudication of complex claims . Research and investigate conflicting benefit structures in multi-payor situations. ... is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various… more
- Prime Therapeutics (Madison, WI)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Clinical Research Analyst , Senior - Remote **Job Description** The Senior Clinical ... Research Analyst works closely with Prime's Health...of relevant Healthcare experience including: analyzing and using healthcare claims data, clinical research study design, and/or… more
- Public Consulting Group (Madison, WI)
- …claim issue research . Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist with ... claim issue research . Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist with… more
- Humana (Madison, WI)
- …first** Humana is seeking an individual for the Senior Business Intelligence Data Analyst to provide support for its pharmacy programs to achieve success on the ... team. Humana is seeking an individual for the Senior Business Intelligence Data Analyst to provide support for pharmacy programs, working heavily with market and… more
- Evolent (Madison, WI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Lead Analyst , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Lead Analyst , Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products. This… more
- Norstella (Madison, WI)
- Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States Date Posted: Nov 20, 2025 Employment Type: Full Time Job ID: R-1548 **Description** At ... to extract meaningful insights from **real-world data (RWD)** sources, including ** claims , laboratory results, billing codes, and electronic health records (EHRs)**… more
- Highmark Health (Madison, WI)
- …intake of operational objectives and information gathering. May perform routine research and evaluate basic output requirements and formats. Communicate business ... 1 - 3 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 0 -… more
- Molina Healthcare (Madison, WI)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. * Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (Madison, WI)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. + Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Centene Corporation (Madison, WI)
- …validating the results. + Responsible to configure source system (Xcelys - Claims processing system) - setting up members benefits and authorization requirements ... as to course of action that best meets the organization's goals. + Research , evaluate and assess the financial impact of issues identified in data/processes. +… more
- Highmark Health (Madison, WI)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... data including, but not limited to: medical/surgical physician and institutional claims and encounters, clinical data, prescription drug data, membership data,… more