- Molina Healthcare (Madison, WI)
- JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** * Serves as … more
- Highmark Health (Madison, WI)
- …SUMMARY** This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a ... product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements.… more
- Rocket Software (Madison, WI)
- …people truly BELIEVE in what they're doing!** **Job Description Summary:** The Senior Benefit Analyst is responsible for building and delivering both global and ... country programs in line with the global total rewards philosophy. The Senior Benefits Analyst supports the design, administration, and analysis of Americas' and… more
- Public Consulting Group (Madison, WI)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Prime Therapeutics (Madison, WI)
- …build the future of pharmacy with us. **Job Posting Title** Clinical Research Analyst , Senior - Remote **Job Description** The Senior Clinical Research Analyst ... the synthesis of data findings in support of clinical claims and programs. **Responsibilities** + Synthesizes a wide variety...levels within the organization + Serves as the lead analyst in producing reports, scorecards, or other data using… 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 ... seeking an individual for the Senior Business Intelligence Data Analyst to provide support for pharmacy programs, working heavily...data ie. Provider, Insurance, etc. + Experience with pharmacy claims data + Advanced knowledge of Excel (ex. Pivot… 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
- Cognizant (Madison, WI)
- **Job Summary:** We are seeking a strong Duck Creek Functional Analyst / Business Analyst to work closely with customer Product Owners. The ideal candidate will ... teams to handle queries and understand requirements. . Experience with Billing and Claims configuration knowledge and Data Insight producer policy holder is an added… more
- Prime Therapeutics (Madison, WI)
- …pricing or financial analysis to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field** **3 ... build the future of pharmacy with us. **Job Posting Title** Principal Pricing Analyst - REMOTE **Job Description** **The Principal Pricing Analyst leads complex… more
- Humana (Madison, WI)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… 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
- Cognizant (Madison, WI)
- **Health Payer Business Analyst , Senior Consulting Manager** **About the Role:** As a Sr. Consulting Manager you will make an impact by driving client engagement, ... firms * Strong background in Healthcare industry, including health plans, claims , and provider operations * Project management and people management experience… 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 reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Cardinal Health (Madison, WI)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... gaps + Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted HCPs/accounts touched)… more
- Molina Healthcare (Madison, WI)
- …leadership and Plan Support functions to review compliance-based issues for benefit planning purposes. **Recoveries & Disputes** + Review and validate provider ... care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of… more
- Centene Corporation (Madison, WI)
- …and validating the results. + Responsible to configure source system (Xcelys - Claims processing system) - setting up members benefits and authorization ... As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:**… more
- Highmark Health (Madison, WI)
- …analytical and financial analysis capability for Highmark's pharmacy and medical benefit specialty drug management programs. Furthermore, the incumbent will utilize ... understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues...experience in support of a Marketing function or Data Analyst role or in a business environment with responsibility… more
- Public Consulting Group (Madison, WI)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages department providing oversight...this role. In addition, PCG provides a range of benefits for this role, including medical and dental care… more