- Public Consulting Group (Columbia, SC)
- …Education + Recovery Services **Duties and Responsibilities** + Analyzes the development of claims assigned at each level of the adjudication process. + Outlines the ... sent with applications. + Monitors and gives direction to Claims Developer regarding specific tasks on claims ....to Claims Developer regarding specific tasks on claims . + Provides monthly reporting statistics. + Ensures adherence… more
- Prime Therapeutics (Columbia, SC)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... and drives every decision we make. **Job Posting Title** Sr. IT Business Systems Analyst Remote **Job Description** The Business Systems Analyst (BSA) Lead IT is… more
- Prime Therapeutics (Columbia, SC)
- …passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst - REMOTE **Job Description** The Business Systems Analyst (BSA) IT is ... document the requirements and technical solutions for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT… more
- Prime Therapeutics (Columbia, SC)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Columbia, SC)
- …and drives every decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is ... experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in the implementation… more
- Prime Therapeutics (Columbia, SC)
- …our passion and drives every decision we make. **Job Posting Title** Health Data Analyst Sr- REMOTE **Job Description** The Senior Health Data Analyst provides ... experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Basic to intermediate SAS coding skills… more
- Prime Therapeutics (Columbia, SC)
- …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Regulatory Complaints & Inquires) - Remote **Job Description** The Regulatory ... Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs and may lead some initiatives within their designated… more
- US Tech Solutions (Columbia, SC)
- …identify quality of care issues. **Experience:** + 2 years clinical experience plus 1 year utilization/medical review, quality assurance, or home health, OR, 3 years ... standards/regulations. Excellent organizational and time management skills. Knowledge of claims systems. Presentation skills. + Preferred Software and Other Tools:… more
- Baylor Scott & White Health (Columbia, SC)
- …while aligning with internal SMEs and current capacities. We have over 1 million lives across multiple blocks of business and industry-leading analytics to ... support our organization. We seek a stakeholder-facing statistical analyst that will be responsible for the extraction, analysis and interpretation of data to… more
- Prime Therapeutics (Columbia, SC)
- …+ Prior experience as a Business Intelligence Developer or Data Analyst supporting business intelligence, reporting, analytics or data warehouse projects. + ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.) + Related industry experience. +… more