- Insight Global (Woonsocket, RI)
- Job Description Insight Global is seeking Business Support Analyst to join a large health insurance client of ours. This team member will be responsible for ... position will be part of the broader NextGen Production Support team and will serve as the Analyst...premium, medical claims, pharmacy claims, and providers for both Medicare and IFP lines of business . This… more
- Wolters Kluwer (Waltham, MA)
- …Location:_** Riverwoods, IL (USA) **About the Role:** We are seeking a highly skilled Business Analyst to join the Mediregs team focusing on claims processing ... contribute to software maintenance and final acceptance testing. The Business Analyst works closely with a cross-functional...and story grooming. **Qualifications:** + 3+ years as a Medicare /Medicaid Compliance Analyst - Revenue Cycle +… more
- Commonwealth Care Alliance (Boston, MA)
- …TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Humana (Providence, RI)
- …Humana is seeking an individual for the Senior Business Intelligence Data Analyst to provide support for its expansion of value-based programs, working ... at Humana is looking for an experienced individual in Business Intelligence that will be working with large volume...Synapse Analytics, and other various analytical tools + Provides support for payments to value-based specialists + Aids in… more
- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Senior Actuarial Analyst will support the financial Forecasting and Pricing needs ... annual reporting. This role will also work with various business partners outside of Actuarial in the annual financial...implementing, and presenting findings. Projects are focused on the Medicare Preferred population and support the goal… more
- Humana (Providence, RI)
- …part of our caring community and help us put health first** The Senior Business Systems Analysis Professional who is part of the System Optimization team, is ... cross-functional teams, and leading process enhancement initiatives to align business objectives with system functionality, ensuring optimal performance and… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs...to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory… more
- Humana (Providence, RI)
- …community and help us put health first** The Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department ... collaboration of provider contract loading and maintenance. The Value-Based Programs Analyst supports our Market Contracting and Market Finance partners in multiple… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst (Regulatory Intelligence and Assessment) - Remote **Job Description** The Senior ... Compliance Analyst assists in the implementation of Prime's compliance programs...organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory… more
- CVS Health (Providence, RI)
- …recommendations eg, training needs, quality controls and procedures) In partnership with business owners, support the design and development of new processes ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...for quality audits and projects, etc associated with the Medicaid/ Medicare unit's functional focus. - Subject matter expert on… more
- Mathematica (Providence, RI)
- … sales leadership with planning travel, conference logistics, and prospecting. * Support the development and maintenance of business development materials (for ... wide-ranging areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. Mathematica… more
- Point32Health (Canton, MA)
- …and complex information into key insights. The individual will work effectively across business areas and often lead collaborative projects. They will need to follow ... complex business processes, consider options when problems arise, and identify...what you will be doing** **Data Submission Integrity** + Support the director across a range of activities, including… more