• Analyst , Business -( Claims

    Molina Healthcare (Grand Rapids, MI)
    …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
    Molina Healthcare (01/13/25)
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  • Business Analyst ( Claims

    Molina Healthcare (Grand Rapids, MI)
    **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
    Molina Healthcare (01/13/25)
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  • Sr Business Systems Analyst

    Molina Healthcare (Grand Rapids, MI)
    …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
    Molina Healthcare (01/13/25)
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  • Pharmacy Receivables Analyst

    Meijer (Grand Rapids, MI)
    …review the job profile below and apply today! The Pharmacy Receivables Analyst works both independently and with cross-functional business partners (Finance, ... Microsoft Office and various vendor provided tools the Pharmacy Receivable Analyst researches, analyzes, corrects and resolves exceptions regarding the status of… more
    Meijer (01/11/25)
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  • Sr Analyst , Medical Economics (NY Medicaid…

    Molina Healthcare (Grand Rapids, MI)
    **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
    Molina Healthcare (12/29/24)
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  • IT Systems Analyst Specialist

    Sedgwick (Grand Rapids, MI)
    …of LLMs + RESTFUL APIs + Knowledge of third party administration and claims management business and technology + Oral and written communication skills ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
    Sedgwick (12/07/24)
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  • Sr Analyst , Business (Remote)

    Molina Healthcare (Grand Rapids, MI)
    **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
    Molina Healthcare (01/13/25)
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  • Analyst I

    PRGX (Grand Rapids, MI)
    About PRGX Global, Inc ABOUT PRGX We provide the business intelligence to unlock incremental value from data and expand impact across our clients' organizations for ... empowers clients in more than 30 countries with the business intelligence to recover $1.2 billion in annual cash... operations. + Finds, supports, and documents audit and claims operations. + Produces claims using appropriate… more
    PRGX (11/26/24)
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  • QA Analyst - ETL / Agile

    Molina Healthcare (Grand Rapids, MI)
    …Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
    Molina Healthcare (12/28/24)
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  • Sr Analyst , Config Info Mgmt - Remote…

    Molina Healthcare (Grand Rapids, MI)
    …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
    Molina Healthcare (01/13/25)
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  • Lead Analyst - QNXT Benefit Configuration

    Molina Healthcare (Grand Rapids, MI)
    …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
    Molina Healthcare (12/29/24)
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  • Sr Benefits Analyst - Config info Mgmt…

    Molina Healthcare (Grand Rapids, MI)
    …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...and existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is… more
    Molina Healthcare (12/05/24)
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  • Workforce Planning Analyst

    Sedgwick (Grand Rapids, MI)
    …their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workforce Planning Analyst **PRIMARY PURPOSE:** To provide workforce development strategies and… more
    Sedgwick (01/14/25)
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  • Reimbursement Analyst

    Corewell Health (Grand Rapids, MI)
    …and physician reimbursement methods will be combined with data analysis and business decision-making abilities to determine correct configuration. Analyst will ... resolution to appropriate leadership. + Apply strong analytical skills and business knowledge to the investigation, analysis and recommendation of creative solutions… more
    Corewell Health (01/09/25)
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  • Sr Analyst , Quality Analytics…

    Molina Healthcare (Grand Rapids, MI)
    **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...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
    Molina Healthcare (12/25/24)
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  • Analyst , Data (Remote)

    Molina Healthcare (Grand Rapids, MI)
    …used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables ... departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods… more
    Molina Healthcare (01/13/25)
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  • Healthcare Analytics Analyst - REMOTE

    Molina Healthcare (Grand Rapids, MI)
    **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
    Molina Healthcare (01/13/25)
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  • Manager, Medical Economics - REMOTE

    Molina Healthcare (Grand Rapids, MI)
    …meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching, ... and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan… more
    Molina Healthcare (01/13/25)
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