- Molina Healthcare (Kenosha, WI)
- …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 (Kenosha, WI)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (Kenosha, WI)
- …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...in research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- Molina Healthcare (Kenosha, WI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc. + Analysis and forecasting of trends in… more
- Molina Healthcare (Kenosha, WI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc. + Analysis and forecasting of trends in… more
- Molina Healthcare (Kenosha, WI)
- …self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to ... **Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the… more
- Molina Healthcare (Kenosha, WI)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... **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… more
- Molina Healthcare (Kenosha, WI)
- **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 (Kenosha, WI)
- …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 (Kenosha, 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...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Convey Health Solutions (Chicago, IL)
- …HEDIS, CAHPS, HOS data, and/or Rewards & Incentives Programs. * Familiarity with healthcare claims management systems and data warehouses. * Experience with ... As a Data Analyst , you will be responsible for analyzing, interpreting,...data, and/or Rewards & Incentives Programs. * Familiarity with healthcare claims management systems and data warehouses.… more
- Molina Healthcare (Kenosha, WI)
- **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides ... as directed by the Enrollment team . Partners with the vendor to analyze business and vendor performance problems and issues using data from internal and external… more
- Elevance Health (Chicago, IL)
- ** Business Information Analyst Sr.** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within ... 50 miles of one of Elevance's Pulse Point locations. **The Business Information Analyst Sr.** is responsible for providing utilization management services, and… more
- The Cigna Group (Chicago, IL)
- … business scenarios for vendor rebates, customer rebates, Chargebacks, Claims & Transaction, Pricing/Pricing Catalogs, Pharma Billing and Agreements to meet ... **Position Title:** SAP Vistex Analyst /Configurator: Pricing, Chargebacks, Rebates, Pharma Billing **Position Overview:** CuraScript SD a wholesale pharmaceutical… more
- Capgemini (Chicago, IL)
- Guidewire Business Analyst Choosing Capgemini means choosing a company where you will be empowered to shape your career in the way you'd like, where you'll be ... **Job Location : Chicago, IL** **Job Description** Capgemini is seeking a Guidewire Business Analyst with Claim Center experience. **Required Skills:** + Minimum… more
- Molina Healthcare (Kenosha, WI)
- …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 (Kenosha, WI)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more
- Molina Healthcare (Kenosha, WI)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… more
- Help at Home (Chicago, IL)
- …team, Help at Home may be a good fit for you._ **Job Summary:** The Senior Analyst , Business Intelligence III is an integral part of the Business ... field. + Seven (7)+ years of experience in a business intelligence, or data analyst role. +...and Excel. + Experience working with clinical data and claims data. + Advanced SQL experience. + CRM Analytics/Tableau… more
- Centene Corporation (Chicago, IL)
- …of business process or data analysis experience (ie documenting business process, gathering requirements), preferably in healthcare . Advanced knowledge of ... flexibility. **Position Purpose:** Perform various analysis and interpretation to link business needs and objectives for assigned function. + Support business… more