- 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)
- …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)
- …both verbally and written. + You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You pay attention to ... 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… 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...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… 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
- 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
- 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
- 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
- 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
- Walgreens (Deerfield, IL)
- …_Primarily responsible for reporting financial information related to Casuality Insurance claims , premiums and allocations to the Accounting and Finance stakeholders ... responsible for managing, tracking and facilitating payments to outside suppliers for claims , insurance and related items. This role is responsible for eliminating… more
- EPAM Systems (Chicago, IL)
- … business (P&C, Life and Variable Benefits, Annuities) and insurance business processes (underwriting, claims , distribution, other) + Demonstrated business ... Join our Consulting practice as an **Insurance Consulting Analyst ** in metro areas including Chicago, Houston, New...create a plan that efficiently uses them to achieve business goals + Assess business needs by… more
- Molina Healthcare (Kenosha, WI)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching,… more
- Terumo Medical Corporation (Chicago, IL)
- …used in a broad range of applications for numerous areas of the healthcare industry. TMC places a premium on providing customers with world-class products, training ... than 160 nations. Terumo Medical Corporation is comprised of two strategic business divisions: Terumo Interventional Systems and Terumo Medical Products. We believe… more