- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- VNS Health (Manhattan, NY)
- OverviewWorks directly with management on highly visible projects to understand business needs and challenges of managed care payors and to develop innovative ... requirements, performs analysis, designs new or enhanced systems to meet operational, business , and clinical needs. Collaborates with Business Unit and/or… more
- Molina Healthcare (New York, NY)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare data, including ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...data, claims , enrollment, ect. + Knowledge of healthcare financial terms (eg, PMPM, revenue) and different standard… more
- Molina Healthcare (New York, NY)
- … 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 (New York, NY)
- …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 knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …and implementation. Essential Qualifications + Minimum 6-7 years of experience as a business analyst in healthcare payer industry. + Expertise and ... Role We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with...business issues & requirements into technical solutions. + Healthcare Insurance Payer in one of more of the… more
- VNS Health (Manhattan, NY)
- …technical expert and principal designer of information systems for the managed healthcare business . Collaborates with senior level management to understand ... OverviewFunctions at the most senior level Business Systems Analyst role. Works directly...wellness programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for… more
- BGB Group (New York, NY)
- …to forecast behaviors, outcomes, and trends. + Extract meaningful insights from healthcare claims data to inform strategies and enhance decision-making. + ... all jobs) (http://www.bgbgroup.com/careers.html) New York, NY BGB Group Data Analyst Our Agency BGB Group is a healthcare...R, SQL, or other advanced analytics tools; experience with claims data or healthcare datasets is highly… more
- Centene Corporation (New York, NY)
- …and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to ... clinical outcomes. + Interpret and analyze data from multiple sources including claims , provider, member, and encounters data. Identify and assess the business… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing, and healthcare reimbursement models. ? Experience in ... of patients. We are accelerating a transition to a business model focused on population health management - our...System. MSHP seeks a Senior Contract Compliance (Hospital Billing) Analyst who will primarily be responsible for tracking, trending,… more
- CVS Health (New York, NY)
- …effective solutions related to the adjudication and processing of pharmacy and medical claims and newly expanded healthcare services. Create and ensure custom ... unit, as needed. + Development of billing/vendor solutions that enable business growth/new healthcare services, working cross-functionally to prioritize,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Data Science Analyst III - Digital and Technology Partners - Remote - Req#3024403** The Data Science Analyst III is a senior role, ... develop sophisticated analytics to provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning,… more
- VNS Health (Manhattan, NY)
- …trend reporting for cost avoidance and recovery initiatives. Co-ordinate with business to align with payment recoveries disseminating findings for affordability ... initiatives. Conducts analysis of claims and payment data across health plans in support...wellness programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for… more
- VNS Health (Manhattan, NY)
- OverviewConducts analysis of claims and payment data across health plans in support of ensuring payment integrity and cost containment. Identifies anomalous ... with vendor's contracted rates. Reconciles and validates underlying analytic data claims , and utilization management systems. Tests the integrity of utilization and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** This position serves as Appeals Analyst for Central Billing Office management. Responsible for monitoring contractual allowances, analyzing and ... appeals opportunities with payors and networks, and reporting performance on underpaid claims . **Qualifications** + Bachelor's degree or greater in related field or… more
- VNS Health (Manhattan, NY)
- …internal and external reporting for the clinical operations teams and business stakeholders. Collaborates with the Business Intelligence, Information Technology, ... and financial wellness programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for qualifying degrees… more
- Mount Sinai Health System (New York, NY)
- …across the organization. **Qualifications** **Education** : o Bachelor?s degree in Business Administration, Healthcare Administration, Legal Studies, or a ... compliance program, ensuring the organization's contracts, specifically related to healthcare billing (hospital and professional), adhere to internal policies,… more