- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary… more
- Ford Motor Company (Boston, MA)
- ** Claims Lead Analyst ** We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves and build a better world -- ... is a hybrid role.** **What you'll do ** Lead development efforts for claims /returns modernization, ensuring current and future business requirements are met with new… more
- Tufts Medicine (Burlington, MA)
- …Profile** **Summary** This role focuses on the design, development, and implementation of information technology (IT) solutions in order to meet the organization's ... and programs. The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and… more
- State of Massachusetts (Quincy, MA)
- …24 hours a day, 7 days a week. *Responsibilities:* . Lead the development, implementation , and maintenance of the pharmacy claims processing and rebating system ... Business/Systems Analyst role, preferably with a focus on Pharmacy/Healthcare claims processing, is required. Five (5) plus years of experience is preferred.**… more
- US Tech Solutions (Quincy, MA)
- **Position Overview:** + Seeking to hire a Business Analyst to join our collaborative Medicaid Management Information System (MMIS) team. The Business Analyst ... care and Reference functional areas to support the development, testing and implementation of projects and enhancements to meet the business objectives of the… more
- Center For Health Information And Analysis (Boston, MA)
- …a driving force in health policy impact! We seek a Senior Health Policy Analyst to lead projects, share content expertise, and provide technical oversight within our ... Informatics and Reporting team. As a Senior Health Policy Analyst at CHIA, you will have the opportunity to:...and quality data, including our newly enhanced Massachusetts All-Payer Claims Database. You will be at the forefront of… more
- Center For Health Information And Analysis (Boston, MA)
- …be a driving force in health policy impact! We seek a Health Policy Analyst to support projects, share content expertise, and provide technical oversight within our ... Health Informatics and Reporting team. As a Health Policy Analyst at CHIA, you will have the opportunity to:...extensive range of health care enrollment, spending, quality, and claims data. You will be at the forefront of… more
- Children's Hospital Boston (Boston, MA)
- …per Week:40 Job Posting Category:Information TechnologyJob Posting Description: This IT Epic Analyst II - Professional Billing and Claims will be responsible ... some custom logic (although still straightforward), etc. + Coordinates the implementation of solutions impacting the supported application, the external vendor, end… more
- Humana (Boston, MA)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... The Senior Business Intelligence Engineer will be primarily responsible for implementation , maintenance and support of Medicaid provider reimbursement for hospitals… more
- Point32Health (Canton, MA)
- …of Health and Human Services (RI and MA), CMS and APCD (All-Payer Claims Database) submissions to state agencies. + Monitor ongoing encounter data/APCDs response ... using advanced SAS and/or SQL skills. + Interface with IT for the implementation of enhancements and timely resolution of production issues pertaining to state… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** Principal Benefit Analyst - REMOTE **Job Description** The Principal Benefit Analyst is ... **Responsbilities** + Manage annual renewal process, including analyze plan utilization, claims and health trends, model plan cost and design options, and… more
- The Cigna Group (Newton, MA)
- …RI and ME._** **_Preferred office location: Newton, MA_** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- LogixHealth (Bedford, MA)
- Location: Hybrid This Role: As a Senior Accounts Payable Analyst at LogixHealth, you will combine your deep understanding of accounts payable as well as a diverse ... accounting skillset to make an impactful difference in the design, implementation , and ongoing maintenance of processes in a highly successful, growing organization.… more
- Healthfirst (MA)
- …(PBM) + Monitors and analyzes key data and procedures for proper claims processing and adjudication system functionality + Performs Quality Control and Quality ... benefit + Provides timely support to other areas to verify and analyze claims processing cases, eligibility and other operational situations and/or issues as they… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …time on line claims adjudication software. + Support new clinical program implementation + Serve as a liaison to Member Services and other internal clients for ... true colors to blue. Position Summary: The Pharmacy Operations Analyst is responsible for primary contact for our providers...claim history, and Pharmacy Program information using the PBM claims software to provide information to both internal and… more