- 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 ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (Kenosha, WI)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... adherence to business and system requirements of customers as it pertains...as applied to the appropriate modules within the core claims processing system (QNXT). * Conducts high dollar, random… 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)
- … 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)
- …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...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… 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...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… 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 contracts and benefits configuration. + Strong background in claims is required. + Experience working on Networx, QNXT… 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)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (Kenosha, WI)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Elevance Health (Chicago, IL)
- ** Business Analyst ll** **Location** : Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate ... a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The ** Business Analyst ll** is responsible for translating basic business… 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
- Convey Health Solutions (Chicago, IL)
- …or technical process enhancement. * Minimum of 1 year of experience working with healthcare data, including medical claims , pharmacy claims , membership, or ... looking for a highly skilled and motivated Software Operations Analyst to join our team. The software operations ...abilities with keen attention to detail. * Exposure to healthcare data domains, including eligibility, claims , payments,… more
- Elevance Health (Chicago, IL)
- …a strong, clinical-first lens to deliver member-centered, lasting pharmacy care. The **Test Analyst ( Business Analyst III)** will be responsible for serving ... **Test Analyst - Pharmacy Benefit Management (PBM)** **Location:** Alternate...as the liaison between the business and IT in translating complex business … more
- Elevance Health (Chicago, IL)
- …of one of our Elevance Health PulsePoint location. The **P** **BM Formulary Analyst ll** is responsible for translating basic business needs into application ... **PBM Formulary Analyst ll** **Location** : This position will work...requirements. **How you will make an impact:** + Analyzes business needs to determine optimal means of meeting those… more
- BD (Becton, Dickinson and Company) (Vernon Hills, IL)
- …and OEM) of BD's Commercial Consumable Sales Contracts for all US business segments, BD Medical [Medication Delivery Solutions (MDS) & Medication Management ... all customer segments (excluding Pharmaceutical Systems, BioSciences, and IDS Capital). Analyst will be responsible to ensure members are aligned appropriately to… more
- CVS Health (Chicago, IL)
- …Excel/Google Sheets experienced preferred + CPC credential is a plus + Database query or business analyst experience a plus + US work authorization + Someone who ... The mission of Oak Street Health is to rebuild healthcare as it should be. We are a rapidly...care providers, service team members, technologists, community outreach experts, business professionals, and more -- all dedicated to our… more
- Cognizant (Chicago, IL)
- …technology discussions and analyze the current landscape for gaps in addressing business needs. Cognizant needs a motivated individual to challenge the status quo ... improve our current services and technologies. Role: Pharma Commercial Analytics - Analyst Job Overview: We are seeking experienced professionals with 4-7 years of… more
- AbbVie (Mettawa, IL)
- …key partners to deliver meaningful business solutions and impact. The 340B COE Business Operations Analyst is a member of a group with technical expertise in ... The 340B Drug Pricing program has become a critical issue impacting AbbVie's business . Originally designed to help safety-net hospitals and clinics give better care… more
- AbbVie (Mettawa, IL)
- …key partners to deliver meaningful business solutions and impact. The 340B COE Business Operations Analyst is a member of a group with technical expertise in ... The 340B Drug Pricing program has become a critical issue impacting AbbVie's business . Originally designed to help safety-net hospitals and clinics give better care… more