- Molina Healthcare (Meridian, ID)
- …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
- Prime Therapeutics (Boise, ID)
- …our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Sumitomo Pharma (Boise, ID)
- …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
- Crawford & Company (Boise, ID)
- …In Everything We Touch Position Summary Under direct supervision, processes medical only claims within authority, processes other claims open only for the ... administration of medical benefits (ie maintenance claims without actuarial reserves); approves payments and claimant reimbursements on lost time disability … more
- Prime Therapeutics (Boise, ID)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Sedgwick (Boise, ID)
- …of LLMs + RESTFUL APIs + Knowledge of third party administration and claims management business and technology + Oral and written communication skills ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
- Evolent (Boise, ID)
- …creativity, accountability, and a growth mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics ... structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between institutional vs… more
- Molina Healthcare (Meridian, ID)
- …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 ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
- Prime Therapeutics (Boise, ID)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, ... as a champion of the consulting and analytic methodology for designated line of business ; may provide work direction, serve as a mentor or train junior level… more
- Molina Healthcare (Nampa, ID)
- …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 (Meridian, ID)
- …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 existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is… more
- Molina Healthcare (Nampa, ID)
- **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 (Meridian, ID)
- …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
- Evolent (Boise, ID)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... Analytics team offers candidates the opportunity to work with key business , analytics, product, and operational leaders to deliver client-specific analytical… more
- Molina Healthcare (Meridian, ID)
- …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
- Highmark Health (Boise, ID)
- …+ Knowledge of multiple processing systems and workflows + Knowledge of claims processing methodologies + Ability to interpret all government regulations + Knowledge ... behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of...employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to… more
- CVS Health (Boise, ID)
- …recommendations eg, training needs, quality controls and procedures) In partnership with business owners, support the design and development of new processes - ... address continuous quality improvement initiatives - Analyze and resolve complex claims scenarios within established time frames - Identify and recommend internal… more
- Molina Healthcare (Boise, ID)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Prime Therapeutics (Boise, ID)
- …passion and drives every decision we make. **Job Posting Title** PBM Sr Business Intelligence Data Visual Consultant - Remote **Job Description** The Senior Data ... delivery of visualization- based solutions. This position collaborates with business partners across client facing divisions, product/ project management, analytics,… more
- Baylor Scott & White Health (Boise, ID)
- …capacities. We have over 1 million lives across multiple blocks of business and industry-leading analytics to support our organization. We seek a stakeholder-facing ... statistical analyst that will be responsible for the extraction, analysis...a variety of sources, including electronic health records, and claims data + **25%** : Provide observations and recommendations… more