- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for ... **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary… more
- Evolent (Boston, MA)
- …reimbursement structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between ... **Required** + 2+ years of SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - **Required** + 2+ years of experience… more
- Robert Half Technology (Providence, RI)
- Description We are offering a long-term contract employment opportunity for a Business Analyst in Providence, Rhode Island, United States. This role is pivotal ... maps of client journeys and internal procedures related to healthcare claims processing. * Conduct analysis of...networks, supporting vendors, and plan designs. Requirements * Role: Business Analyst * Minimum of 3 years… more
- Evolent (Boston, MA)
- …Excel, SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Using analytical tools to integrate various data ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...SQL or SAS is preferred + 2-5 years of healthcare -related experience is preferred **Technical Requirements:** We require that… more
- Dana-Farber Cancer Institute (Boston, MA)
- …Chief Health Information Officer. Given access to an extraordinary range of healthcare data (including medical and pharmacy claims , enrollment, EMR, scheduling, ... (ED&A) team at Dana-Farber is seeking a Senior Clinical Operations Analyst to spearhead high-impact analytics initiatives to inform strategic decision makers… more
- Prime Therapeutics (Boston, MA)
- …analysis to include 1 year of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides… more
- Sumitomo Pharma (Boston, MA)
- …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
- Prime Therapeutics (Boston, MA)
- …complex queries to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- HealthEdge Software Inc (Boston, MA)
- …root-cause issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The ... towards success. **What You Bring:** + Bachelor's degree in Healthcare Administration, Business , Finance, Computer Science, or...degree. + Minimum of 3 years of experience in healthcare payment integrity, content & policy, contracts, claims… more
- Atrius Health (Newton, MA)
- …their health and enhance their lives. * * * * The Financial Analyst Healthcare Economics provides analytical, project management and database support. Gathers, ... Atrius Health is a nonprofit healthcare leader delivering a system of connected care...projects and studies for use in the development of business strategies and tactics. Builds financial models to support… more
- Point32Health (Canton, MA)
- …and complex information into key insights. The individual will work effectively across business areas and often lead collaborative projects. They will need to follow ... complex business processes, consider options when problems arise, and identify...Human Services (RI and MA), CMS and APCD (All-Payer Claims Database) submissions to state agencies. + Monitor ongoing… more
- Baylor Scott & White Health (Boston, MA)
- …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