- Molina Healthcare (New York, NY)
- …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
- Molina Healthcare (New York, NY)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… 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...in research, review and audits for adjudication rates of claims + Must be able to work in cross… 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)
- …work during EST hours **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 (New York, NY)
- **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 (New York, NY)
- **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 (New York, NY)
- …self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to ... **Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the… 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)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… 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...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- Molina Healthcare (New York, NY)
- **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
- 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
- Molina Healthcare (New York, NY)
- …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
- Molina Healthcare (New York, NY)
- …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
- Molina Healthcare (New York, NY)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated analytics to ... provide information, insights and BI ( Business Intelligence) solutions that contribute to sound strategic planning, decision-making, goal setting, and effective… more
- Adecco US, Inc. (Teaneck, NJ)
- Adecco Healthcare is seeking a dedicated and passionate professional to join our client's team! Position Name: **Senior Analyst , Commercial Analytics ... least 5+ years as a Pharmaceutical & Plasma Data Analyst reflected on your Resume, your application will be...Experience in **Data Analysis** , **Pricing Analysis** , and ** Business Analysis** . - Experience within the **pharmaceutical and… 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
- Hackensack Meridian Health (Hasbrouck Heights, NJ)
- …experience in Revenue Cycle Operations + Minimum two years experience in a healthcare billing office or health insurance claims environment; familiar with common ... keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change....**Responsibilities** A day in the life of a Billing Analyst with Hackensack Meridian Health includes: + Utilizes billing… more