- Molina Healthcare (Las Cruces, NM)
- …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 (Santa Fe, NM)
- **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
- Healthfirst (NM)
- …+ Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference ... requirements and provide feedback to stakeholders regarding feasibility of claims business rule and program changes. +...understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively… more
- Healthfirst (NM)
- …systems enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up ... projects related to the development and configuration of new business , member benefits and products, claims editing,...of new business , member benefits and products, claims editing, reference data and their enhancements including … more
- Molina Healthcare (NM)
- **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… more
- Molina Healthcare (Las Cruces, NM)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- Prime Therapeutics (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Molina Healthcare (Albuquerque, NM)
- **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...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Prime Therapeutics (Santa Fe, NM)
- …Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting the business in decision making and ... operations efforts by providing data, reporting and business intelligence services. This role is responsible for acting...experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- Evolent (Santa Fe, NM)
- …(Required):** + Bachelor's Degree + 2+ years' experience in healthcare, Operations, IT business analyst , and/or product management + Highly organized with the ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...Doing:** **What You'll Be Doing:** As a Senior Product Analyst , you will have the opportunity to shape the… more
- Molina Healthcare (Roswell, NM)
- **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
- Evolent (Santa Fe, NM)
- …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 (NM)
- …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 (Santa Fe, NM)
- …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 (NM)
- **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
- Molina Healthcare (NM)
- **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Roswell, NM)
- …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...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
- Molina Healthcare (Roswell, NM)
- …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