- Molina Healthcare (Rio Rancho, NM)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business ...experience ** Required Experience** + 3-5 Years of business analysis + 4+ years managed care experience +… more
- Molina Healthcare (NM)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and ... team member, this role leads efforts to ensure the claims teams and other departments have access to quality...Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business … 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...REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + 1-3 years claims analysis experience + 5+ years medical claims… more
- Molina Healthcare (Rio Rancho, NM)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... Required Education** Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business analysis + 4+… more
- Prime Therapeutics (Santa Fe, NM)
- …work efforts + Desire and ability to educate and advance the business systems analyst practice within the Claims IT team and across the organization + Strong ... It fuels our passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr **Job Description** The Business Systems … 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)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... every decision we make. **Job Posting Title** Senior Pricing Analyst **Job Description** The Senior Pricing Analyst ...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- Molina Healthcare (Las Cruces, 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
- Evolent (Santa Fe, NM)
- …creativity, accountability, and a growth mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics ... reports with complex regulatory/clinical requirements for healthcare lines of business - ** Required ** + 2+ years of...SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - ** Required ** +… more
- Molina Healthcare (NM)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Education** Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business or experience system… more
- Defense Threat Reduction Agency (Albuquerque, NM)
- …is part of the Defense Threat Reduction Agency. Responsibilities As a PROGRAM ANALYST at the GS-0343-11/12 some of your typical work assignments may include: The ... of the position is to serve as a program analyst , responsible for the execution of assigned programs and...division. This position will be responsible for program and business management associated with acquisition of services and products,… more
- Evolent (Santa Fe, NM)
- …for any given domain function with minimal assistance + 5-8+ years of IT and / or business experience in an HMO / PPO Claims , Medicaid, Medicare and / or managed ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...standards when new system enhancements or engineering changes are required . Maintain standard templates and support ongoing maintenance +… 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, ... and will lead high-complexity analysis and special projects as required . **Responsibilities** + Act as a champion of the...the consulting and analytic methodology for designated line of business ; may provide work direction, serve as a mentor… more
- Molina Healthcare (Santa Fe, 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
- 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 ... to develop programs and performance measurement tools. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… 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 ... and performing similar functions for other staff.. **Job Qualifications** ** Required Education** Associate's Degree or equivalent combination of education and… more
- Molina Healthcare (Rio Rancho, 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
- 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 ... Experience working in a managed care environment and commercial line of business is preferred. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree or… more
- HealthEdge Software Inc (Santa Fe, NM)
- …root-cause issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The ... implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior… more
- Molina Healthcare (Rio Rancho, 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...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more