- Molina Healthcare (NM)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, ... and accurate reports. As the senior level team member, this role leads efforts to ensure the claims teams and other departments have access to quality claims … more
- Prime Therapeutics (Santa Fe, NM)
- …Posting Title** IT Business Systems Analyst Sr **Job Description** The Business Systems Analyst (BSA) Senior IT is responsible for serving as a ... stakeholders, development team and broader project team. The BSA Sr IT is also responsible for partnering with the...to educate and advance the business systems analyst practice within the Claims IT team… more
- Healthfirst (NM)
- …systems enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up ... + Lead and deliver projects related to the development and configuration of new business , member benefits and products, claims editing, reference data and their… more
- Prime Therapeutics (Santa Fe, NM)
- …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 (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...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… more
- Molina Healthcare (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
- 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...and existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is… more
- Molina Healthcare (Roswell, NM)
- **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
- Intermountain Health (Santa Fe, NM)
- …understanding and knowledge of the concepts and principals outlined within the Business Analyst Body of Knowledge (BABOK) guide. **Physical Requirements:** ... **Job Description:** As a Business Systems Analyst , you will work...projects. Requirements may be specific to healthcare insurance products, claims , sales activities or other service-related processes; all in… more
- Prime Therapeutics (Santa Fe, NM)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Pricing Analyst **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
- Evolent (Santa Fe, NM)
- …mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics role will be serving key internal ... structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between institutional vs… more
- Evolent (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …a growth mindset. **Job Summary** The QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards for our ... : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise...You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You… more
- TXNM Energy (Albuquerque, NM)
- …for a wide variety of construction, generation, transmission and distribution, and business contracts Manages the negotiation and renewal of various insurance and ... brokerage contracts Manages self-insurance program, claims , litigations, reserves, and allocation processes Oversees the processes to ensure compliance and… more