- Highmark Health (Providence, RI)
- …SUMMARY** This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a ... product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements.… more
- Rocket Software (Providence, RI)
- …people truly BELIEVE in what they're doing!** **Job Description Summary:** The Senior Benefit Analyst is responsible for building and delivering both global and ... country programs in line with the global total rewards philosophy. The Senior Benefits Analyst supports the design, administration, and analysis of Americas' and… more
- Public Consulting Group (Providence, RI)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Prime Therapeutics (Providence, RI)
- …build the future of pharmacy with us. **Job Posting Title** Clinical Research Analyst , Senior - Remote **Job Description** The Senior Clinical Research Analyst ... the synthesis of data findings in support of clinical claims and programs. **Responsibilities** + Synthesizes a wide variety...levels within the organization + Serves as the lead analyst in producing reports, scorecards, or other data using… more
- CVS Health (Woonsocket, RI)
- …with heart, each and every day. **Job Purpose and Summary:** The Call Center Analyst (Level 107) role has evolved beyond traditional call center functions to become ... trends, identify systemic issues, and drive operational improvements. The analyst leverages advanced tools-including Excel (with formulas and pivot...- 30% + Managing a work queue and closing claims - 20% + Taking calls - 10% +… more
- Humana (Providence, RI)
- …first** Humana is seeking an individual for the Senior Business Intelligence Data Analyst to provide support for its pharmacy programs to achieve success on the ... seeking an individual for the Senior Business Intelligence Data Analyst to provide support for pharmacy programs, working heavily...data ie. Provider, Insurance, etc. + Experience with pharmacy claims data + Advanced knowledge of Excel (ex. Pivot… more
- Evolent (Providence, RI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Lead Analyst , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Lead Analyst , Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products. This… more
- Cognizant (Providence, RI)
- **Job Summary:** We are seeking a strong Duck Creek Functional Analyst / Business Analyst to work closely with customer Product Owners. The ideal candidate will ... teams to handle queries and understand requirements. . Experience with Billing and Claims configuration knowledge and Data Insight producer policy holder is an added… more
- Prime Therapeutics (Providence, RI)
- …pricing or financial analysis to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field** **3 ... build the future of pharmacy with us. **Job Posting Title** Principal Pricing Analyst - REMOTE **Job Description** **The Principal Pricing Analyst leads complex… more
- Humana (Providence, RI)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Norstella (Providence, RI)
- Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States Date Posted: Nov 20, 2025 Employment Type: Full Time Job ID: R-1548 **Description** At ... to extract meaningful insights from **real-world data (RWD)** sources, including ** claims , laboratory results, billing codes, and electronic health records (EHRs)**… more
- Cognizant (Providence, RI)
- **Health Payer Business Analyst , Senior Consulting Manager** **About the Role:** As a Sr. Consulting Manager you will make an impact by driving client engagement, ... firms * Strong background in Healthcare industry, including health plans, claims , and provider operations * Project management and people management experience… more
- Highmark Health (Providence, RI)
- …Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits . HNAS is part of Highmark Health, a national blended health ... 5 - 7 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 3 -… more
- CVS Health (Woonsocket, RI)
- …every day. This is a hybrid position. **Position Summary** As a Rebate Formulary Analyst - Manufacturer Rebates you will perform a critical role in the analysis of ... and/or Rebate knowledge beneficial. + Experience with Caremark business systems, claims adjudication, formulary, drug, and client systems with an emphasis on… more
- CVS Health (Woonsocket, RI)
- …it all with heart, each and every day. **Position Summary:** As a Senior Analyst on the Program Modernization Automation and Development AI team, you will serve as ... Experience working with large volumes of medical and pharmacy claims data + Experience with SSIS, Alteryx, Tableau Prep,...every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our… more
- Cardinal Health (Providence, RI)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... gaps + Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted HCPs/accounts touched)… more
- Highmark Health (Providence, RI)
- …analytical and financial analysis capability for Highmark's pharmacy and medical benefit specialty drug management programs. Furthermore, the incumbent will utilize ... understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues...experience in support of a Marketing function or Data Analyst role or in a business environment with responsibility… more
- CVS Health (Woonsocket, RI)
- …**Position Summary** We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance ... investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate...every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our… more
- Public Consulting Group (Providence, RI)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages department providing oversight...this role. In addition, PCG provides a range of benefits for this role, including medical and dental care… more