- Harbor Health Services, Inc. (Mattapan, MA)
- …Management & Quality Programs. Harbor Health offers an excellent, comprehensive benefits package including Health, Dental, Vision, Life, & Disability insurance, 403b ... with UM RNs and Senior Medical Director to deny claims when appropriate. Attends IDT meetings on routine basis....of quality measures and other data by the Quality Analyst for report to regulatory agencies, including CMS and… more
- Highmark Health (Boston, MA)
- …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 (Boston, MA)
- …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
- Center For Health Information And Analysis (Boston, MA)
- …be a driving force in health policy impact! We are seeking a Research Analyst to contribute to our growing research projects within the dynamic Strategy and Research ... team. The Research Analyst will work closely with the research team and...tasks for large datasets such as the All Payer Claims Database (APCD), hospital discharge data (Case Mix), and… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- …initiatives. . Working knowledge of healthcare payer systems and processes ( benefits , claims , enrollment, provider data, UM/PA). . Experience writing ... **Senior Business System Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Massachusetts, Canton **Position… more
- Public Consulting Group (Boston, MA)
- …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 (Boston, MA)
- …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
- Zurich NA (Boston, MA)
- TPA Operations Sr. Performance Analyst 125087 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes ... Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims...for specific initiatives. + Lead the production of periodic benefit follow-ups for key initiatives within the relevant region… more
- Point32Health (Canton, MA)
- …of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and ... authorized representative and must demonstrate superior customer service and benefit interpretation skills in all interactions. This individual prepares cases… more
- Humana (Boston, MA)
- …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 (Boston, MA)
- …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 (Boston, MA)
- **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 (Boston, MA)
- …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
- Bank of America (Boston, MA)
- Fraud Analytics and Innovation Lead Analyst - Fraud Strategy Jacksonville, Florida;Plano, Texas; Richmond, Virginia; Sun City West, Arizona; Boston, Massachusetts; ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Jacksonville/Fraud-Analytics-and-Innovation-Lead- Analyst Fraud-Strategy\_25042825-2) **Job Description:** At Bank of America, we… more
- Beth Israel Lahey Health (Charlestown, MA)
- …a job, you're making a difference in people's lives.** The Revenue Cycle Denial Analyst is charged with coordinating the analysis and effective resolution of denied ... claims with the purpose of reducing overall denials and...requirements, including filing limit, claim processing logic, coordination of benefits requirements, patient responsibility and authorization requirements. Ability to… more
- Humana (Boston, MA)
- …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 (Boston, MA)
- 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 (Boston, MA)
- **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
- Sysco (Plympton, MA)
- …to work first and/or second shift.** **Job Summary:** The Leave of Absence Analyst is responsible for managing employee leave and return to work processes, ensuring ... (FMLA, ADA, short-term disability, etc.) including coordination of state paid benefit programs. + **Consultation:** Provide guidance to colleagues regarding leave… more
- Highmark Health (Boston, MA)
- …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
