- Molina Healthcare (Detroit, MI)
- …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 (Detroit, MI)
- **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 (Detroit, MI)
- …**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
- Molina Healthcare (Detroit, MI)
- **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
- Sedgwick (Detroit, MI)
- …of LLMs + RESTFUL APIs + Knowledge of third party administration and claims management business and technology + Oral and written communication skills ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
- Ford Motor Company (Wayne, MI)
- …We believe our employees and the different perspectives that they bring to the business are the driving forces behind our success. **In this position ** The Quality ... Analyst will report to the Plant Vehicle Evaluation Manager....you'll do ** + Assist reviewing and binning early claims binning claims and customer concerns with… more
- Molina Healthcare (Detroit, MI)
- **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 (Detroit, MI)
- …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 (Detroit, MI)
- …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 (Detroit, MI)
- …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 (Detroit, MI)
- …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
- Carhartt, Inc. (Dearborn, MI)
- …+ Leads gathering and preparation of insurance renewal data, including considering business changes that may impact submissions. Tracks claims submitted under ... ExemptJob Band: Professional Job SummaryThe Sr. Treasury and Risk Analyst serves as a critical role, supporting senior level...set forth by our founder, Hamilton Carhartt. We Lead Business by creating value, delivering on results, and making… more
- Molina Healthcare (Detroit, MI)
- **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
- Molina Healthcare (Detroit, MI)
- …used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables ... departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods… more
- Henry Ford Health System (Detroit, MI)
- …restrictions. Establishes and facilitates communication with individuals, departments, business units, insurance carrier, workers compensation administrator, and ... + Serves as a liaison between the employee, third party administrator/ claims manager, HFHS benefits administration team, and HR representatives regarding LOA… more
- Molina Healthcare (Detroit, MI)
- **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
- WTW (Detroit, MI)
- …sponsorship and/or assistance is not offered for this specific job opportunity.** **The Business ** **Create your future.** Our Health and Benefits business helps ... management program design, pharmacy solutions, disability/absence management strategies and claims audit services. Product-based solutions such as our pharmacy… more
- Molina Healthcare (Detroit, MI)
- …meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching, ... and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan… more