- Healthfirst (SD)
- … business rules within the claims processing system. + Identify claims configuration and contract implementation defects and improve departmental performance ... are adequately implemented based on technical planning documents. + Ensure post implementation accuracy of claims configuration implementations and mass claim… more
- Healthfirst (SD)
- …the development and configuration of new business, member benefits and products, claims editing, reference data and their enhancements including claims ... enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier… more
- Evolent (Pierre, SD)
- …be doing** : This individual will spearhead the requirements management for implementation projects across our client and Evolent organizations. By driving Evolent's ... + 5-8+ years of IT and / or business experience in an HMO / PPO Claims , Medicaid, Medicare and / or managed care healthcare environment + Knowledge of the Affordable… more
- Intermountain Health (Pierre, SD)
- **Job Description:** As a Business Systems Analyst , you will work closely with the business areas to identify and understand their needs and requirements. The major ... to major projects. Requirements may be specific to healthcare insurance products, claims , sales activities or other service-related processes; all in support of… more
- Lincoln Financial Group (Pierre, SD)
- …73933 **Role at a Glance** Lincoln National Corporation seeks an Analyst , Application Development in Radnor, PA to consult/analyze and deliver assignments/projects ... for Group Protection IT Claims of application development responsibility. Act as a resource...and existing programs to determine requirements, solution, test and implementation plans. Create Group Protection systems, tools and functionality,… more
- HealthEdge Software Inc (Pierre, SD)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...and maintaining detailed documentation to support the building and implementation of proprietary healthcare edits, including specifications, test plans,… more
- Prime Therapeutics (Pierre, SD)
- …in the project management, programming, testing and documentation aspects of the analyst responsibilities to drive the highest level of performance and meet or ... reporting requirements and testing of new reporting development prior to implementation to Production. + Participates in initiatives or projects that support… more