- Public Consulting Group (Providence, RI)
- …Education + Recovery Services **Duties and Responsibilities** + Analyzes the development of claims assigned at each level of the adjudication process. + Outlines the ... sent with applications. + Monitors and gives direction to Claims Developer regarding specific tasks on claims ....to Claims Developer regarding specific tasks on claims . + Provides monthly reporting statistics. + Ensures adherence… more
- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary… more
- Prime Therapeutics (Providence, RI)
- …our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Providence, RI)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **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
- CVS Health (Providence, RI)
- …to GPS to rework claims after validating as overpaid **Required Qualifications** * 1 years experience working with GPS and ECHS * Knowledge of ACAS claims ... This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and...experience along with provided guidance to review and validate claims for overpayment. The ideal candidate will be able… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is ... experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in the implementation… more
- Evolent (Providence, RI)
- …Business, Economics, Engineering, Physical/Life Sciences, or a related field (preferred).** ** 1 + years of professional experience in claims -based healthcare ... positively contribute to Evolent's broader mission. **Collaboration Opportunities:** The Analyst , Performance Suite Analytics utilizes and develops analytic tools to… more
- Children's Hospital Boston (Boston, MA)
- 77503BRJob Posting Title:IT EPIC ANALYST II - Hospital BillingDepartment:Information Services-ApplicationsAutoReqId:77503BRStatus:Full-TimeStandard Hours per Week:40 ... Category:Information TechnologyJob Posting Description: This Hospital Billing IT Epic Analyst II will be responsible for: + Serves as...+ High School Diploma / GED, Bachelor's required. + 1 year of experience directly involved in Epic application… more
- Bank of America (Boston, MA)
- Account Takeover and Device Policy Analyst Charlotte, North Carolina;Belfast, Maine; Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, ... fraud risk and create mitigation strategies. As a Client Protection Fraud Policy Analyst , you will capitalize on your Fraud knowledge strategic thinking to solve… more
- Army National Guard Units (East Greenwich, RI)
- …GUARD TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a BUDGET ANALYST (T32), PD Number D1900000 and is part of the RI USPFO Rhode Island ... of this position is to serve as the budget analyst and consultant for the management and administration of...program areas or functional assignment. SPECIALIZED EXPERIENCE: Must have 1 year equivalent specialized experience to at least the… more
- Prime Therapeutics (Providence, RI)
- …and drives every decision we make. **Job Posting Title** Senior Health Informatics Analyst - Remote **Job Description** + Performs exploratory data analysis and data ... mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out financial, clinical and utilization analyses using a variety of… more
- Tufts Medicine (Boston, MA)
- …on the technical side are appropriately applied. **Job Description** **Minimum Qualifications:** 1 . High school diploma or equivalent 2. Three (3) years of ... for local travel to remote hospital sites **Preferred Qualifications:** 1 . Bachelor's Degree **Duties and Responsibilities:** The duties and responsibilities… more
- Prime Therapeutics (Providence, RI)
- …new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to ... solution design; develop strategic partnerships with various levels of leadership and analyst teams within the organization + Support enterprise adoption of Tableau… more
- Prime Therapeutics (Providence, RI)
- …Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, analyzing, and delivering Treasury ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more