- Molina Healthcare (Kenosha, WI)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- BD (Becton, Dickinson and Company) (Vernon Hills, IL)
- …and OEM) of BD's Commercial Consumable Sales Contracts for all US business segments, BD Medical [Medication Delivery Solutions (MDS) & Medication Management ... all customer segments (excluding Pharmaceutical Systems, BioSciences, and IDS Capital). Analyst will be responsible to ensure members are aligned appropriately to… more
- Molina Healthcare (Kenosha, WI)
- …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...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… more
- Molina Healthcare (Kenosha, WI)
- …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 knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Molina Healthcare (Kenosha, WI)
- **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
- Molina Healthcare (Kenosha, WI)
- …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...in contracts and benefits configuration. + Strong background in claims is required. + Experience working on Networx, QNXT… more
- Molina Healthcare (Kenosha, WI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (Kenosha, WI)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Molina Healthcare (Kenosha, WI)
- **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
- Molina Healthcare (Kenosha, WI)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more
- AbbVie (Mettawa, IL)
- …key partners to deliver meaningful business solutions and impact. The 340B COE Business Operations Analyst is a member of a group with technical expertise in ... The 340B Drug Pricing program has become a critical issue impacting AbbVie's business . Originally designed to help safety-net hospitals and clinics give better care… more
- AbbVie (Mettawa, IL)
- …key partners to deliver meaningful business solutions and impact. The 340B COE Business Operations Analyst is a member of a group with technical expertise in ... Pricing program has become a critical issue impacting AbbVie's business . Originally designed to help safety-net hospitals and clinics...Experience with IQVIA data sources (eg HCOS data), Rx claims data, PBM rebate data. + Knowledge of 340B… more
- US Tech Solutions (North Chicago, IL)
- …SUMMARY:** + Under general direction, the **Post Market** Quality Assurance (PMQA) Analyst I will investigate and maintain **complaint files,** in compliance with ... FDA and international Competent Authorities. + In addition will process claims for financial **reimbursement and replacement products** in accordance with… more