- Prime Therapeutics (Trenton, NJ)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Trenton, NJ)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- Prime Therapeutics (Trenton, NJ)
- …make. **Job Posting Title** Claims Technical Analyst, Sr. **Job Description** The Senior Claims Technical Analyst is responsible for serving as the claims ... This role is also responsible for providing training and mentorship to Claims Technical Analysts and Associate Analysts, along with leading process improvement and… more
- Deloitte (Philadelphia, PA)
- Senior Consultant, Operations & Technology Transformation, Insurance, Guidewire Developer - ETL/Data Migration What we do Operations and Technology ... and technology solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems strategy, develop system… more
- Deloitte (Philadelphia, PA)
- Operations Technology Transformation Senior Consultant, Guidewire Configuration / Integration What we do Operations and Technology Transformation delivers ... and technology solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems strategy, develop system… more
- Deloitte (Philadelphia, PA)
- Senior Consultant, Operations and Technology Transformation, Guidewire Application Java Developer What we do Operations and Technology Transformation ... and technology enabled solutions focused on "heart of the business " issues in specific sectors including Health Care &...2025 Work you'll do As an OTT Insurance Transformation Senior Consultant, you will bring technical expertise to deliver… more
- HealthEdge Software Inc (Trenton, NJ)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- The Cigna Group (Philadelphia, PA)
- …- Required + Teradata and Databricks - Preferred + Ability to understand business operations requirements and translate them into technical applications + ... **Summary** The Part D Stars Business Analytics Senior Advisor will be...Advisor will lead development of data analyses utilizing pharmacy claims , clinical outcomes, and Stars quality measures to make… more
- Penn Medicine (Philadelphia, PA)
- …academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will ... using data, the Data Scientist will provide statistical analysis of medical claims . This position will function to make significant contributions related to … more
- CVS Health (Trenton, NJ)
- …which contain multiple issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and ... Serves as point person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as well as other… more
- Sedgwick (Philadelphia, PA)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Senior Vice President Business Development **PRIMARY PURPOSE:** To expand and ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
- HealthEdge Software Inc (Trenton, NJ)
- …are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite of ... in claims processing. The successful candidate will be responsible for taking a senior level role in analyzing claims data, as well as translating contract… more
- The Cigna Group (Philadelphia, PA)
- …needs and support delivery of plan KPIs. + Oversee end-to-end operations , including claims management, contract administration, account management, and ... role will be the owner of our Stop Loss business . Cigna leads the nation with the most Stop...of revenue annually with earnings of approximately $1B. The senior director of Stop Loss will be responsible for… more
- Zurich NA (Trenton, NJ)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Trenton, NJ)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- AECOM (Philadelphia, PA)
- …department is actively seeking a creative, highly talented attorney to support AECOM's operations in its East Region. This will be a hybrid position including a ... that may have an important bearing on the conduct of the organization's business + Work with management and staff to resolve pre-litigation disputes and potential… more
- Deloitte (Philadelphia, PA)
- …and Energy & Resources. Our OTT team applies deep sector knowledge and technical business operations consulting experience to take a more strategic view of our ... What we do Operations and Technology Transformation delivers market leading expertise...solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems… more
- Prime Therapeutics (Trenton, NJ)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- Humana (Trenton, NJ)
- …support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated individual to influence the ... successfully position Humana to enter new markets enabling the future of the business . As a centrally positioned strategic function this team coordinates with growth… more
- Deloitte (Philadelphia, PA)
- …to clients to gain a competitive advantage by integrating tax strategy into their business operations while working within the confines of their individual risk ... Are you a senior tax professional who wants to specialize in...advisory services to clients in the insurance industry across business functions such as underwriting, claims , IT,… more