• Analyst , Business -( Claims

    Molina Healthcare (Madison, WI)
    …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 (12/20/24)
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  • Business Analyst ( Claims

    Molina Healthcare (Kenosha, WI)
    **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 (12/21/24)
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  • Analyst , Claims Research

    Molina Healthcare (WI)
    **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements ... are appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or… more
    Molina Healthcare (11/15/24)
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  • Americas Operations Senior Business

    Zurich NA (Stevens Point, WI)
    …collaborating with key stakeholders throughout the Americas Claims and Assistance Business Operations. **The Senior Business Analyst /Product Owner is ... Americas Operations Senior Business Analyst / Product Owner 120060...owns the Travel Program of Work for the Americas Claims and Assistance Business Operations. This person… more
    Zurich NA (01/09/25)
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  • Business Analyst

    TEKsystems (Milwaukee, WI)
    Description IT Application Analyst / Business Analyst currently a 6 month contract but the manager is ideally hoping for head count to add this person as a ... Wisconsin. the Customer Experience team is looking for a Business Analyst as they continue to build...to build out include pill bay, review status of claims , edelivery functionality on documents, etc. They are currently… more
    TEKsystems (01/05/25)
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  • Business Systems Configuration…

    Intermountain Health (Madison, WI)
    **Job Description:** At SelectHealth, the Business Systems Configuration Analyst I is responsible to analyze, design, configure, test, implement and support ... Facets software configuration through an understanding of business requirements as well as technical knowledge of the systems. Using relational databases and SQL… more
    Intermountain Health (01/07/25)
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  • Pricing Analyst - Remote

    Prime Therapeutics (Madison, WI)
    …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 (01/09/25)
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  • Business Process Analyst

    IQVIA (Milwaukee, WI)
    …build and enhance your interpersonal skills that are necessary to build effective business relationships with your clients. Those skills are pertinent because as an ... analyst , you will be responsible for multiple accounts and...writing with a customer. o Research and resolve Chargeback claims . o Ensure accurate and appropriate responses to disputes.… more
    IQVIA (12/14/24)
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  • Analyst , Medicaid Rebates

    Sumitomo Pharma (Madison, WI)
    …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
    Sumitomo Pharma (11/07/24)
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  • Subrogation Analyst - Third Part Liability

    Elevance Health (Waukesha, WI)
    Job Description **Subrogation Analyst ** _Location: Virtual with the ideal candidate living 50 miles from the Louisville, KY, Waukesha, WI, or Indianapolis, IN ... care cost containment company offering subrogation recovery services. The **Subrogation Analyst ** is responsible for handling complex Third Party Liability and other… more
    Elevance Health (01/09/25)
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  • Sr. Pricing Analyst - Pharmacy Network…

    Prime Therapeutics (Madison, WI)
    …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
    Prime Therapeutics (01/08/25)
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  • Sr Analyst , Medical Economics (NY Medicaid…

    Molina Healthcare (Milwaukee, WI)
    **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
    Molina Healthcare (12/29/24)
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  • Provider Payment Appeal Analyst I

    Elevance Health (WI)
    …within 50 miles of an Elevance Health PulsePoint.** The **Provider Payment Appeal Analyst I** is responsible for supporting the Payment Dispute process across all ... lines of business and is specifically responsible for the resolution of...root cause and appropriate resolution. + Must work with Claims Operations to remediate impacted claims . **Minimum… more
    Elevance Health (01/01/25)
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  • Senior Analyst , Client Analytics - 2+…

    Evolent (Madison, WI)
    …creativity, accountability, and a growth mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics ... structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between institutional vs… more
    Evolent (12/05/24)
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  • Sr Analyst , Business (Remote)

    Molina Healthcare (Milwaukee, WI)
    **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 (12/19/24)
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  • Quality Assurance Analyst

    Zurich NA (Stevens Point, WI)
    Quality Assurance Analyst 119466 Travel Guard meets the diverse needs of leisure and corporate travelers alike through its comprehensive portfolio of travel ... to hear from you! Zurich North America is seeking a **Quality Assurance Analyst ** tojoin our Group inNorth American,Stevens Point, WI. At Zurich, technology is at… more
    Zurich NA (12/12/24)
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  • Sr. Applied Stars and Quality Analytics…

    Prime Therapeutics (Madison, WI)
    …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, ... as a champion of the consulting and analytic methodology for designated line of business ; may provide work direction, serve as a mentor or train junior level… more
    Prime Therapeutics (12/24/24)
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  • Sr Analyst , HEDIS Quality Performance

    Molina Healthcare (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 (12/28/24)
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  • Sr Analyst , Healthcare - Remote

    Molina Healthcare (WI)
    **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
    Molina Healthcare (11/23/24)
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  • Sr Analyst , Config Info Mgmt - Remote…

    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...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
    Molina Healthcare (01/08/25)
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