- Molina Healthcare (Kenosha, WI)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business ...experience ** Required Experience** + 3-5 Years of business analysis + 4+ years managed care experience +… more
- 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...REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + 1-3 years claims analysis experience + 5+ years medical claims… more
- Molina Healthcare (Madison, WI)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... Required Education** Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business analysis + 4+… more
- Intermountain Health (Madison, WI)
- …configuration, business knowledge, and effective communication skills to implement required business functions with turn-around time within established SLAs. ... **Job Description:** At SelectHealth, the Business Systems Configuration Analyst I is...systems or in healthcare, with a thorough understanding of claims processing and billing + Intermediate proficiency to demonstrate… more
- Prime Therapeutics (Madison, WI)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides… more
- IQVIA (Milwaukee, WI)
- …o Assists with training projects. **Minimum Education, Experience, & Specialized Knowledge Required :** o Bachelor Degree in finance, business , statistics, math ... build and enhance your interpersonal skills that are necessary to build effective business relationships with your clients. Those skills are pertinent because as an … more
- 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
- Prime Therapeutics (Madison, WI)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- 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
- 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
- Evolent (Madison, WI)
- …creativity, accountability, and a growth mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics ... reports with complex regulatory/clinical requirements for healthcare lines of business - ** Required ** + 2+ years of...SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - ** Required ** +… more
- 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
- Molina Healthcare (Milwaukee, WI)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Education** Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business or experience system… more
- 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, ... and will lead high-complexity analysis and special projects as required . **Responsibilities** + Act as a champion of the...the consulting and analytic methodology for designated line of business ; may provide work direction, serve as a mentor… 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...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
- 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 ... to develop programs and performance measurement tools. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… more
- 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 ... and performing similar functions for other staff.. **Job Qualifications** ** Required Education** Associate's Degree or equivalent combination of education and… more
- Molina Healthcare (Racine, 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...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- Molina Healthcare (Racine, WI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... Experience working in a managed care environment and commercial line of business is preferred. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree or… more
- Molina Healthcare (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