- Somatus (Mclean, VA)
- …Analytics to create impact among Somatus' clients and leadership by analyzing Somatus' healthcare claims and care management data. This position will work ... grow, and be the best version of themselves, including: + Subsidized, personal healthcare coverage (medical, dental vision) + Flexible Paid Time Off (PTO) + 401(k)… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …to help resolve high-impact business issues by recommending action plans related to quality assurance. + Assist the Data Reporting Analyst in collecting data ... Lives** Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so... Auditor (CQA), Quality Improvement Associate (CQIA), Quality Process Analyst Certification (CQPA). + Bachelor's… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …to support health economic claims . **Job Duties** + Serve as a primary analyst for clinical studies and RWE research using multiple clinical trial data and ... healthcare administrative data in support value proposition, abstract/manuscript submission....standards relevant to medical devices (eg, FDA, EMA, PMDA), quality systems/SOPs, data integrity and audit readiness. + Lead… more
- Molina Healthcare (Grand Island, NE)
- …identifies and recommends updates to policies, SOPs, and job aids to improve claims quality and efficiency. + Collaborates with external departments and ... **Job Description** **Job Summary** The Senior Claims Research Analyst provides senior-level support...position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Molina Healthcare (Lincoln, NE)
- JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. *...position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- WelbeHealth (Columbus, OH)
- …health insurance claims + Experience working with CMS and Medicaid healthcare claims highly preferred + Demonstrated skills within Microsoft Office ... ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role...Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and… more
- AIG (Jersey City, NJ)
- …and efficiency. How you will create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") ... Claims Complex Director - Healthcare Professional...analyst will investigate losses, orchestrate defense strategies for healthcare provider insureds, conduct independent assessments as to exposures… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- **Senior Business System Analyst - Healthcare ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Massachusetts, ... as a Business Analyst or Business Systems Analyst in the healthcare payer domain. ....APIs or payer modernization initiatives. . Working knowledge of healthcare payer systems and processes (benefits, claims ,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Healthcare Analyst Senior Location: Hybrid | Eagan, Minnesota Career Area: ... ready to make a difference, join us. The Impact You Will Have The Senior Healthcare Analyst is responsible for contributing to and supporting the strategic needs… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** The Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. This position designs ... on how to use reports related to Risk and Quality /HEDIS for Medicaid, Marketplace and Medicare/MMP. **Job Duties** +...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… more
- Molina Healthcare (OH)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... on how to use reports related to Risk and Quality /HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research,...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… more
- Molina Healthcare (Rio Rancho, NM)
- JOB DESCRIPTION Job Summary Provides lead level analyst support for configuration information management activities. Responsible for accurate and timely ... implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules… more
- Molina Healthcare (St. Petersburg, FL)
- JOB DESCRIPTION Job Summary Provides senior level analyst support for configuration information management activities. Responsible for accurate and timely ... implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Cross and Blue Shield of Minnesota Position Title: Principal Risk Adjustment Healthcare Analyst Location: Hybrid | Eagan, Minnesota Career Area: Data ... and Blue Shield of Minnesota is hiring a Principal Healthcare Analyst on our Risk Adjustment team...responses, and reporting. * Knowledge of managed care and healthcare claims preferred. * Bachelor's degree. Compensation… more
- Sharp HealthCare (San Diego, CA)
- …Do** Under the direction of the Manager of EDI Management, the Systems Analyst -EDI Mgmt will use technical and analytic skills to complete monitoring, reviewing, ... mapping inbound and outbound data files for Sharp Health Plan. The Systems Analyst -EDI Mgmt will work with general Health Plan operational data sets including, but… more
- Elevance Health (Indianapolis, IN)
- **Senior Healthcare Economics Analyst ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... position is not eligible for current or future visa sponsorship._ The **Senior Healthcare Economics Analyst ** (Advanced Analytics Analyst Senior) creates… more
- Hartford HealthCare (Hartford, CT)
- …matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The Clinical Risk Management Data Analyst is responsible for ... this is *your moment.* **Job:** **Legal / Compliance* **Organization:** **Hartford HealthCare Corp.* **Title:** *Clinical Risk Management Data Analyst *… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: Summary: The Healthcare Statistical Analyst & PFO performs technical services within the actuarial ... and aids in the creation of new analysis pertaining to benefit designs, claims experience, Value Based Payment (VBP) programs and valuation of internal and… more
- Integra Partners (Troy, MI)
- The Quality Assurance Analyst is responsible for... will fairly and consistently review the calls, emails, claims , etc. of our team for accuracy and provide ... in support of the departmental goals and initiatives. The Quality Assurance Analyst evaluates both verbal and...remain focused and motivated during the auditing process + Healthcare experience preferred + Fluent in Spanish and English… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role We are seeking a detail-oriented and proactive QA Analyst to support quality assurance efforts across Brighton Health Plan Solutions' core ... portfolios- Claims , Provider, and Enrollment. In this role, you will...processes. You will play a key part in ensuring high- quality software delivery by validating business requirements, improving test… more
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