- Molina Healthcare (Buffalo, NY)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... healthcare business needs into technical solutions. This role works closely...queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain… more
- The Cigna Group (New York, NY)
- **_LOCATION: Must live in the New York City/New Jersey area. Will be required to go into the NYC office two times per month._** The **Provider Contracting Lead ... Analyst ** serves as an integral member of the Provider...communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance,… more
- MVP Health Care (Schenectady, NY)
- …and continuous improvement. To achieve this, we're looking for a **Professional, Quality Analyst ** to join #TeamMVP. This is the opportunity for you if you have ... Workplace** . **Qualifications** **you'll** **bring:** + Bachelor's Degree in Business , Math, Computer Science, Information Systems, related field or five… more
- Hartford Steam Boiler Inspection and Insurance Company (New York, NY)
- Actuarial Analyst Sr **Company** HSB **Location** New York , United States Location: Remote, USA Join HSB's expanding pricing team and make a difference by providing ... methods to deliver proactive insights and innovative solutions to empower our business , including but not limited to developing rates and forecasts, identifying key… more
- City of New York (New York, NY)
- …to vendors providing services to DSS/HRA/DHS and reimbursement to employees for business related out of pocket expenses incurred in the delivery of services. ... Associate III to function as a Human Services Payment Analyst who will: - Perform quality assurance review of...and CARES within the prescribed period. - Reconcile monthly claims and maintain a claim-control register to ensure the… more
- CVS Health (Albany, NY)
- …Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation ... staff, and team members as more complex cases and strategies are developed. ** Required Qualifications** + 3-5 years of experience in a medical claim background with… more
- Molina Healthcare (Albany, NY)
- …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
- WTW (New York, NY)
- …put together a 'Market Submission' document, containing in-depth information about a client's business including claims information, the classes of business ... **This role is hybrid.** Hiring locations: New York, Los Angeles **The Business .** **Graduate Program Overview** The CRB Graduate Development Program (GDP) is a… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …multiple high-risk projects, including projects involving external vendors and multiple business areas that have a significant legal and/or financial impact to ... Company's Business . This individual should have hands on experience in...more work streams, including: Client Implementation, Enrollment & Eligibility, Claims processing & Reimbursements, Member/Provider self-service, Customer Service, Legal… more
- Highmark Health (Albany, NY)
- …in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities. **ESSENTIAL ... strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought… more