- MetLife (Oriskany, NY)
- …Responsibilities: * Conducts quality reviews of Americans with Disabilities Act (ADA) claims . * Identifies trends, root causes, and quality gaps from the analysis ... Coach and mentor ADA Specialists to drive improvements in claim handling. * Provide additional support to the Absence...supported. Required: * 3+ years of experience managing ADA claims . * Experience managing absence claims for… more
- WMCHealth (Valhalla, NY)
- Revenue Integrity Analyst Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Revenue Integrity ... Internal Applicant link Job Details: Job Summary: The Revenue Integrity Analyst reviews and revises accounts to achieve revenue enhancement and compliance.… more
- Evolent (Albany, NY)
- …Stay for the culture. **What You'll Be Doing:** Job Description ** Analyst , Integration Quality** Integration testing in the healthcare ecosystem requires complete ... testing is exercised to ensure source to target integrity. The IQ Analyst (IQA) performs analysis, reporting, and technical testing across multiple domains. Active… more
- Evolent (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS, Specialty… more
- Highmark Health (Albany, NY)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency ... to establishing rates, rating structures and systems and reserves. The Actuarial Analyst has accountability to providing in depth analysis on the overall risk… more
- WMCHealth (Valhalla, NY)
- Compliance Analyst , 340B Program ( On-Site ) Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Executive/Management Department: Pharmacy ... Internal Applicant link Job Details: Job Summary: The 340B Program Compliance Analyst is responsible for maintaining regulatory compliance within the 340B Program… more
- Molina Healthcare (NY)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Molina Healthcare (NY)
- **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory...+ Basic familiarity with healthcare data types such as claims , encounters, or eligibility data + Comfortable working with… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...to mine and manage information from large data sources. ** Preferred Qualifications:** + Proficiency with Power BI and/or Tableau… more