- Molina Healthcare (Ann Arbor, MI)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing . This role will focus on identifying, reviewing, and validating Medicaid… more
- Prime Therapeutics (Lansing, MI)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field. + Previous experience using ... drives every decision we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description**...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- Norstella (Lansing, MI)
- Sr. Medical Analyst Company: MMIT Location: Remote, United States Date Posted: Jul 30, 2025 Employment Type: Full Time Job ID: R-1370 **Description** **Why ... market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role, you… more
- Baylor Scott & White Health (Lansing, MI)
- …issues. + Knowledge and expertise of medical benefit policies and plan designs, claims hospital and medical processing , and adjudication with data skills. + ... and/or level **Job Summary** **100% Remote position** The Benefit Configuration Analyst examines configuration change requests. They establish the technical scope,… more
- Molina Healthcare (Grand Rapids, MI)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- PRGX (Grand Rapids, MI)
- …analyze the client's business operations. + Finds, supports, and documents audit and claims operations. + Produces claims using appropriate audit concepts for ... writing claims , updating claims management system, and billing claims to...with experience in retail or grocery procurement, and A/P processing . WORKING CONDITIONS The physical demands described here are… more
- Molina Healthcare (MI)
- **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team, contributing to the end-to-end data ... Databricks, not all required elements are neatly organized or centralized. The analyst will be expected to investigate and connect disparate data sources, with… more
- Humana (Lansing, MI)
- …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral… more
- CVS Health (Lansing, MI)
- …analytical, critical-thinking, and problem-solving skills. **Preferred Qualifications** + Claims processing experience. + Customer service experience. ... and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and...provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply… more
- Molina Healthcare (Ann Arbor, MI)
- …Ensure that provider information is loaded accurately to allow for proper claims processing , outbound reporting and directory processes. **JOB QUALIFICATIONS** ... for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims… more