- Molina Healthcare (Green Bay, WI)
- …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... and other analytic / programming tools as needed + Reporting includes Risk Adjustment program performance metrics, risk score...functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data … more
- Molina Healthcare (Madison, WI)
- …in data analysis. Performs research and deep-dive analysis of complex healthcare claims data , CMS return files, and financial cost, revenue, and vendor ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk...from requestors to develop Notebooks, Workflows, and Power BI reporting using multiple data sources, crosswalks, and… more
- Highmark Health (Madison, WI)
- …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
- Molina Healthcare (Racine, WI)
- …solutions. + Write advanced SQL queries to extract, validate, and analyze healthcare data , including claims , pharmacy, and lab datasets. + Build and maintain ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating… more
- Molina Healthcare (Kenosha, WI)
- …all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims ... business rules as they apply to each database. Validate data to be housed on provider databases and ensure...provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes.… more
- Molina Healthcare (Milwaukee, WI)
- …vendor relationship management activities + Partners with vendor and vendor management team with data analytics and reporting needs to support data driven ... **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of...analyze business and vendor performance problems and issues using data from internal and external sources to provide solutions… more
- Highmark Health (Madison, WI)
- …+ 5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project ... :** Highmark Health **Job Description :** **JOB SUMMARY** This job creates data -driven insights which identify actionable opportunities and/or create analytics and … more
- American Family Insurance - Corporate (Madison, WI)
- …of business. + Evaluate profit factors and conduct analysis of performance data to provides product strategy recommendations relating to profit, growth, retention, ... enhanced products and services. + Work with partners in pricing/actuarial or claims to ensure product compliance and financial viability. + Prepare contract… more
- Molina Healthcare (Milwaukee, WI)
- …cross-functional coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & ... core function of the role. + Validate findings and test assumptions through data , but lead with contextual knowledge of claims processing, provider contracts,… more
- Molina Healthcare (Green Bay, WI)
- …core function of the role. + Validates findings and test assumptions through data , but lead with contextual knowledge of claims processing, provider contracts, ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more