- Molina Healthcare (Albany, NY)
- …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (NY)
- …health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver ... through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality… more
- Molina Healthcare (Yonkers, NY)
- …health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver ... through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality… more
- Catholic Health Services (Melville, NY)
- …pertinent industry experience. Skills: + 5+ years of claim experience, preferably healthcare liability or other professional liability claims . + Strong ... Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named...was named Long Island's Top Workplace! Job Details The Claims Analyst is responsible for monitoring, analyzing, and reporting… more
- Cognizant (Albany, NY)
- …you will make an impact by leading the implementation and optimization of Facets Claims solutions for healthcare clients. You will be a valued member of ... **Product Consultant - Facets Claims & Payer Domain** **Work Model: Remote** **Employment...help you stand out** + Certified Facets Professional + Healthcare Payer Professional Certification + Experience driving Agile practices… more
- Molina Healthcare (Syracuse, NY)
- …Experience working on SQL, PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Humana (Albany, NY)
- …implement data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization ... that align with customer needs and objectives + Deep understanding of healthcare claims taxonomy (service categories, such as LTSS) **Additional information**… more
- Evolent (Albany, NY)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... public health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider, clinical vendor, managed care, or… more
- Mount Sinai Health System (New York, NY)
- …and executive-facing roles ? Advanced analytical capabilities required, experience with healthcare claims analysis and clinical quality measures highly preferred ... finance and strategic business needs (eg, market sizing), and healthcare topics (eg, claims analysis) with guidance...(eg, market sizing), and healthcare topics (eg, claims analysis) with guidance from Quality Director ? Effective… more
- City of New York (New York, NY)
- …obligations, regulatory requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. 2. Claims Data ... Validation: Verify the accuracy, completeness, and timeliness of daily healthcare claims payment data submitted by the health plan prior to authorize payment.… more