- 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
- CVS Health (Madison, WI)
- …Trifacta, Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data . + Experience in healthcare industry, including health ... our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to,… more
- CVS Health (Madison, WI)
- …evaluating and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth ... with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider… more
- Humana (Madison, WI)
- …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 ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Highmark Health (Madison, WI)
- …+ 2 years of Coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 1 year of Project ... :** Highmark Health **Job Description :** **JOB SUMMARY** This job creates data -driven insights which identify actionable opportunities aligned to the Quadruple Aim… 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 & ... integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and...the role. + Validate findings and test assumptions through data , but lead with contextual knowledge of claims… more
- Molina Healthcare (Green Bay, WI)
- …trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... the role. + Validates findings and test assumptions through data , but lead with contextual knowledge of claims...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Evolent (Madison, WI)
- …research skills + Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, ... key member of the Product team, focused on client data integrations. This individual will play a critical role...(Required):** + Bachelor's Degree + 2+ years' experience in healthcare , IT business analyst , and/or product management… more