- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role We are seeking a detail-oriented and proactive QA Analyst to support quality assurance efforts across Brighton Health Plan Solutions' core portfolios- ... Claims , Provider, and Enrollment. In this role, you will...retrospectives, as a QA voice and quality advocate. + Lead or participate in defect triage and resolution discussions,… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …so that others can too._ In this exciting role, as a Sr. Analyst within OAPI supply chain team, you will work cross-functionally across various departments ... adequate production takes place to meet market demands. + Lead regular Sales and Operations Planning (S&OP) meetings with...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Warner Music Group (New York, NY)
- …that retains the creative spirit of a nimble independent. **Job Title: Sr. Analyst , Financial** **A little bit about our team:** Warner Music Group's Center of ... excited to share this new opportunity for a Sr. Analyst , Participations with strong analytical & financial capabilities, to...update cash forecasts and budgets, investigate audit issues and claims , perform tasks as part of the overall close… more
- Cognizant (Albany, NY)
- **Health Payer Business Analyst , Senior Consulting Manager** **About the Role:** As a Sr. Consulting Manager you will make an impact by driving client engagement, ... * 2+ years of Digital technology (Business or Technical Consultative) team lead experience, and client management responsibilities * 6-8 years of consulting… more
- Elevance Health (New Hyde Park, NY)
- **Actuarial Analyst II** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. The **Actuarial Analyst II** completes projects and performs complex actuarial studies. **How You Will… more
- Trinity Health (Syracuse, NY)
- …position Monday - Friday, Day Shift Schedule **Position: Clinical Risk Management Analyst ** **Mission Statement:** We, St Joseph's Health and Trinity Health, serve ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more
- Amazon (New York, NY)
- Description Amazon One Medical is hiring a Actuarial Manager Analyst . Actuarial rigor is one of the keys to our success. This candidate will responsible primarily ... sound monthly reserving process for Total Medical Expense (TME) estimation, and lead continuous evaluation of TME performance compared to plan expectations. Key job… more
- Warner Music Group (New York, NY)
- …including, without limitation, tracking audit notifications, reviewing and analyzing the claims contained in the audit reports we receive, making recommendations to ... internal label clients regarding how to respond to those claims , facilitating settlement negotiations between the party auditing and...made accurately and promptly. **Here you'll get to:** + Lead all aspects of the tracking of audit notice… more
- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,… more
- Cardinal Health (Albany, NY)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted...processes, metrics, or models + Works on or may lead complex projects of large scope + Projects may… more
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