- Prime Therapeutics (Madison, WI)
- …and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job Description** The ... to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization… more
- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of… more
- Molina Healthcare (Kenosha, WI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... on researching, presenting and documenting is required, + Experience with Medicare, Medicaid and Marketplace is required. + Medical coding experience is highly… more
- Molina Healthcare (Kenosha, WI)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Milwaukee, WI)
- …at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct secondary pricing logic and compliance ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Elevance Health (Waukesha, WI)
- **Actuarial Analyst III** **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 III** completes very diverse and complicated projects and performs very complex… more
- Molina Healthcare (Green Bay, WI)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Molina Healthcare (WI)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina… more
- Evolent (Madison, WI)
- …landscape + Good knowledge US Healthcare - Payer side, Knowledge of Medicare, Medicaid , Commercial Plans and understanding on claims workflow, members, providers ... Stay for the culture. **What You'll Be Doing:** Job Description ** Analyst , Integration Quality** Integration testing in the healthcare ecosystem requires complete… more
- Molina Healthcare (WI)
- **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory...+ Basic familiarity with healthcare data types such as claims , encounters, or eligibility data + Comfortable working with… more