• Payment Integrity DRG Coding & Clinical Validation…

    Excellus BlueCross BlueShield (Rochester, NY)
    …(RHIA or RHIT) or a Nursing Degree. . Three (3) years' experience in claims auditing, quality assurance, or recovery auditing, of (MS/APR) DRG coding for ... II (in addition to Level I Qualifications) . Five (5) years' experience in claims auditing, quality assurance, or recovery auditing, of (MS/APR) DRG coding for… more
    Excellus BlueCross BlueShield (10/23/25)
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  • Data Science Analyst III - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated analytics to ... decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding of the… more
    Mount Sinai Health System (10/08/25)
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  • Data Science Analyst II - Enterprise Data…

    Mount Sinai Health System (New York, NY)
    …occasionally at 150 E 42nd Street Corporate Offices** The Data Science Analyst II collaborates with stakeholders from across the organization to develop ... decision-making, goal setting, and effective performance measurement. The Data Science Analyst II demonstrates sound and a more advanced understanding of the… more
    Mount Sinai Health System (08/15/25)
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  • Senior Analyst , Performance Suite…

    Evolent (Albany, NY)
    quality reporting, and benchmarking + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and ... that fosters expertise and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding health plan cost &… more
    Evolent (10/15/25)
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  • Senior Contract Manager Analyst - Mount…

    Mount Sinai Health System (New York, NY)
    …focus on accuracy and compliance. **Preferred Skills:** + In-depth knowledge of healthcare revenue cycle processes, including billing, claims management, and ... largest US health systems with a strong reputation for quality of care and research. We have over 38,000...Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is… more
    Mount Sinai Health System (07/30/25)
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  • Sr. Medical Analyst , RWD

    Norstella (Albany, NY)
    …seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role, you will leverage your expertise in healthcare ... Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States...related field. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory… more
    Norstella (10/22/25)
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  • Informatics Analyst II

    CDPHP (Latham, NY)
    …SAS, SQL, Python, R, or other coding language preferred. + Knowledge of healthcare claims data elements, state, federal and regulatory requirements and/or ... physician-founded, member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York.… more
    CDPHP (09/30/25)
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  • Data Validation Analyst

    Independent Health (Buffalo, NY)
    …for completeness, accuracy, and adherence to business requirements. The Data Validation Analyst is responsible for performing quality verification tasks and ... and external solutions supporting Reliance Rx initiatives. The Data Validation Analyst develops standard operating procedures (SOPs) for existing and new reports,… more
    Independent Health (10/05/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …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
    Humana (10/21/25)
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  • PBM Senior Reporting Analyst

    CVS Health (Albany, NY)
    …Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including health insurance, PBM ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… more
    CVS Health (10/16/25)
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