- 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
- Prime Therapeutics (Madison, WI)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Analyst Pricing - Remote **Job Description** The Senior Pricing ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Molina Healthcare (Kenosha, WI)
- …and/or detects violation of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the Business ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- Evolent (Madison, WI)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Senior Analyst , Healthcare Analytics Consultant The Client Analytics team provides a ... the impact of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams… 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 business issues related to cost, utilization and revenue for...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting 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 (Kenosha, WI)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- American Family Insurance - Corporate (Madison, WI)
- The Senior Product Development Analyst is responsible for supporting the creation and enhancement of innovative insurance products and services for Commercial ... decisions, and partnering with IT to get solutions implemented. You will report to a senior manager, product. In this hybrid role, you will be expected to work a… more
- Molina Healthcare (Racine, WI)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives ... by translating healthcare business needs into technical solutions. This role works closely...queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and… more
- Prime Therapeutics (Madison, WI)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization + ... drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy...define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business… more