- Molina Healthcare (NY)
- …easy to understand. + Research and develop reports and analysis for senior management and effectively communicate results. **JOB QUALIFICATIONS** **Required ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk...analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue,… more
- CVS Health (Albany, NY)
- …has an exciting opportunity to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...team is highly collaborative. You will report to the Senior Reporting Manager within the Compliance Pharmacy Payments team.… more
- Highmark Health (Albany, NY)
- …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
- Molina Healthcare (Buffalo, NY)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives ... into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver… more
- Axis (New York, NY)
- …of the Financial Lines book. They will proactively engage with Reserving, Risk Management , Finance, Claims , and Data & Analytics colleagues to achieve desired ... upon request for candidates taking part in the selection process. **Actuarial Analyst , NA FL** **North American Financial Lines Pricing** **Actuarial** **How does… more
- MetLife (Oriskany, NY)
- …for quality improvements to the training and procedures team. * Presents findings to Senior Level Management and other key stakeholders. * Coach and mentor ADA ... Responsibilities: * Conducts quality reviews of Americans with Disabilities Act (ADA) claims . * Identifies trends, root causes, and quality gaps from the analysis… more
- Molina Healthcare (Buffalo, NY)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... into technical solutions. This role works closely with clinicians, care management teams, and business stakeholders to gather requirements and deliver actionable… more
- St. Mary's Healthcare (Amsterdam, NY)
- …report areas of high financial risk and make resolution recommendations to senior management . * Perform trend analysis and key performance indicator ... law. Responsibilities: * Interpret and analyze data from multiple sources including claims , provider, patient, and encounters data. Identify and assess the business… more
- CVS Health (Albany, NY)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more
- AIG (New York, NY)
- Make your mark in Catastrophe Risk Management The North American Catastrophe Risk Management team is responsible for catastrophe modelling and portfolio exposure ... management for AIG's North American Insurance businesses. Effective Catastrophe Management is integral to the success of the business and our catastrophe… more