- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL Server… more
- MetLife (Cary, NC)
- …Key Responsibilities * Date science in Dental: Contributions to underwriting models, claims auto-adjudication logic and models, fraud waste and abuse analyses and ... models (mostly provider-related), dental network analyses, consumer analytics, network expansion analytics and much more. * Leads and contributes to data analysis and modeling projects from project/sample design, business review meetings with internal and… more
- World Insurance Associates, LLC. (Exeter, NH)
- …excellent service, and professional communication + Handling renewals, service requests, claims , billing and new policies + Maintain a thorough understanding of ... the markets and their appetites, underwriting guidelines, submitting and procedures + Review all applications, policies, endorsements and audits for accuracy + Coordinate expiration list with department manager to obtain renewal business information… more
- Army Installation Management Command (Honolulu, HI)
- …payments, control of Government furnished property, change orders, contractor claims , excusable delays, and mutual mistakes. Monitors contractor performance to ... ensure full compliance with contract terms, conditions, and specifications. Performs job-site visits as necessary to conduct special compliance checks. Performs all contract termination functions to include assigning settlement agreements. Performs contract… more
- BD (Becton, Dickinson and Company) (Franklin Lakes, NJ)
- …+ Champion Product Excellence: Support product innovation through compelling claims development, comprehensive training programs, and creation of powerful sales ... tools that showcase our portfolio's unique value. + Lead Transformative Initiatives: Orchestrate new product launches, line extensions, and cost enhancement projects while driving NRFit adoption in key markets to ensure continued relevance and growth. + Expand… more
- Arkansas Children's (Little Rock, AR)
- …Familiarity with healthcare datasets (eg, AHA, PHIS, US News benchmarks, claims data) and ability to translate complex datasets into actionable insights. ... + **Communication Skills:** Ability to present findings clearly in written reports, dashboards, and presentations that can be understood by non-technical stakeholders. + **Problem-Solving Acumen:** Capable of developing new methods, tools, or processes that… more
- Centene Corporation (Sacramento, CA)
- …care or medical group experience, provider relations, quality improvement, claims , contracting, utilization management, or clinical operations. Project management ... experience at a medical group, IPA, or health plan setting. Strong communication and presentation skills Proficient in HEDIS/Quality measures, cost and utilization. Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive benefits package… more
- EFI Global (Fort Lauderdale, FL)
- …**Collaborates with sales and operations managers, architects, developers, insurance adjusters, claims managers and attorneys to develop demand for your professional ... services.** **Collaborates with EFI's national team of forensic experts to leverage experiences and assist on projects.** **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** **Performs other duties as assigned.** **Supports the organization's quality program(s).**… more
- Xcel Energy (Minneapolis, MN)
- …the preparation of all required federal consolidated and state income tax returns and claims for refund to ensure accurate and timely filing and minimization of tax ... liability. + Participates in the determination of the monthly tax accruals and disclosures to ensure compliance with IRS, GAAP, Sarbanes Oxley and regulatory income tax accounting and public utility normalization requirements. The timeliness and accuracy of… more
- The Hartford (San Francisco, CA)
- …is a dedicated group of underwriters, risk engineering consultants and liability claims specialists experienced in hard-to-place products and premises risks. We face ... catastrophic exposures in our high-hazard book every day. This is a great opportunity for Middle Market or Primary Casualty, or Excess Casualty Underwriters looking to expand their knowledge into high hazard liability risks. In this role, they are able… more