- Centene Corporation (Lansing, MI)
- …all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting + Extract, load, model, and reconcile ... Experience in emerging trend analysis, financial modeling, claims pricing, contract /network analysis, and/or ROI evaluation preferred. Familiarity with claims… more
- Elevance Health (Indianapolis, IN)
- …of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.** PRIMARY ... policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support… more
- Northwell Health (Melville, NY)
- …needed in Beacon/Beans, Data Courier/Env Release, Dorothy Home Care - Clinical , EpicCare Ambulatory - Specialty, Healthy Planet, Hospital Billing , Inpatient ... specialty, service line, years of relevant experience, education, credentials, negotiated contracts , budget and internal equity). The salary range for this position… more
- FlexStaff (Brooklyn, NY)
- …incorporating behavioral skills training and specific performance feedback while ensuring clinical integrity of the programs. + Clinically review session notes on ... specialty, service line, years of relevant experience, education, credentials, negotiated contracts , budget and internal equity). The salary range for this position… more
- TEKsystems (Syracuse, NY)
- …in the org from members leaving the team. They support office and clinical locations around the country as well as aspen dental corporate/office employees. Common ... (verified via references) Time frame for completion: 3 month contract Job Type & Location This is a Contract position based out of Syracuse, NY. Pay and Benefits… more
- CareFirst (Baltimore, MD)
- …is in compliance with these regulations. Identify potential audit and/or contract compliance issues and recommend strategies to Division management for resolution. ... to Medicaid and/or Medicare processing. Participate in workgroup projects around clinical editing. Create, maintain and communicate policies as need to support.… more
- IQVIA (Parsippany, NJ)
- …client or offering focused. **_Essential Functions_** + Ensures fulfillment of contract specifications and ad-hoc client requests to build client satisfaction, under ... IQVIA offices as appropriate. IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences… more
- McLaren Health Care (Grand Blanc, MI)
- …or healthcare financial analysis to include experience working with hospital clinical /claim and financial data, working with large databases; data extraction and ... or healthcare financial analysis to include experience working with hospital clinical /claim and financial data, working with large databases; data extraction and… more
- TEKsystems (Syracuse, NY)
- …had in the org from members leaving the team. They support office and clinical locations around the country as well as corporate/office employees. Common issues that ... to be committed and locked down when interviewing Job Type & Location This is a Contract position based out of Syracuse, NY. Pay and Benefits The pay range for this… more
- Evolent (Atlanta, GA)
- …from product strategy analyses and translating them to complex risk-based contract development, and they will partner closely with executives across analytics, ... professional experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care, or related healthcare consulting entity + Ability… more