- Molina Healthcare (Columbus, OH)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and… more
- CVS Health (Austin, TX)
- …day. **Position Summary** CVS Health is looking for an experienced Business Analyst , QA and Technical SME with focus on balancing high-impact business management ... our various enterprise operations teams using a variety of platforms. We service medical , pharmacy, sales, product and call center support models across the CVS… more
- CVS Health (Woonsocket, RI)
- …experience within the healthcare industry + Experience working with large volumes of medical and pharmacy claims data + Experience with SSIS, Alteryx, Tableau ... it all with heart, each and every day. **Position Summary:** As a Senior Analyst on the Program Modernization Automation and Development AI team, you will serve as… more
- Molina Healthcare (NM)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of 2 years of experience in a healthcare billing office or health insurance claims environment. + Familiar with common medical billing practices, concepts, and ... serve as a leader of positive change. The Third Party Follow-Up Analyst provides statistical and financial data enabling management to accurately monitor accounts… more
- Bozeman Health (Bozeman, MT)
- Position Summary: The Credit Balance Analyst is responsible for processing refunds for third party insurance, Medicare, Medicaid, and Government-Assisted Programs; ... of all insurance and/or Government rules regarding payment, credit procedures, claims submittal and appeal process. Candidate must have excellent written and… more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... and pricing rules are accurately interpreted and reflected in our claims payment environment. **Key Responsibilities** + Configure and optimize provider pricing… more
- MVP Health Care (Fishkill, NY)
- …improvement. To achieve this, we're looking for an Overpayment Recovery and Monitoring Analyst to join #TeamMVP. If you have a passion for managing audits, ... medical coding, and analytical thinking and this is the...activities and manual reviews as requested, ensuring accuracy of claims and supporting overall payment accuracy. + Perform research… more
- CVS Health (Woonsocket, RI)
- …every day. This is a hybrid position. **Position Summary** As a Rebate Formulary Analyst - Manufacturer Rebates you will perform a critical role in the analysis of ... and/or Rebate knowledge beneficial. + Experience with Caremark business systems, claims adjudication, formulary, drug, and client systems with an emphasis on… more
- Trinity Health (Chelsea, MI)
- …Full time **Shift:** Day Shift **Description:** Summary Position Summary: The Billing Analyst is responsible for a variety of tasks and activities including ... insurance authorizations, accounts receivables, invoices, and billing for durable medical equipment and supplies. She/he supports ChelseaCare HME (CCHME) colleagues… more