- NTT DATA North America (Raleigh, NC)
- …an overall sourcing strategy. NTT DATA Services currently seeks a **QA Data Analyst ** to join our team in **NC, Remote.** **Role Responsibilities** + Write advanced ... validation, and reconciliation between sources and outputs. + Work with claims (institutional, professional, dental, pharmacy) and clinical data sources (lab,… more
- ChenMed (Miami, FL)
- …great people to join our team. Working with limited guidance, the Senior Analyst VBC (Value Based Care) Performance is responsible for proactively tracking the risk ... assist with developing inputs to the revenue and external medical costs components of the annual financial plan. +...improvement, solution assessment, etc. + Analyzes and validates payer claims data. Assists markets to identify factors driving … more
- CareFirst (Baltimore, MD)
- …of HHS risk score methodology, risk score calculation, enrollment, submissions, premiums, medical and pharmacy claims , and provider data. Incumbent is ... **Resp & Qualifications** **PURPOSE:** The Senior ACA Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key… more
- UIC Government Services and the Bowhead Family of Companies (Aberdeen, MD)
- **Overview** Bowhead seeks a Program Analyst to perform a variety of program support functions to the CECOM SecurityAssistanceManagement Directorate (SAMD). ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- UIC Government Services and the Bowhead Family of Companies (Patuxent River, MD)
- **Overview** Bowhead seeks an experienced Foreign Military Sales (FMS) Program Analyst to support PMA 263. Position is hybrid and requires the individual to live ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- VaynerMedia (New York, NY)
- Overall Purpose: We are seeking a Social Commerce Analyst focused on affiliate management to run day-to-day activation for multiple client brands in a fast-paced, ... goals + Write clear, one-page briefs that include hooks, claims guardrails, required assets, CTAs, and timelines to improve...experience, and location. + Employer-sponsored 401k with match + Medical , Dental, and vision coverage + Unlimited PTO +… more
- Corewell Health (Grand Rapids, MI)
- … medical records, internal documentation from enterprise-wide systems including: claims payments, billing and enrollment, care management, medical , pharmacy ... and behavioral health authorizations, customer service interactions, prescription claims , medical policies, and plan documents).Evaluate information gathered to… more
- CVS Health (Harrisburg, PA)
- …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning ... the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator,… more
- The Cigna Group (Jersey City, NJ)
- …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, ... office 3 days per week._** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider...Cigna's competitive position. + Supports initiatives that improve total medical cost and quality. + Drives change with external… more
- Molina Healthcare (GA)
- …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