- Prime Therapeutics (Montgomery, AL)
- …related work experience; HS diploma or GED is required + 2 years of experience within Claims Processing, Audit, Quality or Pharmacy + Must be eligible to work in ... our passion and drives every decision we make. **Job Posting Title** QA Analyst PBM Implementation - Remote **Job Description** The Quality Assurance (QA) Analyst… more
- University of Michigan (Ann Arbor, MI)
- …interpret data related to managed care programs, including reimbursement rates, claims data , and provider performance metrics. + Collect and maintain ... Managed Care Payer/Operations Analyst Apply Now **How to Apply** A cover...directly interact with payers including Revenue Cycle, Care Management, Pharmacy , and the professional medical groups. + Collaborate with… more
- Evolent (Carson City, NV)
- …fosters expertise and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding health plan cost ... **What You'll Be Doing:** **Who You'll Be Working With:** The Senior Analyst Performance Suite Analytics utilizes and develops project management tools to solve… more
- CareFirst (Baltimore, MD)
- …markets risk score methodologies, risk score calculations, enrollment, submissions, medical and pharmacy claims , and provider data . Incumbent is responsible ... score calculation, financial risk calculations, submission processes and key regulatory deadlines for data submission. Understand the impact of the claims on the… more
- Lompoc Valley Medical Center (Lompoc, CA)
- …to ensure charges are posted correctly and accurately. * Identify error trends from data obtained through claims review and denials. * Prepare reports and ... and internal equity. Position Summary: * The Revenue Cycle Analyst is responsible for auditing and evaluating the revenue...for review. * Provides feedback to Manager, Director and Pharmacy Director of reimbursement situations that may result in… more
- HUB International (Newport Beach, CA)
- …the region's PEO client programs. This role focuses on analyzing group census and claims data , preparing competitive quotes, and partnering with the sales and ... **Summary:** The **Underwriting Analyst , New Business,** supports the HUB SoCal PEO...**Essential Duties and Responsibilities:** + Review and analyze census data , demographics, and claims experience for prospective… more
- CareFirst (Baltimore, MD)
- …risk score methodology, risk score calculation, enrollment, submissions, premiums, medical and pharmacy claims , and provider data . Incumbent is responsible ... & Qualifications** **PURPOSE:** The Senior ACA Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy...based on the HHS-HCC (Hierarchical Condition Code) model. Perform data mining of claims and data… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current… more
- The County of Los Angeles (Los Angeles, CA)
- PHARMACY SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3794484) Apply PHARMACY SUPERVISOR I Salary $164,128.32 - ... notice. DEFINITION: Supervises professional and support personnel in the provision of pharmacy services in a hospital, clinic, correctional facility, or other health… more
- Insight Global (Raritan, NJ)
- …site per week. The Data Analyst will support the contracting, claims , rebates and audit needs for Pharmacy Benefit Managers and Managed Care ... Job Description A client is seeking a Data Analyst to sit in Raritan, NJ 3 days on… more