- Molina Healthcare (Warren, MI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Molina Healthcare (Ann Arbor, MI)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- Highmark Health (Lansing, MI)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, ... proactively identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational… more
- Prime Therapeutics (Lansing, MI)
- …fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing ... Analyst participates in the assessment of value generated by...or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation… more
- Corewell Health (Grand Rapids, MI)
- …issues whenever possible. Ensure compliance with all mandated, legislative, regulatory and accreditation requirements. Assist customers and staff throughout the ... State and Federal decisions are properly implemented. Assist the Lead , Supervisor and/or Manager in coordinating activities and in...plan to ensure all activities are completed by the regulatory time line, gather all relevant information for the… more
- Molina Healthcare (Detroit, MI)
- **Job Description** **Job Summary** The Analyst , Risk Adjustment-Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics team. Designs ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and related financial data like risk...for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,… more
- Highmark Health (Lansing, MI)
- …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... and non-technical, and internal and external audiences, and the ability to lead through influence + Healthcare industry expertise and experience, knowledge about the… more