- Cognizant (Jefferson City, MO)
- About the role As a ** Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end ... test strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality … more
- Evolent (Jefferson City, MO)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Prime Therapeutics (Jefferson City, MO)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Centene Corporation (Jefferson City, MO)
- …support for business operations in all or some of the following areas: claims , provider data, member data, clinical data, HEDIS, pharmacy, external reporting + ... compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis + Assist with training and mentoring other Data… more
- Prime Therapeutics (Jefferson City, MO)
- …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst … more
- Highmark Health (Jefferson City, MO)
- …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 processes, and implement… more
- Prime Therapeutics (Jefferson City, MO)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- Evolent (Jefferson City, MO)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value...health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- CVS Health (MO)
- …service orientation and attention to detail. **Preferred Qualifications** + Background in healthcare or claims processing experience. + Experience with Aetna ... technical expertise with strong communication and problem-solving skills to deliver high- quality support and drive continuous improvement. + Respond promptly and… more
- CVS Health (MO)
- …accordance with company standards while meeting and exceeding accessibility, compliance, quality , and cost initiatives. Verifies contract compliance and adherence to ... metrics and training to ensure compliance with the company's regulatory, safety, quality , and confidentiality protocols and standards. + Ensures a high level of… more