- Cognizant (Raleigh, NC)
- 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
- Robert Half Accountemps (Raleigh, NC)
- Description We are looking for a detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. This long-term contract position is ideal ... high- quality results. Responsibilities: * Process and reconcile medical claims efficiently, ensuring all records are accurate and up-to-date. * Resubmit… more
- Evolent (Raleigh, NC)
- …**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
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role Brighton Health Plan Solutions is seeking a Senior Quality Analyst , who will oversee contract and benefit configuration to ensure accurate ... claims processing and network compliance. This is a remote...our people are committed to the improvement of how healthcare is accessed and delivered. When you join our… more
- Prime Therapeutics (Raleigh, NC)
- …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
- Elevance Health (Durham, NC)
- **Title: Grievance/Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... accommodation is granted as required by law._ The **Grievance/Appeals Analyst I** is an entry level position in the...and indemnity) related to clinical and non clinical services, quality of service, and quality of care… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role We are seeking an enthusiastic, results-oriented Enterprise Sr. Business Analyst /Product Specialist in the healthcare payer domain of Health Plan ... payer domain or Health Plan Administration (Benefits & Claims Administration, Vendor integration, Portals) and Healthcare ...Minimum 7 years of experience as a Senior Business Analyst or Product Specialist in healthcare payer… more
- Motion Recruitment Partners (Garner, NC)
- …HEDIS metrics + Helping to maintain the processes that ingest and integrate claims and clinical data to produce quality metrics and associated care ... Senior Data Analyst / HEDIS Garner, North Carolina **100% Remote**... to support the team responsible for generating HEDIS quality metrics/care gaps and reporting data to respective payers.… more
- The Cigna Group (Charlotte, NC)
- …with local healthcare providers-physicians, hospitals, clinics, and other healthcare facilities-to help deliver high- quality , cost-effective healthcare . ... and negotiate contracts, initiate new agreements, and contribute to building strong healthcare provider networks. **As a Network Contracting Analyst , you will:**… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain with Multi-employer Trust or Health Plan ... for client or product. The ideal candidate will have worked in-depth in healthcare payer domain in Multi-employer Trust (Hours & Eligibility management), Health Plan… more