- Molina Healthcare (Yonkers, NY)
- …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 (Yonkers, NY)
- **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
- Molina Healthcare (Yonkers, NY)
- …**Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Yonkers, NY)
- …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Mount Sinai Health System (New York, NY)
- …onsite occasionally at 150 E 42nd Street Corporate Offices** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the ... goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding...others in the Data Science team and takes the lead role in project initiatives. **Qualifications** + BA or… more
- AIG (Parsippany, NJ)
- …studies across accounts, portfolios, and business segments to ensure rate adequacy and regulatory compliance. + Lead the budgeting process and other financial ... measurement. They collaborate with Marketing, Operations and Financial Management. Senior Actuarial Analyst - A&H At AIG, we are reimagining the way we help… more
- IBM (New York, NY)
- …including content creation, review and approval, digital asset management (DAM), claims management, and modular content * Implement client's E2E content supply ... chain operating model * Lead requirements elicitation for client's Vault Promomats implementation *...content creation, review and approval, digital asset management (DAM), claims management, and modular content * Consulting experience with… more
- WTW (New York, NY)
- …of contact for your clients in all aspects of their insurance program, any claims , wording, coverage or industry news related queries are directed to you, so these ... Submission' document, containing in-depth information about a client's business including claims information, the classes of business needing renewal and any other… more
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