- Guidehouse (Arlington, VA)
- …including resolution practices and audit strategies. + Experience applying advanced data analytics to healthcare claims , including anomaly detection, trend ... (eg, MPH, MHA, MBA, JD, or related). + 5 to 7+ years of experience in healthcare data analytics , consulting, or claims operations, preferably with a focus on… more
- Evolent (Washington, DC)
- …research, mathematics, economics) + At least 3-5 years of professional experience in claims -based healthcare analytics with a payer, provider, clinical ... and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding...vendor, managed care, or related healthcare consulting entity + Experience with managing … more
- Evolent (Washington, DC)
- …public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed ... or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Evolent (Washington, DC)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Analyst, Client Analytics ** Integrate and analyze claims and enrollment data from multiple sources ... we would want for our loved ones. The Client Analytics team offers candidates the opportunity to leverage data...when faced with challenges or tradeoffs. + Building and managing performance metrics and standard report production. + Identifying… more
- Humana (Washington, DC)
- …claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims utilizing revenue codes, CPT/HCPCS, ICD-10 diagnosis codes, DRG, ... reporting & analysis, reserving or trending) + Experience in managing large healthcare claim datasets and conducting...datasets and conducting trend analysis + Deep understanding of healthcare claims taxonomy (service categories, such as… more
- Amazon (Arlington, VA)
- …process, ensuring adherence to best practices, optimizing performance, and managing risks throughout the project. The AWS Professional Services organization ... and/or Scala to implement data lake architectures - Experience of working with healthcare and life sciences data (eg EHR, HL7/FHIR, insurance claims , genomics,… more
- General Dynamics Information Technology (Fairfax, VA)
- …+ Proficiency with healthcare management systems (provider enrollment systems, claims adjudication systems) and data analytics tools (Power BI, Tableau, ... VA, DoD, or CDC/NIOSH programs). + Strong knowledge of healthcare delivery systems, managed care operations, claims ...(MES), or public health program. + Demonstrated success in managing budgets, contracts, SLAs, and performance metrics in a… more
- The Cigna Group (Mclean, VA)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... value-orientation. + Contributes to the development of alternative network initiatives. Supports analytics required for the network solution. + Works to meet unit… more
- The Cigna Group (Washington, DC)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution. + Works to meet unit cost… more
- Baylor Scott & White Health (Washington, DC)
- …of work experience above the minimum qualification- EXPERIENCE + 2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , ... collaborating to resolve encounter data and process issues and managing policy and procedure documentation. + Oversee updates to...MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with Healthcare claims , enrollment and pharmacy data is… more