Data Analyst :: Healthcare Payer domain with AI/ML

Job Title: Data Analyst Remote Required experience (must-have) 8+ years in healthcare insurance (payer) across at least one of: Commercial, Medicare Advantage, MedicaidDemonstrated work on core payer functions such as:Claims (professional/institutional), EDIs, payments, adjustments, COBUtilization management (prior auth), care management, provider network, member enrollment/eligibilityGrievances/Appeals, fraud/waste/abuse (SIU)3 5+ years delivering data/AI/ML projects end-to-end in production

Hello Everyone, Greetings from Dizer! We are currently looking for a Data Engineer with at least 5+ years of recent experience in the Healthcare domain. This is a 100% remote role, so no relocation or travel is required. The clients key requirements are: Claims Processing experience Healthcare / Medicaid / Medicare domain experience Please share suitable profiles at . Thanks, Kenny.

Functional Description: This role requires significant expertise of Medicaid Enterprise System modules and data warehouse or decision support systems. This role provides input and direction supporting a large data warehouse implementation and operations. The selected SME will provide direction to business and technical team members related to claims, provider, and recipient data. Roles in this function could partner with stakeholders to understand data requirements and support development tool

PBM experience Agile Healthcare Government programs, compliance, or Medicare. NCPDP 4 year degree is required (must be achieved) claims adjudicator integration understanding with strong business and technical acumen