financial claims examiner ii Jobs in new york, ny

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PBM Strategy and Implementation Consultant

TalTeam

Remote

Contract

This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The successful candidate will be responsible for a new pharmacy supply chain implementation and PBM transition, including managing execution activities, aligning stakeholders, contract management, vendor relationship management, and driving business readiness. Project Leadership & Accountability Manage business execution team, ensuring alignment of team efforts with goals, o

Data Analyst II Medical Economics

Centene Corporation

Florida, USA

Full-time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v

Senior Analyst Network Relations

CVS Health

Idaho, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Financial Health Care Executive for Pharmacy Benefits Program

Vega Consulting Solutions

Remote or Baltimore, Maryland, USA

Contract

Vega Consulting is hiring! Financial Healthcare Executive for a Pharmacy Benefits Management Program implementation with our direct client. This is a contract to hire opportunity. Seeking candidates who are eligible for hire and able to travel to Maryland when required. The PBM Executive must have has the financial acumen and deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The successful candidate will be responsible for a new pharmacy supp

Provider Service Analyst, Medicaid, Remote, USA

Gainwell Technologies LLC

Remote or Denver, Colorado, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary We are seeking a talented individual for a Provider Services Analyst - Medicaid who provides on-site and remote account analysis

Data Analyst III Medical Economics

Centene Corporation

Missouri, USA

Full-time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v

Sr. Accountant (SAP / Payroll and Benefits) - Remote

C4 Technical Services

Remote or Eagan, Minnesota, USA

Contract

Sr. Accountant Remote Summary: The main function of an accountant is to analyze financial information and prepare financial reports to determine or maintain record of assets, liabilities, profit and loss, tax liability, or other financial activities within an organization. A typical accountant is responsible for analyzing and communicating financial information for clients. Job Responsibilities: Review accounting records, financial statements or other financial reports created by staff to a

Senior Analyst, Network Relations

CVS Health

Virginia, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Claims Systems Delivery Manager (Remote in US)

Gainwell Technologies LLC

Remote or Milwaukee, Wisconsin, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Claims Systems Delivery Manager (Remote in US) at Gainwell, you can contribute your skills as we harness the power of tec

Sr. Analyst, Network Pricing Management

CVS Health

Arizona, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Data Engineer

CVS Health

Franklin

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Systems Analyst III - EPIC Billing

Cleveland Clinic

Remote or Cleveland, Ohio, USA

Full-time

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives - beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Systems Analyst - EPIC Billing Location Cleveland Facility Remote Location Department Job

Staff Software Development Engineer

CVS Health

Remote or Buffalo Grove, Illinois, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Staff Full Stack Java Developer - myPBM

CVS Health

Remote or Buffalo Grove, Illinois, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Sr Data Analyst P&C Insurance / Reinsurance - to 150k + bonus (SK)

Phaxis, LLC

New York, New York, USA

Full-time

Salary is 130k to 150k + bonus We are seeking a detail-oriented Sr Data Analyst with strong SQL skills and a background in Property & Casualty (P&C) insurance or reinsurance. The ideal candidate will play a critical role in transforming data into actionable insights to support underwriting, pricing, and risk management decisions. Responsibilities: Extract, clean, and analyze data using SQL and other tools to support business functions Develop dashboards and reports to track key metrics for under

Jr. Data Scientist, Machine Learning - Remote

ConsultNet, LLC

Remote or South Jordan, Utah, USA

Full-time

Title: Jr. Data Scientist, AI and Machine Learning Location : 100% Remote Target Start Date : ASAP Type: contract or contract to hire Pay Rate: DOE We're looking for an industry-leading Data Scientist focused on building production-level machine learning solutions. Rather than a research role, this position emphasizes applying ML/AI to real-world healthcare challenges-such as reducing costs and improving care quality. You'll work with structured and unstructured data (claims, membership, provi

Senior Automation Engineer

CVS Health

Remote or Northbrook, Illinois, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

AI/ML Health Data Scientist

Navigant Consulting

Remote

Full-time

Job Family: Data Science Consulting Travel Required: Up to 10% Clearance Required: Ability to Obtain Public Trust What You Will Do: Business Development Identify policy and/or business problems and successfully capture from sourcing through award/close.Perform research on key accounts and clients to effectively qualify and scope new business opportunitiesDiscuss and develop solutions with client service teams and existing/new clientsActively engage within target accounts and relevant market(

Data Management Operations Specialist

Guardian Life Insurance Company

Remote or Bethlehem, Pennsylvania, USA

Full-time

Job Overview: We are seeking a highly skilled and proactive Data Management Operations Specialist to join our Data Management team in the insurance industry. This individual will play a critical role in supporting the Data Management Strategy and Operations Leader by overseeing the daily operations of our data management processes, ensuring the accuracy, accessibility, and compliance of data, and implementing strategic initiatives aimed at optimizing data governance and quality. This is a uniqu

.NET Architect w/ Workers' compensation & ACORD .AL3

GreyCell Labs, Inc

New York, New York, USA

Third Party, Contract

24 months of experience with Azure DevOps Server, including expertise in source control, building and releasing pipelines, work item tracking, and automated deployment processes. 84 months of experience utilizing NYCIRB (New York Compensation Insurance Rating Board) guidelines and regulations to develop and support software applications for analyzing and processing Workers' Compensation insurance premiums. The candidate must demonstrate expertise in maintaining data integration solutions that in