financial claims examiner ii Jobs in san jose, ca

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Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or Albany, New York, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

•

Remote or Queens, New York, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

•

Remote or Houston, Texas, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or Austin, Texas, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or El Paso, Texas, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or Corpus Christi, Texas, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or San Antonio, Texas, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 20 hours ago | Updated 20 hours ago

Sr. Analyst, Network Pricing Management

CVS Health

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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
Posted 19 hours ago | Updated 7 hours ago

Sr. Chief Engineer

Cushman & Wakefield

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Remote or Chatham, New Jersey, USA

Full-time

Job Title Sr. Chief Engineer Job Description Summary Senior Chief Engineer is responsible for the effective daily leadership of his/her staff, managing the engineering program to the highest level of quality work and customer service and the administration of his/ her department in alignment with the Management Team, C&W Engineering Platform and Client expectations. The Senior Chief Engineer will perform at the highest of ethical standard, reflecting the core values of C&W as defined in its Bus
Posted 1 day ago | Updated 7 hours ago

Data Engineer

CVS Health

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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
Posted 1 day ago | Updated 7 hours ago

AI Innovation Lead - Data Science Lab

Guardian Life Insurance Company

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Remote or New York, New York, USA

Full-time

Lead AI Innovation Lead - Data Science Lab Overview Guardian is on a transformation journey to evolve into a modern, forward-thinking insurance company committed to enhancing the wellbeing of its customers and their families. As part of the Data & AI team, this role presents a distinctive opportunity to collaborate with the CDAO and the Head of Data Science, actively contributing to Guardian's ongoing evolution. Guardian's Data & AI team spearheads a culture of data insights across Guardian,
Posted 53 days ago | Updated 8 hours ago

Systems Analyst III - EPIC Billing

Cleveland Clinic

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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
Posted 60+ days ago | Updated 7 hours ago

Staff Software Development Engineer

CVS Health

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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
Posted 16 days ago | Updated 7 hours ago

Staff Full Stack Java Developer - myPBM

CVS Health

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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
Posted 22 days ago | Updated 7 hours ago

Jr. Data Scientist, Machine Learning - Remote

ConsultNet, LLC

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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
Easy Apply
Posted 45 days ago | Updated 7 hours ago

Senior Automation Engineer

CVS Health

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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
Posted 60+ days ago | Updated 7 hours ago

AI/ML Health Data Scientist

Navigant Consulting

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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(
Posted 6 days ago | Updated 8 hours ago

Ivanti ITSM/ITAM Admin

Innosoul inc

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Remote

Third Party, Contract

Job ID: OR-11127-25 Remote Ivanti ITSM/ITAM Admin (ITIL must) with Neurons, ITAM/CA SDM/APM migration, CMDB, asset tracking, configuration item/CI, SQL Server/MySQL/PostgreSQL/MS Access, ETL experience Location: Salem, OR (DHS/OHA) Duration: 6 Months Position: 1 This position is approved for remote or hybrid work. Remote onboarding will be required for the first day. Reference must Skills: Skills Database Data Analysis Advanced (7-9 Years) Yes Skills Database Data Modeling Advanced (7-9 Years)
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Posted 7 days ago

Data Management Operations Specialist

Guardian Life Insurance Company

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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
Posted 60+ days ago | Updated 8 hours ago

Fraud Specialist

Psinapse Technology

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Livermore, California, USA

Full-time

Our client is seeking a dedicated and detail-oriented Fraud Specialist to join our team on a contract to hire basis. Ideal candidates will have experience in monitoring accounts, identifying fraudulent activities, and collaborating with various stakeholders to resolve fraud-related issues. This role requires analytical skills, strong communication abilities, and a commitment to maintaining the highest level of professionalism. The hourly pay rate is $25.55 - $34.74. RESPONSIBILITIES: Review ne
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Posted 60+ days ago | Updated 14 days ago