Analyst jobs at Dayton Children's Hospital - 1816 jobs

:The Information Technology Customer Support Analyst will be responsible for providing technical support to end-users of IT systems and applications. The role involves diagnosing and resolving technical issues, providing guidance and training to end-users, and ensuring that all issues are resolved in a timely and effective manner. The Information Technology Customer Support Analyst will also be responsible for documenting support requests and maintaining accurate records of support incidents. Education: • Preffered: Bachelor's degree in Computer Science, Information Technology, a related field, or 8 years of equivalent experience. Experience: • Required: 4+ years of experience in IT customer support or related field, with a focus on end-user support and troubleshooting OR Bachelor's degree in Computer Science, Information Technology, a related field, or 8 years of equivalent experience. Skills: • Leads a team of service desk analysts, including hiring, training, and performance management. • Understands and assists with maintaining operational efficiency withing the service desk team. • Effectively collaborates with tier 2 and tier 3 resources to ensure end to end operational effectiveness across the incident lifecycle. • Responsible for assisting with resource management and process management of the service desk team. • Assists with the development of long term service desk strategies that align with the organization's overall IT and business objectives. Licensure/Certification/Registration: ▪ N/A

This job supports one or more analytical aspects of the application product life cycle, within a sub-product scope (one or more application components). Uses regular judgement and discretion to collaborate with customers in order to: Understand capability needs; Gather project specifications; Create business cases; Translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities); Analyze data to determine business problems, trends, or opportunities for process improvements; Create/execute test cases; Provide root cause analysis and corrective action plans; Verify delivery of customer needs, and Ensure quality delivery. The incumbent identifies, documents, and resolves risks, defects and issues. Analyzes market trends for competitive insight to correlate into business value statements. Builds organizational and platform knowledge in one or more disciplines to advance professional track career. Uses functional and organizational knowledge to mentor junior resources. Requires thorough understanding of end systems impact of changes across multiple systems, clinical disease process, and healthcare data. As a **Clinical Business Systems Analyst** , you will play a critical role in shaping the digital healthcare strategy for the organization and our clients. You will be responsible for fostering strong partnerships with stakeholders, providing expert consultation on the design and feasibility of our clinical digital healthcare products, implementing large scale data exchange initiatives, and providing development and operations support. This role involves translating intricate clinical requirements into clear, actionable plans for product and technical teams. Our products are designed for clinical identification and stratification and facilitating precise member routing to in-person, telephonic, and digital outreach programs. Your contributions will directly impact our ability to deliver impactful member outreach. **ESSENTIAL RESPONSIBILITIES** + Work with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, requirements and personalization to different clients, and user interface design. + Participate in the full software development life cycle by actively participating on Agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need. + Support various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle. + Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation. + Other duties as assigned. **EDUCATION** **Minimum** + Bachelor's Degree in Business Management, Information Systems, or closely related field **Substitutions** + Degree in Nursing, Informatics, Business Management, Health Administration, Public Health or related field **Preferred** + None **EXPERIENCE** **Minimum** + 3 - 5 years in IS/IT or Healthcare **Preferred** + 1 - 3 years in Lean/Six Sigma experience + 1 - 3 years in the Health Insurance Industry + 1 - 3 years in the Healthcare industry **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred** + Six Sigma + Project Management Professional (PMP) + Clinical License **SKILLS** + Analytical Skills + Problem-Solving + Communication Skills + Report Writing + SQL + Agile Methodolgy + Agile Project Management + Manage Multiple projects concurrently + Proven ability to effectively juggle multiple competing projects + Strong planning and execution + Data Exchange **Language Requirements (other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Remote Teaches / trains others regularly Rarely Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Rarely Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J270367

This job supports one or more analytical aspects of the application product life cycle, within a sub-product scope (one or more application components). Uses regular judgement and discretion to collaborate with customers in order to: Understand capability needs; Gather project specifications; Create business cases; Translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities); Analyze data to determine business problems, trends, or opportunities for process improvements; Create/execute test cases; Provide root cause analysis and corrective action plans; Verify delivery of customer needs, and Ensure quality delivery. The incumbent identifies, documents, and resolves risks, defects and issues. Analyzes market trends for competitive insight to correlate into business value statements. Builds organizational and platform knowledge in one or more disciplines to advance professional track career. Uses functional and organizational knowledge to mentor junior resources. Requires thorough understanding of end systems impact of changes across multiple systems, clinical disease process, and healthcare data. As a **Clinical Business Systems Analyst** , you will play a critical role in shaping the digital healthcare strategy for the organization and our clients. You will be responsible for fostering strong partnerships with stakeholders, providing expert consultation on the design and feasibility of our clinical digital healthcare products, implementing large scale data exchange initiatives, and providing development and operations support. This role involves translating intricate clinical requirements into clear, actionable plans for product and technical teams. Our products are designed for clinical identification and stratification and facilitating precise member routing to in-person, telephonic, and digital outreach programs. Your contributions will directly impact our ability to deliver impactful member outreach. **ESSENTIAL RESPONSIBILITIES** + Work with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, requirements and personalization to different clients, and user interface design. + Participate in the full software development life cycle by actively participating on Agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need. + Support various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle. + Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation. + Other duties as assigned. **EDUCATION** **Minimum** + Bachelor's Degree in Business Management, Information Systems, or closely related field **Substitutions** + Degree in Nursing, Informatics, Business Management, Health Administration, Public Health or related field **Preferred** + None **EXPERIENCE** **Minimum** + 3 - 5 years in IS/IT or Healthcare **Preferred** + 1 - 3 years in Lean/Six Sigma experience + 1 - 3 years in the Health Insurance Industry + 1 - 3 years in the Healthcare industry **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred** + Six Sigma + Project Management Professional (PMP) + Clinical License **SKILLS** + Analytical Skills + Problem-Solving + Communication Skills + Report Writing + SQL + Agile Methodolgy + Agile Project Management + Manage Multiple projects concurrently + Proven ability to effectively juggle multiple competing projects + Strong planning and execution + Data Exchange **Language Requirements (other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Remote Teaches / trains others regularly Rarely Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Rarely Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J270367

Sr. Incentives & Strategy Analyst page is loaded## Sr. Incentives & Strategy Analystlocations: Remote USAtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR100531**GoodRx is the leading prescription savings platform in the U.S.**Trusted by more than 25 million consumers and 750,000 healthcare professionals annually, GoodRx provides access to savings and affordability options for generic and brand-name medications at more than 70,000 pharmacies nationwide, as well as comprehensive healthcare research and information. Since 2011, GoodRx has helped consumers save nearly $75 billion on the cost of their prescriptions.Our goal is to help Americans find convenient and affordable healthcare. We offer solutions for consumers, employers, health plans, and anyone else who shares our desire to provide affordable prescriptions to all Americans.## About the Role:We are seeking a strong *Sr. Incentives & Strategy Analyst* to design, evaluate and optimize our incentive programs. This individual will drive insights from data to support strategic decisions and reporting for GoodRx's two consumer incentive programs, Consumer Discounts and Rewards, which together drive over $15M in incremental revenue each year. This role will work cross-functionally with teams including Finance, Pricing, Product & Design to shape the evolution of these programs, from how they are managed & optimized internally to how they are presented to our users. A strong analytical foundation is essential, along with the ability to to dive deep into data to measure and improve program impact. This role is best suited for an enthusiastic problem-solver who is energized by tackling ambiguous business challenges and who can communicate effectively with stakeholders. ## Responsibilities:* Identify opportunities to optimize and expand incentive programs; translate data into insights to guide decision-making and partner with Product & Design teams to implement improvements.* Determine the incremental value driven by incentive programs by analyzing fill patterns and user journey behavior* Optimize consumer discounts by evaluating pricing economics and adjusting discount levels to maximize impact and efficiency.* Monitor ongoing program performance, identifying key trends, drivers, and areas for intervention.* Produce weekly and monthly reporting on performance, insights, and trends.* Present biweekly status updates to senior leadership.## ## **Skills & Qualifications:*** 5+ years experience in an analytical role collaborating with multiple stakeholders* Advanced SQL, Excel, and PowerPoint proficiency* Dashboarding & data visualization skills (Tableau, Looker, etc.)* Exceptional written and oral communication skills* Ability to influence cross-functional partners by translating data into actionable insights* Experience in any of the following is a plus: - Analytics at a technology or healthcare company - Experience with loyalty or discount programs All GoodRx employees are responsible for reviewing and complying with all Company safety and security policies and procedures, being vigilant and observant of potential security threats (including phishing attempts) and proactively communicating with the Security Team to raise any concerns.At GoodRx, pay ranges are determined based on work locations and may vary based on where the successful candidate is hired. The pay ranges below are shown as a guideline, and the successful candidate's starting pay will be determined based on job-related skills, experience, qualifications, and other relevant business and organizational factors. These pay zones may be modified in the future. Please contact your recruiter for additional information.San Francisco and Seattle Offices:$119,000.00 - $179,000.00New York Office:$109,000.00 - $164,000.00Santa Monica Office:$99,000.00 - $149,000.00Other Office Locations:$89,000.00 - $134,000.00GoodRx also offers additional compensation programs such as annual cash bonuses or commission, and annual equity grants for most positions as well as generous benefits. Our great benefits offerings include medical, dental, and vision insurance, 401(k) with a company match, an ESPP, unlimited vacation, 13 paid holidays, and 72 hours of sick leave. GoodRx also offers additional benefits like mental wellness and financial wellness programs, fertility benefits, generous parental leave, pet insurance, supplemental life insurance for you and your dependents, company-paid short-term and long-term disability, and more!We're committed to growing and empowering a more inclusive community within our company and industry. That's why we hire and cultivate diverse teams of the best and brightest from all backgrounds, experiences, and perspectives. We believe that true innovation happens when everyone has a seat at the table and the tools, resources, and opportunities to excel.With that said, research shows that women and other underrepresented groups apply only if they meet 100% of the criteria. GoodRx is committed to leveling the playing field, and we encourage women, people of color, those in the LGBTQ+ communities, individuals with disabilities, and Veterans to apply for positions even if they don't necessarily check every box outlined in the job description. Please still get in touch - we'd love to connect and see if you could be good for the role!GoodRx is committed to providing reasonable accommodations for candidates with disabilities during our recruiting process. If you need any assistance or accommodations due to a disability, please reach out to us at accommodations@goodrx.com.We prioritize candidate safety. Please be aware that all official communication will only be sent from **@****goodrx.com** or ************************addresses.GoodRx is America's healthcare marketplace. The company offers the most comprehensive and accurate resource for affordable prescription medications in the U.S., gathering pricing information from thousands of pharmacies coast to coast, as well as a tele-health marketplace for online doctor visits and lab tests. Since 2011, Americans with and without health insurance have saved $60 billion using GoodRx and million consumers visit each month to find discounts and information related to their healthcare. GoodRx is the #1 most downloaded medical app on the iOS and Android app stores. For more information, visit .**We help Americans get the healthcare they need at a price they can afford.**We believe everyone deserves affordable and convenient healthcare. We build better ways for people to find the best care at the best price. Our technology gives all Americans - regardless of income or insurance status - the knowledge, choice, and care they need to stay healthy. We're here to help.Come and help us create the future of healthcare. #J-18808-Ljbffr

The Business Analyst's role will elicit, analyze, specify, and validate the business needs of stakeholders, be they customers or end users. This includes interviewing stakeholders and gathering and compiling user requirements to understand the technology solutions they need. The Business Analyst will apply proven communication, analytical, and problem-solving skills to help the business make good technology decisions. The Business Analyst will also be proactive at following emerging Technology trends, watching for new technologies to optimize business processes. The Business Analyst will play a pivotal role in ensuring IT's understanding of business requirements. What's in it for you? Compensation based on experience Faith and purposed-based career opportunity! Fully Paid Health Benefit Retirement and Life insurance 12 Paid Holidays PLUS Birthday Lunch is provided DAILY. Professional Certification Development Hybrid remote/on-site work arrangements available Responsibilities Position will dually report into the Project Management office and Functional Vertical VP, the duties and responsibilities of the Business Analyst role include: Strategy and Planning Collaborate with project sponsors to determine project scope and vision. Clearly identify project stakeholders and establish user classes, as well as their characteristics. Conduct interviews to gather user requirements via workshops, questionnaires, surveys, site visits, workflow storyboards, use cases, scenarios, and other methods. Identify and establish scope and parameters of requirements analysis on a project-by-project basis to define project impact, outcome criteria, and metrics. Work with stakeholders and project team to prioritize collected requirements. Research, review, and analyze the effectiveness and efficiency of existing requirements-gathering processes and develop strategies for enhancing or further leveraging these processes. Acquisition and Deployment Assist in conducting research on software and hardware products to meet agreed-upon requirements and to support purchasing efforts. Participate in the QA of purchased solutions to ensure features and functions have been enabled and optimized. Participate in the selection of any requirements documentation software solutions that the organization may opt to use. Operational Management Analyze and verify requirements for completeness, consistency, comprehensibility, feasibility, and conformity to standards. Develop and utilize standard templates to write requirements specifications accurately and concisely. Translate conceptual user requirements into functional requirements in a clear manner that is comprehensible to developers/project team. Where applicable, develop prototypes of interfaces and attributes based on user requirements. Create process models, specifications, diagrams, and charts to provide direction to developers and/or the project team. Develop and conduct peer reviews of business requirements to ensure that requirement specifications are correctly interpreted. Assist with the interpretation of user requirements into feasible options and communicate these back to the business stakeholders. Manage and track the status of requirements throughout the project lifecycle; enforce and redefine as necessary. Communicate changes, enhancements, and modifications of business requirements - verbally or through written documentation - to project managers, sponsors, and other stakeholders so that issues and solutions are understood. Act as the departmental Solution(s) configuration subject matter expert (SME). Requirements Functional process expertise in Finance and Accounting systems and processes. Proven experience with business and technical requirements analysis, elicitation, modeling, verification, and methodology development. Experience overseeing the design, development, and implementation of software and hardware solutions, systems, or products. Ability to create systematic and consistent requirements specifications in both technical and user-friendly language. Exceptional analytical and statistical skills with the ability to apply them to systems issues and products as required. Demonstrated project management skills and project management software skills, including planning, organizing, and managing resources. Understanding of application development and software development life cycle concepts Able to influence and drive individuals and teams to meet key milestones and overcome challenges. Ability to work in a team and/or be an effective individual contributor. Experience with the following is preferred Professional certifications with International Institute of Business Analysis Accounting Practitioner Healthcare Industry Microsoft Office Suite of Products Monday Project Management Platform Sage Intacct Accounting Software About Christian Healthcare Ministries Founded in 1981, Christian Healthcare Ministries (CHM) is a health cost sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.

The Business Analyst IV is a senior-level position responsible for driving strategic initiatives and leading cross-functional teams to deliver innovative solutions that address complex business challenges. This role bridges the gap between business needs and technology solutions while influencing organizational strategy and fostering a culture of collaboration and continuous improvement. Essential Functions: Establish and maintain strong relationships with senior stakeholders to understand business goals and drive alignment on strategic initiatives Review project artifacts such as business cases, contracts and architectural diagrams to ensure alignment with business objectives and requirements Identify, sequence, create, and maintain Epics throughout their lifecycle, ensuring traceability and alignment with strategic objectives Operate cross-functionally across teams and business areas to coordinate updates for Epics and Features, ensuring smooth transitions and alignment during refinement processes Lead teams in complex requirements elicitation efforts using advanced facilitation and modeling techniques Ensure comprehensive requirements documentation and traceability that aligns with strategic objectives according to corporate standards Provide input on project status reports related to requirements, assist in resolving escalated items, and escalate issues or risks to the Program/Project Manager and Product Owner as needed Provide input on change requests, incremental funding, and strategic estimates, including Business Analyst estimates Oversee Epic and Features throughout their lifecycle for multiple high-impact projects and programs, managing resource allocation, risk assessment, and stakeholder communication to ensure successful outcomes and alignment with business strategy Champion initiatives for process improvement and innovation, utilizing industry best practices to enhance operational efficiency, reduce costs, and improve service delivery Provide leadership and mentorship to business analysts and project teams, fostering a culture of knowledge sharing, professional growth, and continuous improvement Collaborate with executive leadership, IT, product management, and other departments to ensure cohesive strategy execution and successful implementation of requirements. Take action on insights from dashboard and metric analysis to correct data and optimize business processes Define, track, and analyze key performance indicators (KPIs) to assess the status and throughput of requirements, providing actionable insights for continuous improvement Prepare and present detailed reports, including strategic findings, recommendations, and progress updates, to executive leadership and key stakeholders as requested Perform any other job duties as requested Education and Experience: Bachelor's degree or equivalent years of relevant experience is required Master's degree is preferred A minimum of seven (7) years of experience in requirements management is required Experience working with Azure DevOps, Service Now, JIRA, Modern Requirements, or equivalent suite of business requirements management tools and software development processes, including hybrid/agile, is required Competencies, Knowledge and Skills: Proficient in Microsoft Office tools, including Word, Excel, and Visio Demonstrated a mastery of skill and understanding of business analysis principles, process, and applications/elicitation tools used for managing requirements Exceptional analytical thinking and problem-solving skills Extensive knowledge of IT development cycle, and Agile Framework, and other development frameworks Deep understanding of a project lifecycle, including processes, techniques and tools Strong interpersonal skills and proven ability to establish effective working relationships with stakeholders at all levels Exceptional written and verbal communication skills Ability to work independently and within a team environment Effective listening and critical thinking skills Ability to coordinate and lead cross-functional teams Effective decision making and problem-solving skills with close attention to detail Time management skills, ability to develop, prioritize and accomplish goals with a sense of urgency Ability to multi-task and remain flexible during organizational and/or business changes Customer service oriented Licensure and Certification: IIBA, Six Sigma, or Agile Certifications preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $94,100.00 - $164,800.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-GB1

The Claims Management Analyst III is responsible for leading eBusiness initiatives and coordination of activities across multiple functional areas. Essential Functions: Manage the EDI (Electronic Data Interchange) trading partners and network of clearinghouses to ensure accurate and timely exchange of information Works closely with Vendor Management to improve and maintain the trading partner agreement with the trading partners. This includes cost reduction and adding services Develop and maintain a partnership with the trading partner account representatives Manage trading partner performance, establish and monitor service level agreements, regulatory requirements, and contractual metrics Provide Subject Matter Expertise (SME) to all departments regarding eBusiness specific EDI transactions Build, sustain and leverage relationships to constantly allow for continuous improvement of the EDI business process Responsible for eBusiness EDI requirements that support regulatory, compliance, and business needs And eBusiness EDI regulatory reporting Provide critical reporting and analysis of functional performance, and make recommendations for enhancements, cost savings initiatives and process improvements Review and analyze the effectiveness and efficiency of existing processes and systems, and participate in development of solutions to improve or further leverage these functions Participate in the process of estimating initiative budgets as well as developing business cases and tracking the benefits Understand business strategy, define and lead eBusiness initiatives such as working with IT and others internal departments to automate functions Understand the process to receive claims, claims rejections and denial processes, claims payment methodologies, adjudication processing, and Encounters to enable synergies among It and business groups Contribute to and/or develop user stories or provide user story guidance for sprint planning Develop, document and perform testing and validation as needed Develop and maintain an in-depth knowledge of the company's business and regulatory environments Identify issues, risks, and mitigation opportunities Perform any other job duties as requested Education and Experience: Bachelor's degree or equivalent years of relevant work experience is required Minimum of five (5) years of health care operations experience in insurance, managed care, or related industry is required Competencies, Knowledge and Skills: Advanced knowledge of healthcare EDI files (837, 277CA, 999, 270/271, 276/277, etc.) Advanced computer skills Demonstrated exceptional communication (verbal and written) and high level of professionalism Data analysis and trending skills to include query writing Knowledge of Claims IT processes and systems Working knowledge of managed care and health claims processing Ability to effectively interact with all levels of management within the organization and across multiple organizational layers Demonstrates excellent analysis, collaboration skills, facilitation and presentation skills Strong interpersonal, leadership and relationship building skills Decision making and problem solving skills Ability to work independently and within a team environment Time management skills; capable of multi-tasking and prioritizing work Attention to detail Effective decision making / problem solving skills Critical thinking and listening skills Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-RW1

Start Your Career in Healthcare Information Technology Today! Getting your first job can be difficult when employers want experience, but to gain that experience, you need your first job. We bridge the gap between your education and professional career by helping you gain the experience and training you need within the Healthcare Information Technology Industry. Optimum Healthcare IT is looking for recent college graduates with an interest in moving into the Healthcare IT Industry. Our Optimum CareerPath training program will equip you with the tools needed for your success as a Healthcare IT Analyst. Healthcare IT Analyst Job Responsibilities: · The Healthcare IT Analyst will have primary responsibility for the design, build/configuration, testing, validation, documentation, and ongoing support for the Healthcare applications. · This position will implement, administer, and support assigned systems under the guidance of senior members of the team. · The position will have a good understanding of healthcare organizations, ancillary systems, and health system operations. · Analyze and document user requirements, procedures, and problems to automate or improve existing systems. Review system capabilities, workflow, and scheduling limitations. · Document workflows, configure and/or build activities, change management adherence, end-user notifications, training information, and status reporting in the appropriate system. · Develop, document, and revise system design procedures, test procedures, and quality standards. · Expand or modify the system to serve new purposes or improve workflows. · Review and analyze the system and performance indicators to locate problems and correct errors. Escalate problems and issues to the appropriate staff to ensure timely resolution. · Coordinate projects, schedule, and facilitate meetings as necessary to complete assignments. · Technical and functional analyst support of systems that may include Electronic Health Records platforms (Epic, Cerner), IT Project Management, ERP Systems (Workday, Oracle, PeopleSoft, UKG), ITSM applications (ServiceNow), data and analytics applications (Tableau, PowerBI), cloud deployments (GCP, Azure, AWS), and other digital platforms and services. Requirements: · Bachelor's Degree · US work authorization (This position is not open to any H1B /F1/ H-4 EAD OPT/STEM degrees) · Excellent communication skills (verbal and written) · Ability to exercise tact and good interpersonal skills · Superb analytical and time management skills required · Self-starter, self-motivated, high level of initiative · Result-focused, ability to solve complex problems and resolve conflicts in a timely manner · Internships or research project work are highly desired in a healthcare setting · Understanding of how data works and looks, coming from different formats, is preferred · Ability to travel during the training program if necessary

The Provider Engagement Communications Analyst II executes small project plans and provides support for new market implementations along with existing markets and products. This role is responsible for aiding in the oversight of all network Provider Engagement communication materials including updating, tracking, cataloging, and socializing materials & templates. Essential Functions: Work collaboratively with team and other business areas to support both internal and external communications assuring execution of the Provider Engagement Strategy and meeting all compliance and regulatory standards Maintain ongoing oversight of all Network Provider Engagement communications to ensure they are audited annually, providing the necessary and most current information and in the appropriate format to support our network partners/providers in working successfully with CareSource and providing quality service for our members Assist business partners and subject matter experts to ensure network provider engagement communication materials delivers quality content which aids providers in meeting communication goals Support operational effectiveness by assisting in development of communication templates, streamlining approval processes, and maintaining up-to-date communications Support development and delivery of all accompanying materials and assets including communication collateral, P&Ps, SLAs and any other needed network provider engagement communication resources Coordinate work with operational and clinical departments on key initiatives of the Network Provider Engagement portfolio, including initiating and leading activities to foster speed to market and quality of deliverables Assist with network provider communication needs across current and new markets, strategic initiatives, process improvements, and general updates Support program readiness for growth through the development of communication templates, initiatives and operational processes with the goal of scalability to multiple markets/lines of business and multiple provider types including traditional, non-traditional and specialty providers. Regular reporting and maintenance of ongoing communications to peers, leaders, and key stakeholders Perform any other job-related instructions, as requested Education and Experience: Bachelor's degree or equivalent years of relevant work experience is required A minimum of three (3) years of managed care experience is required A minimum of two (2) years of experience in leading business initiatives to drive systemic change is preferred Competencies, Knowledge and Skills: Ability to execute small to medium project plans including business requirements gathering, definition/prioritization, project scope definition, identification and communication with SMEs and/or business owners, documentation, reporting strategy and change management process. Proficient in Microsoft Office Suite including Word, Excel and PowerPoint Proficient in SharePoint use and site development Effective identification of business requirements, assessment of proposed satisfaction to those requirements, and understanding the needs of business partners Excellent written and verbal communication and interaction skills Effective problem-solving skills with attention to detail Ability to develop, prioritize and accomplish goals Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-EM1

Aires (************** has been providing best-in-class relocation management services for over 40 years and is a recognized industry leader in delivering high quality relocation and assignment management services to leading corporations. We Have... An award-winning technology platform, built in-house, that aligns with the future state of Global Mobility A strong Aires brand consistently ranked among the mobility industry's highest annual customer-satisfaction scores and a client retention rate of over 98% A high internal promotion rate and long-tenured employees, highlighting our commitment to career growth and development A comprehensive benefits package, including a 401K match Hybrid work environment - Must be Pittsburgh based An excellent career opportunity is currently available for a Client Service Analyst reporting to the Aires Pittsburgh, PA office. This exciting opportunity is in a high growth environment where you will utilize your experience to provide reporting and configuration support to the Client Service team. The Client Service Analyst acts as a subject matter expert in reporting database and modifies reporting to meet clients needs. The position will also be responsible for updating and maintaining the client database to capture user accounts, policy data, and authorization information. Position Responsibilities: Provides reporting, configuration and administrative support to the Client Service team. Completes basic modification of standard reports within reporting tools for internal and external users. Enters new information and maintains policy database. Assists with database updates for various items (authorization/tracking information, NAS requirements, Aires Team, client requirements, etc.) Requests & tests changes to authorization forms, cost estimate tools and IT MobilityX customizations. Creates client MobilityX accounts and assists with user administration. Adds and updates contacts in database. Enters client fee schedules into the online tool. Updates implementation guide & completes client policy documentation and edits. Assists in training clients in MobilityX (for SBO/Non CSM clients). Conducts data audits and scrubs to maintain 100% data integrity on client reporting and MobilityX. Assists with manual client processes including review of billings, PO assignments, and TEQ audits to ensure accuracy. Required Qualifications: High School Diploma/GED required, associate or bachelor's Degree preferred 2-3 years of client services support in the relocation industry 2-3 years of extensive customer service experience in the relocation industry GMS and CRP certifications preferred Additional Qualifications: Excellent customer service and administrative skills Computer literacy with MS Office products, and ability to grasp proprietary software Demonstrated ability to manage multiple competing tasks Ability to follow policies and procedures Can-do attitude Genuine desire to help others Team oriented mindset, with a strong sense of care and urgency Desire to embrace our core values: Client Focus, Results, Responsibility & Accountability, Collaboration and Innovation. American International Relocation Solutions, LLC. provides equal opportunity to all persons through policies and practices to recruit, hire, train, and promote, in all job classifications, based on merit and qualifications without regard to race, religion, color, national origin, citizenship, sex, age, veteran status, disability, genetic information, or any other protected characteristic. Aires will not discriminate against persons because of their disability, including disabled veterans. Aires is committed to providing reasonable accommodations to qualified individuals so that an individual can perform their job-related duties. If you are interested in applying for an employment opportunity and require special assistance or an accommodation to apply, please contact us at .

Job SummaryThe Senior Serialization Analyst is a key role within Supply Chain that will be responsible for monitoring and maintaining internal and external metrics associated with serialization compliance. They perform data-driven analysis and use that information to identify trends and proactively communicate to both internal and external stakeholders about any changes uncovered. * Salary Range: $85,000-$100,000 Position is eligible to participate in a bonus plan with a target of 6% of the base salary (include only if applicable to the grade level) * Final pay determinations will depend on various factors, including, but not limited to experience level, education, knowledge, skills, and abilities. * Our benefits and programs are comprehensive and thoughtfully crafted to ensure our colleagues live healthy lives and have support when it matters most. Benefits offered include a 401(k) plan with company contributions, paid vacation, holiday and personal days, employee assistance program, and health benefits to include medical, prescription drug, dental and vision coverage. Applicants must be authorized to work for ANY employer in the United States. Fresenius Kabi is unable to sponsor or take over sponsorship of an employment visa either now or in the future.Responsibilities The Senior Serialization Analyst will monitor and maintain internal compliance metrics associated with serialization Manage and maintain exceptions management mailbox Perform data driven analysis on both internal and external exceptions associated with serialization Identify trends in exceptions, and proactively communicate any change in the trends as needed Perform detailed technical investigations related to serialization in both internal and external systems Provide process and technical support as a part of suspect and illegitimate product investigations Serve as primary communicator with external customers on serialization exceptions Support functional and validation testing of serialization systems Monitor current regulations and industry trends related to serialization Identify and coordinate any serialization process improvements cross functionally between IT, manufacturing, distribution centers, and external customers. Manage system enhancement projects related to serialization Onboard new customers to GS1 Electronic Product Code Information Services (EPCIS) and coordinate any required testing with customers and internal stakeholders All employees are responsible for ensuring the compliance to company documents, programs and activities related to the Health, Safety, Environment, Energy, and Quality Management Systems, as per your roles and responsibilities Requirements Bachelor's degree in a relevant field such as pharmaceutical sciences, engineering, or supply chain management is required. Minimum of 5 years of experience within Supply Chain industry. Advanced skills in interpreting complex datasets, identifying trends, and making data-driven decisions to optimize processes and solve problems. SAP serialization OER or ATTP preferred Strong communication and interpersonal skills, with the ability to collaborate with stakeholders at all levels of the organization. Experience in pharmaceutical distribution or related industries, with a strong understanding of serialization requirements and processes Project management skills, with the ability to prioritize tasks, manage timelines, and lead cross-functional teams effectively Knowledge of Microsoft Office Suite including Project. Additional Information We offer an excellent salary and benefits package including medical, dental and vision coverage, as well as life insurance, disability,401K with company contribution, andwellness program. Fresenius Kabi is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, citizenship, immigration status, disabilities, or protected veteran status.

We are seeking a skilled SAP Basis Systems Analyst III to join our dynamic team at CareSource. In this role, you will be responsible for implementing and maintaining multiple SAP instances, ensuring the stability and performance of our SAP environment, which includes Sandbox, Development, QA, Production, and N+1 systems. You will play a critical role in supporting our SAP HANA databases and administering various SAP applications. Key Responsibilities: Implement and maintain multiple SAP instances, including Sandbox, Development, QA, Production, and N+1 environments. Provide SAP HANA database support using HANA Studio and HANA Cockpit. Administer SAP applications, including planning and performing application upgrades, support packs, add-ons, migrations, performance management, and problem resolution. Execute system refreshes and upgrades for ABAP and S/4HANA systems. Perform SAP client administration tasks, such as creating, copying, deleting, and exporting/importing clients as needed. Configure Solution Manager for managed system setup, technical monitoring, and alerting. Review EarlyWatch reports and address any reported issues. Apply SAP HotNews, SAP Security Notes, and kernel upgrades across the SAP landscape. Monitor all SAP systems, including work processes, user activity, system logs, short dumps, locks, developer traces, CPU, memory, and disk space. Meet defined SLAs by providing hands-on support and technical leadership for incidents. Design and implement optimal SAP configurations to maximize system performance and availability. Maintain SAP performance through planning and executing tuning strategies. Manage SAP archiving processes using OpenText to ensure efficient data retention, compliance, and retrieval while optimizing system performance and minimizing data storage costs. Administer SAP Business Technology Platform (BTP) to develop, integrate, and extend SAP applications, enabling seamless connectivity and enhancing business processes through innovative cloud-based solutions. Develop and maintain system documentation for all SAP instances and interfaces. Provide status reports for projects to management. Manage projects and ensure task deadlines are met. Qualifications: Proficient in the administration of SAP NetWeaver ABAP and JAVA stacks. Experience in the administration of SAP areas including S/4HANA, BW/4HANA, ECC, BW, BPC, GRC, SLT, Solution Manager, ADS, Ariba, BTP, OpenText, EPM, and Analysis for Office. Demonstrated expertise in SAP BASIS/HANA administration tasks, including installations, upgrades, problem resolution, patching, note application, performance tuning, transport management, and sizing. Experience with MSSQL, HANA, MS Windows Server, and Linux OS. Hands-on experience with HEC environments. Experience with SAP Cloud Connector. Familiarity with ServiceNow. Strong team player with the ability to work collaboratively in a group environment. Availability for on-call rotation and after-hours support as needed. Compensation Range: $94,100.00 - $164,800.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-GB1

The Quality Analyst III is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross-functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance Essential Functions: Generate comprehensive reports, graphics and dashboards that effectively summarize and display data for key stakeholders Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques and provide management level summaries that explain key findings Provide technical expertise and guidance to team members on SQL, SAS, and DAX coding best practices, visualizations, and table locations Interpret and maintain understanding of technical specification and other quality reporting requirements and ensure any changes are implemented and communicated with key stakeholders timely Interact and work collaboratively with business partners on analysis, reports and data patterns to identify trends Gather, understand and refine requirements for analytics requests including but not limited to HEDIS, Population Health, Pharmacy Quality, Accreditation, Health Equity, business development and RFP requests Collaborate with IT teams to enhance data collection and reporting systems Perform any other job duties as assigned Education and Experience: Bachelor of Science/Arts degree in Management Information Systems (MIS), computer science or related field or equivalent work experience is required Master of public health (MPH), Business Administration (MBA), mathematics, statistics, or related field is preferred Minimum of three (3) years of experience in data analysis and/or analytic programming is required Minimum of three (3) years of HEDIS or similar healthcare quality performance metrics experience is required 3-5 years Programming experience (i.e., SQL, SAS) is required Programming in DAX/Power BI is preferred Health care delivery, clinical experience and/or payer experience is preferred. Competencies, Knowledge, and Skills: Intermediate proficiency level with Microsoft Office Suite Complex problem-solving skills for solving multi-dimensional business questions Proficient in Programming language (i.e., two of SQL, SAS and/or DAX) is required Managed Care Organization knowledge and familiarity Graphic development & presentation skills Exposure to statistical concepts strongly preferred Critical thinking and active listening skills Effective verbal and written communication skills Ability to lead analytic efforts Ability to serve as liaison with business partners Knowledge of managed care and health care data coding Ability to interface with IT teams, familiarity with MDS and advanced data architecture Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-GB1

The Quality Analyst II is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross-functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance. Essential Functions: Generate graphics that effectively describe, explore and summarize analyses for communication to appropriate parties Responsible for completing the analysis process to determine best course of action for each inquiry/problem Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques and provide management level summaries that explain key findings Collaborate with team members on technical specifications and coding tactics Assist in quality dashboard development and reporting using Power BI and other visual data tools Gathers and understands requirements for analytic requests Perform any other job duties as assigned Education and Experience: Bachelor of Science/Arts degree in Management Information Systems (MIS), computer science or related field or equivalent work experience is required Minimum of two (2) year experience of HEDIS or similar quality healthcare performance metrics experience is required. 2 years Prior programming experience (i.e. SQL, SAS, Python or DAX) is required Health care delivery and/or payer experience is preferred Clinical experience is preferred Competencies, Knowledge and Skills: Proficient with Microsoft Office Suite Proficient in minimum one of the programming skills (i.e., SAS, SQL, or DAX) required Analytic skills for solving multi-dimensional business questions Graphic development & presentation skills Exposure to statistical concepts preferred Critical listening & thinking skills Effective verbal and written communication skills Problem Solving skills Knowledge of managed care and health care data coding Ability to work with IT teams, familiarity with MDS and data architecture Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-GB1

The Encounters Systems Analyst II is responsible for performing analysis of Encounters data and understanding the financial and clinical impact of changes and decisions to the business process to ensure that the Service Level Agreements are achieved. Essential Functions: Perform analysis of Encounter data. Understand the financial and clinical impact of changes and decisions to the business process to ensure that the Service Level Agreements (SLAs) are achieved Support for Regulatory Data projects Responsible for reviewing Encounter rejections and providing resolution of minor to complex data issues or process changes Support for Claims Encounter Subject Matter Expertise (SME) for both CMS and State agencies and internal CareSource impacted organizations (IT, Claims, New Business, Enrollment, etc.) Build, sustain and leverage relationships with persons within his/her area of responsibility to allow for continuous improvement of the Encounter Data business process Support for testing and delivering process to business. Participate in claims data processes to ensure accuracy and compliance with CMS and state agencies Participate in the key claims data management and readiness to state and governing entities Understand the Claims Encounter Data requirements in detail to enable one to support efforts to ensure claims data submissions achieve the required SLAs through requested changes internally and externally Recognize inconsistencies and gaps to improve productivity, accuracy and data usability and streamlining procedures and policies Support Claims Encounters regulatory reporting Support for critical reporting and analysis of functional performance, and make recommendations for enhancements, cost savings initiatives and process improvements Monitor various management and oversight metrics and reports as required Support Claims Encounter initiatives such as working with IT and others internal departments to automate Claims Encounters functions; improve regulatory report development with reporting department Provide support of vendors, managing SLA's, regulatory requirements and contractual metrics Maintain positive and strategic relationships with internal and external stakeholders Contribute to and/or develop user stories or provide user story guidance for sprint planning Understanding of how claims payment methodologies, adjudication processing and State Encounter regulations interrelate to maintain compliant Encounter reconciliation processes and SLA's Perform any other job duties as requested Education and Experience: Bachelor's degree in Science/Arts or equivalent years of relevant work is required Master's Degree in Science/Arts is preferred; concentration in Healthcare Analytics or Data Science preferred Minimum of one (1) year to two (2) years of managed healthcare, claims, or managed care regulated environment experience is required Minimum of one (1) year of experience using at least two of the following tools is required: SQL, SAS, SSIS. MySQL, ORACLE, R, or PowerBI Competencies, Knowledge and Skills: Intermediate computer skills, Advanced skills in Excel Edifecs knowledge is preferred Data analysis and trending skills Demonstrated understanding of claims operations specifically related to encounters Advanced knowledge of coding and billing processes, including CPT, ICD-9, ICD-10 and HCPCS coding Knowledge of Claims IT processes/systems and analytic processes Knowledge of Agile is preferred Knowledge of Facets is preferred Experience in Documentation of business requirements Advanced working knowledge of managed care and health claims processing and reimbursement methodologies Experience with 837O files to States and/or CMS (MA EDS) preferred Experience with 835 files preferred Excellent communication skills; both written and verbal required Ability to work independently and within a team environment Time management skills; capable of multi-tasking and prioritizing work Attention to detail Effective decision making / problem solving skills Critical thinking and listening skills Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SD1

Job Title: Health Payer Technology Medicare Consultant Job Level: Senior Level Job Description: THIS IS WHAT YOU WILL DO... You will be adapting existing methods and procedure to create possible alternative solutions to moderate complex problems. You will design and implement solutions that are Medicare complaint. You will be understanding the strategic direction set by senior management as it relates to team goals. WE ARE LOOKING FOR SOMEONE.!! Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is experienced in systems and processes required to support health plan! Who is currently in Medicare/ Medicaid! Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience! Who holds 2 years experience with Medicare systems and technologies with formal consulting! Qualifications Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Additional Information All your information will be kept confidential according to EEO guidelines.

About Client: They help in transforming the leading organizations and communities around the world. Organizations infrastructure and culture is amazing. Best place!! Job Title: Health Payer Technology Medicare Consultant Job Level: Senior Level Job Description: THIS IS WHAT YOU WILL DO... You will be adapting existing methods and procedure to create possible alternative solutions to moderate complex problems. You will design and implement solutions that are Medicare complaint. You will be understanding the strategic direction set by senior management as it relates to team goals. WE ARE LOOKING FOR SOMEONE.!! Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is experienced in systems and processes required to support health plan! Who is currently in Medicare/ Medicaid! Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience! Who holds 2 years experience with Medicare systems and technologies with formal consulting! Qualifications Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Additional Information All your information will be kept confidential according to EEO guidelines.

About Client: They help in transforming the leading organizations and communities around the world. Organizations infrastructure and culture is amazing. Best place!! Job Title: Health Payer Technology Medicare Consultant Job Level: Senior Level Job Description: THIS IS WHAT YOU WILL DO... You will be adapting existing methods and procedure to create possible alternative solutions to moderate complex problems. You will design and implement solutions that are Medicare complaint. You will be understanding the strategic direction set by senior management as it relates to team goals. WE ARE LOOKING FOR SOMEONE.!! Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is experienced in systems and processes required to support health plan! Who is currently in Medicare/ Medicaid! Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience! Who holds 2 years experience with Medicare systems and technologies with formal consulting! Qualifications Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Additional Information All your information will be kept confidential according to EEO guidelines.

Facility:Work From Home - OhioDepartment:Revenue Integrity ServicesSchedule:Full time Hours:40Job Details:The senior revenue integrity analyst is responsible for planning and oversight of the revenue integrity analysts' performance of essential department accountabilities, including reporting to department leadership about goal status. This position will be responsible for all aspects related to revenue integrity, including maintaining work queues, understanding, and applying yearly regulatory changes, maintaining the chargemaster, and preventing revenue leakage. The senior revenue integrity analyst works accounts in assigned Revenue Integrity work queues to facilitate accurate, compliant billing of patient accounts and assists revenue integrity analysts with completion of tasks and work queues. The position will be certified in Epic CDM Management/Revenue Integrity to create, edit, delete and research various CDM requests for all hospital departments for both hospital and professional billing. The senior analyst is responsible for establishing and enforcing the hospitals' pricing, coding, and regulatory changes. The incumbent needs to have knowledge of how billing and the CDM interacts for chargemaster build and will assist in hospital decision making related to chargemaster requests. The position will also provide operational analytical support with regards to reimbursement, charge lag, revenue trends, and other revenue related items. The senior revenue integrity analyst will coordinate and collaborate the above actions with, but not limited to, Health Information Management, Information Systems, Billing, Finance and Operations. Department Specific Job Details: Education Bachelor's degree in Health Information Management, Finance or related field required Masters preferred Experience Required 6-10 years of revenue integrity, analyst, etc. experience in healthcare Experience with EPIC electronic health record EPIC CDM/Revenue Integrity (HB and PB) certification within 6 months of employment required Ability to research CPT and regulatory requirements Experience with CPT and HCPCS codes and interpreting CPT guidance Experience in healthcare billing, CMS Medicare and Medicaid reimbursement methodologies Proficiency in Microsoft Office Tools (Outlook, Excel) Preferred qualifications/skills Trisus (Craneware) chargemaster experience Strata experience Registered Health Information Administrator (RHIA) Certification Education Requirements: Bachelors (Required) Certification/License Requirements: