Current jobs related to Analyst - Senior - Payment Integrity Unit - Detroit MI United States - Blue Cross Blue Shield of Michigan
-
Senior Consultant, Payments
2 weeks ago
Dallas, GA, United States Cognizant Technology Solutions Full timeSenior Consultant, Payments Management Banking & Financial Services Texas, North Carolina, Georgia ABOUT US Cognizant is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run...
-
Senior Financial Analyst
4 days ago
Detroit, MI, United States Taft Stettinius & Hollister LLP Full timeTaft is seeking a Senior Financial Analyst to support our Accounting team in our Chicago, Cincinnati, Cleveland, Columbus, Dayton, Detroit, Indianapolis, or Minneapolis offices.The Senior Financial Analyst is responsible for assisting with the financial planning and budget process for the firm.Duties/Responsibilities:Primary responsibility of becoming a...
-
Senior Financial Analyst
5 days ago
Detroit, United States Neighborhood Service Organization Full timeOverview of Duties and Responsibilities: This position promotes the mission, vision, values and strategic plan of Neighborhood Service Organization and helps to achieve the objectives of the Finance Department. The Senior Financial Analyst responsibilities include; leading the financial planning and budgeting processes, analyzing financial statements and...
-
Senior Financial Analyst
2 weeks ago
Detroit, United States Dynatrace Full timeYour role at Dynatrace The Senior FP&A Analyst role at Dynatrace is integral to the Commercial Finance team, reporting to the Manager of FP&A. The incumbent will join a fast-paced organization, playing a central role in providing financial support and guidance as part of the monthly/quarterly close, forecast activities, and the annual planning process. As...
-
Financial Analyst
3 weeks ago
Wilmington, DE, United States ChristianaCare Full timeAre you looking for a career opportunity working for a healthcare organization that is based on excellence and love?ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of...
-
Senior Financial Analyst
5 days ago
Florham Park, NJ, United States ADP (Automatic Data Processing) Full timeADP is hiring a Senior Financial Analyst, FP&A Are you a financial analyst with expertise in creating financial models from scratch, building macros in Excel, and partnering with business units to provide critical analysis and support?Are you empathetic to client needs and inspired by transformation and impacting the lives of millions of people every day?Are...
-
Senior Quality Assurance Analyst
2 weeks ago
Troy, IL, United States Cognizant Technology Solutions Full timeJob Title: Senior Quality Assurance Analyst Job Summary: We are seeking a highly skilled Senior Quality Assurance Analyst to join our team. The ideal candidate will have extensive experience in preparing test plans, managing test cycles, and ensuring the quality of software applications. The Senior Quality Assurance Analyst will be responsible for leading QA...
-
united states Creative Financial Staffing Full timeSummary of Position The Senior Financial Analyst will support a range of activities in the Corporate FP&A group and be responsible for specific analysis directly supporting corporate decision making. Primary duties will be in the areas of consolidated budgeting and forecasting, tax and accounting processes support, preparation of management reporting and...
-
Senior Telematics Data Analyst
17 hours ago
Detroit, Michigan, United States Aperia Technologies Full timeAperia Technologies is a pioneer in the development of innovative hardware and data analytics solutions for the commercial vehicle fleet industry. We are seeking a Senior Telematics Data Analyst to join our team.About the JobAs a Senior Telematics Data Analyst, you will be responsible for designing and delivering advanced data analytics solutions to support...
-
Senior Operations Analyst
6 days ago
Detroit, Michigan, United States MetaSense Inc Full timeWe are seeking a skilled Senior Operations Analyst to join our team at MetaSense Inc. As a key member of our operations team, you will be responsible for analyzing business processes and identifying opportunities for improvement.About the Role:Analyze business operations and develop strategies to improve efficiency and effectiveness.Collaborate with...
-
Senior Data Analyst for Automotive Industry
3 weeks ago
Detroit, Michigan, United States G-TECH Services, Inc. Full timeAbout the CompanyG-TECH Services, Inc. specializes in providing highly skilled staff in technical fields like engineering, IT, procurement, finance, and accounting.We have established relationships with respected companies and understand their job requirements and corporate cultures.Job OverviewAs a Senior Data Analyst for our client, you will work as an...
-
Senior Financial Business Analyst
2 days ago
Detroit, Michigan, United States Little Caesars Full timeAbout the Role:As a Senior Financial Analyst at Little Caesars, you will play a pivotal role in shaping the company's financial future. You will be responsible for providing advanced financial and business analysis support to the company, working on projects of the greatest difficulty and largest financial impact.You will provide direction to other staff in...
-
Senior Business Analyst
4 weeks ago
Boca Raton, FL, United States Pursuit Software Full timeJob Role: Senior Business Analyst Location: Boca Raton, FL (Fully Onsite), minimum travel is required Responsibilities: Work with technology teams, business teams, vendors, and subject matter experts to perform daily activities and serve as a conduit between them through triage, research, requirements, testing, and support. Serve as a business advisor to...
-
Senior Intelligence Analyst
2 weeks ago
Pittsburgh, PA, United States Hispanic Technology Executive Council Full timeSenior Intelligence Analyst - SVPAt BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the worlds financial system we touch nearly 20% of the worlds investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the table to create solutions with our...
-
Senior Financial Operations Analyst
3 weeks ago
Detroit, Michigan, United States Neighborhood Service Organization Full timeAbout the RoleThis position promotes the mission, vision, values, and strategic plan of Neighborhood Service Organization. As a Senior Financial Analyst, you will be responsible for leading the annual operating and capital budgeting processes, reviewing and analyzing financial statements and reports, tracking key performance indicators (KPIs), and preparing...
-
Payments Solutions Architect
4 days ago
Charlotte, AR, United States Innova Full timeInnova Solutions has a client that is immediately hiring for a Payments Solutions Architect Position type: Contract Job Role: Payments Solutions Architect Job Location(s): Either Chicago, IL 60661 / Charlotte, NC 28202 / Plano, TX 75024 Job Duration: 12-18 Months contract (Long-Term) Position Type: Hybrid Contract- (3 days onsite and 2 days remote) Client...
-
Senior Quantitative Analyst
4 weeks ago
Detroit, Michigan, United States Rock Family of Companies Full timeWe are seeking a highly skilled Senior Data Analyst to join our team at the Rock Family of Companies. As a key member of our data analysis department, you will be responsible for collecting, organizing, and analyzing data from various sources to provide actionable insights and recommendations.Job DescriptionYou will use your analytical skills to extract...
-
Senior Integrated Producer Role
15 hours ago
Detroit, Oregon, United States Monks Limited Full timeJob Description:Monks Limited is seeking a seasoned Senior Integrated Producer to join our expanding team. In this critical role, you will lead all aspects of production, including identifying strategic partners, managing relationships, establishing timelines, and determining budgets while reporting to the Executive Producer.About the Role:Create innovative...
-
Senior Compensation Analyst
3 weeks ago
Albuquerque, NM, United States UNM Medical Group, Inc. Full timeUNM Medical Group, Inc. is hiring for a Senior Compensation Analyst to join our Human Resources Department. The position is a REMOTE, full-time opportunity located in Albuquerque, New Mexico.*Please note, selected candidate must have a permanent address and live in New Mexico or be willing to relocate to New Mexico*The Human Resources team at the UNM Medical...
-
Senior Business Analyst
2 months ago
United, United States Dale Workforce Solutions Full timeClient: Health Insurance Company Job: Senior Business Analyst Location: On-site 3x/week in Philadelphia, PA Duration: contract to hire (eligible to convert after 90 days on contract) Looking for a Senior Business Analyst to sit in the PMO that is very confident and can handle an executive level audience. The best candidate will be outgoing, confident and...
Analyst - Senior - Payment Integrity Unit
1 month ago
Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers.
- Identify and analyze operational data and develop insights in support of business objectives.
- Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.
- Identify and/or analyze business problems and develop recommendations for solutions to problems.
- Lead the development and implementation of projects and/or teams in order to produce desired results.
- Document and communicate project concepts, milestones and results.
- Recommend and assist with implementing standard policies and procedures.
- Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.
- Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
- Provide support to internal departments and external entities by answering questions, supplying information and training.
- Create and present reports and presentations to display operational data and proposed business changes.
Qualifications
- Bachelor's Degree in a related field is preferred.
- Four (4) years of experience in a related field is required.
- Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
- Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.
- Excellent verbal, written communication and interpersonal skills.
- Ability to lead and contribute to business unit and/or corporate projects.
- Proficient in Microsoft Office Suites.
- Ability to develop and maintain effective working relationships.
Departmental Preferences:
- Designs, develops, and documents objective approaches to investigate, analyze, and pursue claims overpayment hypotheses.
- Knowledge of Blue Care Network Commercial & Medicare Advantage plan operations.
- Strong working knowledge of claims operations, including knowledge of coordination of benefits (COB), claims process flows for medical/surgical, DME, and pharmaceutical vendors.
- Knowledge of related laws, legal codes, government regulations, and applicable CMS policy.
- Ability to work with mathematical concepts such as probability and statistical inference, fractions, percentages, ratios, and proportions to practical situations.
- Ability to define problems, collect data, establish facts, and draw valid conclusions.
