![Strategic Staffing Solutions](https://media.trabajo.org/img/noimg.jpg)
Health Care Analyst
4 weeks ago
STRATEGIC STAFFING SOLUTIONS HAS AN OPENING Healthcare Analyst Location: Detroit, MI On-Site Hybrid Duration: 12 Months Role Type: W2 Contract Engagement SUMMARY: The Healthcare Analyst position is responsible for assisting Medicare Advantage PPO, HMO and PDP plans meet CMS compliance requirements for PBM oversight, CMS reporting and benefit set up and testing. Other related skills may be required to perform this job. RESPONSIBILITIES/TASKS: • Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality. • Assists Customer Service with questions and clearly communicates responses to inquiries. • Assist in CMS and other data audits conducted by CMS and internal audit teams • Identifies and/or analyzes business problems and devise procedures for solutions to the problems. • Effectively leads projects in order to produce desired results. • Responsible for corporate communication of project results. • Recommends and assists with implementing standard policies and procedures. • Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis. • Participates in systems testing, develops procedures/controls, and provides recommendations for the ongoing improvement of the updated process. • Assists personnel (both internal and external) by answering questions, supplying information, and training. • Develops and maintains an effective working relationship with customers. Participates in group or committee discussions. Education: bachelor’s degree in a related field is preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company’s learning philosophy, is required. EXPERIENCE: Four (4) years’ experience in a related field is required (prefer health plan or PBM). • Experience with Microsoft Office applications including Excel, Word and Outlook. • Must have data analysis, and problem resolution skills. Spreadsheet and/or Database skills. • Experience resolving eligibility and pharmacy claims related issues. • Experience with responding to CMS requests regarding pharmacy claims timely. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: • Knowledge of pharmacy claim processing and Medicare guidance related to Part D products. • Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines. • Ability and willingness to learn and take on more responsibilities based on activities with the team. • Experience with PBM systems and tools. • Ability to understand questions from external areas and articulate timely and accurate responses. • Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities. • Analytical, organizational, planning and problem solving skills • Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies • Ability to plan, organize, direct, and control projects. • Excellent written and verbal communication skills. • Ability to lead and contribute to process improvement projects. • Ability to read and interpret documents such as data flows, process flows, technical diagrams, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. • Administer and adhere to corporate and departmental policies, practices and procedures. The four pillars of our company are to: • Set the bar high for what a company should do • Create jobs • Offer people an opportunity to succeed and change their station in life • Improve the communities where we live and work through volunteering and charitable giving
-
Health Care Analyst
4 weeks ago
Southfield, United States TekWissen LLC Full timeJob DescriptionJob DescriptionOverview: TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc. Title: Health Care AnalystWork...
-
Health Care Analyst
4 weeks ago
Southfield, United States VeeRteq Solutions Inc. Full timeJob DescriptionJob DescriptionTitle: Health Care AnalystWork Location: Southfield, MI, 48075Duration: 12 MonthsJob Type: Contract Work Type: OnsiteDept: Medicare Pharmacy Operation Engagement Description: The Healthcare Analyst position is responsible for assisting Medicare Advantage PPO, HMO and PDP plans meet CMS compliance requirements for PBM oversight,...
-
Health Care Analyst
3 weeks ago
Southfield, United States KYYBA Inc Full timeTitle: Health Care AnalystLocation: Southfield MiWill this position be required to work onsite for any reason at any time? YesSUMMARY:The Healthcare Analyst position is responsible for assisting Medicare Advantage PPO, HMO and PDP plans meet CMS compliance requirements for PBM oversight, CMS reporting and benefit set up and testing. Other related skills may...
-
Health Care Analyst
3 weeks ago
Southfield, United States KYYBA Inc Full timeTitle: Health Care AnalystLocation: Southfield MiWill this position be required to work onsite for any reason at any time? YesSUMMARY:The Healthcare Analyst position is responsible for assisting Medicare Advantage PPO, HMO and PDP plans meet CMS compliance requirements for PBM oversight, CMS reporting and benefit set up and testing. Other related skills may...
-
Health Care Analyst
4 weeks ago
Southfield, United States w3r Consulting Full timeSUMMARY: The Healthcare Analyst position is responsible for assisting Medicare Advantage PPO, HMO and PDP plans meet CMS compliance requirements for PBM oversight, CMS reporting and benefit set up and testing. Other related skills may be required to perform this job. The maximum hourly rate reflects budget estimates only and does not reflect the final...
-
Analyst - Senior
2 months ago
Southfield, United States Blue Cross Blue Shield of Michigan Full timeEmployer: Blue Cross Blue Shield of Michigan Job Title: Analyst-Senior Job Location: 20500 Civic Center Drive, Southfield, MI 48076 Job Type: Full-time, 9am – 6pm, 40 hours a week, Monday – Friday Duties: Identify and analyze operational data and develop insights in support of business objectives. Develop and improve work flows and business processes...
-
Director of Nursing
3 months ago
Southfield, United States Hope At Home Health Care Full timeJob DescriptionJob DescriptionBecome a part of the Hope At Home Family!We currently have a position available for a Clinical Manager with Home Health care experience!This position is only for an onsite location in our Southfield office and the individual will provide clinical management support throughout our service area Wellsky/Kinnser Software...
-
Behavior Analyst Clinical Supervisor
2 days ago
Southfield, Michigan, United States Akoya Behavioral Health Full timeJob OverviewAkoya Behavioral Health is a clinician-owned and operated in-home ABA program dedicated to supporting children with autism. Our approach emphasizes collaboration with families and caregivers, believing that their involvement is crucial for effective outcomes. Our clinical team is led by a BCBA with over 20 years of expertise in the ABA field,...
-
Financial Analyst | Hybrid
1 month ago
Southfield, United States AmeriHealth Caritas Full time**Financial Analyst | Hybrid** Location: Southfield, MI Primary Job Function: Finance ID**: 34240 **Job Brief** This is a hybrid role and requires 2-3 days in the office in Southfield, MI. Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well...
-
Regional Financial Analyst
7 days ago
Southfield, Michigan, United States State of Michigan Full timePOSITION SUMMARY Oversee and guide financial and accounting operations within the Region and Transportation Service Centers (TSC). Facilitate the preparation and dissemination of financial reports and performance metrics for the Region, aimed at assessing and communicating its overall financial health while promoting ongoing enhancements. Act as the main...
-
Registered Nurse
7 days ago
Southfield, Michigan, United States Accelerated Home Health Care Services Full timeAbout Accelerated Home Health Care Services Accelerated Home Health Care Services is dedicated to providing high-quality, compassionate care to patients in the comfort of their homes. We believe in empowering our patients and their families through personalized care plans and a team of dedicated healthcare professionals. Job Summary As a Registered Nurse at...
-
Travel Nurse RN
1 month ago
Southfield, United States Supplemental Health Care Full timeSupplemental Health Care is seeking a travel nurse RN Telemetry for a travel nursing job in Southfield, Michigan. Job Description & Requirements Specialty: Telemetry Discipline: RN Start Date: ASAP Duration: 13 weeks Employment Type: Travel Job Description: Supplemental Health Care is seeking Telemetry RNs in Southfield, Michigan for a 13-week assignment...
-
Travel Nurse RN
1 month ago
Southfield, United States Supplemental Health Care Remote Work Freelance Full timeSupplemental Health Care is seeking a travel nurse RN Telemetry for a travel nursing job in Southfield, Michigan. Job Description & Requirements Specialty: TelemetryDiscipline: RNStart Date: ASAPDuration: 13 weeksEmployment Type: TravelJob Description:Supplemental Health Care is seeking Telemetry RNs in Southfield, Michigan for a 13-week assignment at a...
-
Travel Nurse RN
4 weeks ago
Southfield, United States Supplemental Health Care Remote Work Freelance Full timeSupplemental Health Care is seeking a travel nurse RN Telemetry for a travel nursing job in Southfield, Michigan. Job Description & Requirements Specialty: TelemetryDiscipline: RNStart Date: ASAPDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelJob Description:Supplemental Health Care is working with a hospital in Southfield,...
-
Travel Nurse RN
1 month ago
Southfield, United States Supplemental Health Care Remote Work Freelance Full timeSupplemental Health Care is seeking a travel nurse RN Telemetry for a travel nursing job in Southfield, Michigan. Job Description & Requirements Specialty: TelemetryDiscipline: RNStart Date: ASAPDuration: 13 weeksEmployment Type: TravelJob Description:As one of the largest Healthcare jobs placement agencies in the U.S., Supplemental Health Care has been...
-
Medicare Compliance Analyst
2 days ago
Southfield, Michigan, United States OpTech Full timeJob Title: Health Care Analyst Why work at OpTech? OpTech is a woman-owned organization that values your contributions, fosters your development, and consistently supports you. At OpTech, you will receive health and dental benefits from your first day of employment, along with training opportunities, flexible and remote work options, career...
-
Healthcare Analyst
3 weeks ago
Southfield, United States KYYBA Inc Full timeMy name is Martin and I'm a recruiter at Kyyba. I have the below requirement with my direct health care client based in Southfield,MI. I've included the job description here for your review. Please let me know if you'd like to discuss this opportunity in greater detail. Job Title: Healthcare AnalystLocation: Southfield,MIDuration: 12+ MonthsHybrid Work Open...
-
Healthcare Analyst
3 weeks ago
Southfield, United States KYYBA Inc Full timeMy name is Martin and I'm a recruiter at Kyyba. I have the below requirement with my direct health care client based in Southfield,MI. I've included the job description here for your review. Please let me know if you'd like to discuss this opportunity in greater detail. Job Title: Healthcare AnalystLocation: Southfield,MIDuration: 12+ MonthsHybrid Work Open...
-
Travel Registered Respiratory Therapist
1 month ago
Southfield, United States Supplemental Health Care Remote Work Freelance Full timeSupplemental Health Care is seeking a travel Registered Respiratory Therapist for a travel job in Southfield, Michigan.Job Description & RequirementsSpecialty: Registered Respiratory TherapistDiscipline: Allied Health ProfessionalStart Date: ASAPDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelJob Description:Supplemental...
-
Travel Registered Respiratory Therapist
1 month ago
Southfield, United States Supplemental Health Care Full timeSupplemental Health Care is seeking a travel Registered Respiratory Therapist for a travel job in Southfield, Michigan.Job Description & RequirementsSpecialty: Registered Respiratory TherapistDiscipline: Allied Health ProfessionalStart Date: ASAPDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelJob Description:Supplemental...