Jobs in Analyst

Business Analyst I

Detroit, MI

Responsible for assisting and supporting the Group Operational Readiness team in the project coordination, establishment, and delivery of programs including but not limited to 2022 and 2023 ASC Contracting. Top 3 Required Skills/Experience – The most important must-have skills. Include: • Advanced Microsoft Skills in Word and Sharepoint, along with intermediate skills in Excel and…

Business Analyst

Detroit, MI

Engagement Description – This position will require strong technical skills, operational knowledge as well as support the increasing analytical needs in operations and support succession planning. Top 3 Required Skills/Experience – • Intermediate to Advanced proficiency in MS Excel and Access • Project management • Continuous improvement minded Required Skills/Experience – The rest of the…

Business Analyst

Detroit, MI

Will this position be required to work onsite for any reason at any time? Yes, vaccine is required. Engagement Description – Responsible for serving as a liaison between the Pharmacy Services Operations and PBM IT to provide technical solutions required for the achievement of business goals. Responsible for planning, organizing, directing, implementation, and leading department…

Business Analyst

Detroit, MI

Engagement Description – Position operates cross functionally within broad objectives related to the Healthy Kids Dental Medicaid program to ensure optimum oversight of dental vendor and satisfying contract requirements. Research, compile and analyze appropriate and relevant reporting and policies and make recommendations for operational improvements. Collaborate with other business areas internally and externally as well…

Intermediate Controls Specialist

Detroit, MI

Intermediate Controls Specialist provides support for all plant floor related automation control based systems supported by the IT organization. Responsibilities include but not limited to: • Support includes the implementation of system changes, support of daily plant activities relating to these systems, and system management including the implementation of IT standards and incident management. •…

Systems Analyst II

Detroit, MI

Systems Analyst is responsible for planning, developing, testing and implementing IT system solutions that improve business efficiency and productivity as well as support business strategies and goals. They identify and communicate business needs and translate business requirements into technical system and functional specifications. Systems Analysts determine if internal or external solutions exist or whether new…

Medical Records retrieval analyst

Detroit, MI

Engagement Description – Medical Records retrieval analyst. This role is responsible for retrieval metrics for various government and coding audits. This role also works with several departments to ensure record retrieval is at a high rate and has to coordinate retrieval efforts interdepartmentally and with clients. Top 3 Required Skills/Experience – • communication • project…

Systems Analyst II

Detroit, MI

• 3 years’ experience in NASCO 3270 mainframe including preparing/executing test claims for all lines of business • Minimum 3 years’ experience in BFM/BFAST environment, GENO Table, Procedure & Diagnosis Files • Experience in CSR creation, updates & development • Knowledge of Medical, Benefit and Payment Policy • Ability to work effectively with multiple internal/external…

Business Analyst Advanced

Detroit, MI

Engagement Description – Order/analyze data within reports, coordinate remediation of operational issues with internal and external customers, assist with some audit activity, monitor operational reports, identify and resolve process gaps, assist in creation and review of department processes and other miscellaneous duties as defined. Top 3 Required Skills/Experience – • Analytical • Program Management/while understanding…

Systems Analyst III

Detroit, MI

Engagement Description – IT Corporate Services (ITCS) Contract to Hire Systems Analyst III Position - Supporting Oracle Cloud ERP and Oracle EPM. Top 3 Required Skills/Experience – • 3-5 years of functional or technical experience using Oracle Cloud ERP and/or Oracle EPM (EPBCS, FCCS, ARCS, EDMCS) • 1-2 years of technical experience developing Oracle Integration…

Pricer

Detroit, MI

Engagement Description – • Daily input and maintenance of enterprise practitioner/ provider pricing data • Identify relevant issues and route to appropriate department for action and resolution • Perform departmental functions such as: data preparation/presentation, interaction with internal and external sources to resolve inquires • Promote and engage in positive and constructive daily team interactions.…

Prior Authorization Specialist

Detroit, MI

Engagement Description – This position requires the ability to multitask within a high-volume concierge contact center setting. Top 3 Required Skills/Experience – • Ability to process Coverage Determination Requests within CMS Timeframes • Ability to communicate all pharmacy benefits both verbally and written • Ability to have strong attention to detail while multitasking within a…

Business Analyst

Detroit, MI

Engagement Description – Service Operations is in need of a dedicated compliance liaison to support monitoring compliance with Center for Medicaid and Medicare Services (CMS), Patient Protection and Affordable Care Act (PPACA), National Committee for Quality Assurance (NCQA) accreditation, Health Information Trust Alliance (HITRUST), state mandates, regulations, and for ensuring that the operational areas develop…

Data Analyst III

Detroit, MI

Work closely with customers, vendors, business analysts and application development project teams to resolve information flow and content issues. When data related system problems occur, they perform root-cause analysis and recommend or execute corrective action. Work Complexity Works on multiple projects/issues/enhancements. Works on complex enterprise-wide projects/issues/enhancements. Engagement Description – SUMMARY: The Analyst is responsible for…

Digital Analyst

Detroit, MI

Works with all stakeholders and internal Digital Experience members to derive and document functional requirements for digital projects. Acts as a liaison between the requestors (business) and the digital strategy/design/execution teams, who interpret and act upon the requirements that this role defines and documents. Collaborates with subject matter experts to ensure requirements are accurate, complete,…

Business Analyst Adv

Detroit, MI

Top 3 Required Skills/Experience – • Knowledge of Stars, Risk Adjustment, Provider Network Management, and Medical Management. • Excellent analytical, planning, problem solving, verbal, and written skills to communicate complex ideas. • Ability to work independently, within a team environment, and communicate effectively with employees at all levels. Required Skills/Experience – The rest of the…

Systems Analyst I

Detroit, MI

Engagement Description – This role will be responsible for the delivery of Policy Change Requests. The work includes but is not limited to business requirement assessment, detailed system analysis, benefit designs and testing. Top 3 Required Skills/Experience – • Strong medical and facility claims background, understanding of the billing process, ICD codes, procedure codes, diagnosis…

Prior Authorization Specialist

Detroit, MI

SUMMARY: Support providers (pharmacists and physicians) with Medicare Part D drug coverage inquiries, Grievances, and prior authorizations. RESPONSIBILITIES/TASKS: Answer telephones in an efficient and timely manner to lend appropriate assistance to providers. Process prior authorization requests under the supervision of a Clinical Pharmacist. Apply pharmacy prior authorization criteria used in the adjudication of pharmacy PA…

Systems Analyst II

Detroit, MI

Will the Resource be required to come into the office now or on occasion. No System Analyst II Other Skills: 4 Key required skills: • Relational databases including Oracle, SQL Server, DB2, SQL and stored procedures • Reminder: When submitting candidates please include a response to the questions listed below. • Please give an example…