Health Analytics BI Analyst: Fraud & Payment Integrity
Blue Cross & Blue Shield of NC
Blue Cross and Blue Shield of North Carolina is seeking a strategic analytics partner for the Special Investigations Unit and Payment Integrity teams. You will deliver actionable business intelligence, financial reporting, operational insights, and audit support to identify fraud, waste, abuse, and payment accuracy opportunities. You will develop reporting and analytical solutions for provider investigations, overpayment recovery, and executive decision-making, translating complex healthcare #J-18808-Ljbffr Blue Cross and Blue Shield of North Carolina
$89.17k - $142.68k
...Serves as a strategic analytics partner to the... ...Investigations Unit (SIU) and Payment Integrity teams by... ...to identify fraud, waste, abuse, payment... ...initiatives. The analyst develops reporting... ...business partners, BI Analysts, Data Scientists... ..., and competitive health benefits and...Business intelligenceFraud$95k - $118k
Department: Revenue Integrity Reports To: Director, Revenue Integrity Cost Center... ...The Senior Revenue Integrity Analyst works in the Luminis Health Revenue Integrity department and serves... ...educates clinical departments on lost payment opportunities Performs internal review...SuggestedFull timeWork at office- General Dynamics Information Technology is seeking a Sr. Healthcare Data Analyst to deliver insights that turn Medicaid data into action for CMS. You will apply advanced analytics to detect fraud, waste, or abuse and support program oversight. Responsibilities include...FraudRemote job
$129.3k - $177.8k
...caring community The Actuary, Analytics/Forecasting analyzes and... ...analytics, forecasting, data integrity, and business intelligence initiatives... ...will be provided with payment for their internet expense. A... ..., nurses, behavioral health specialists and more, spend up...Business intelligenceFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- GDIT seeks a Sr. Healthcare Data Analyst to turn Medicaid data into actionable insights that support CMS mission. You will use advanced analytics and visualization to identify fraud, waste, and abuse across the Medicaid program. Responsibilities include data analysis,...FraudRemote job
- Luminis Health is seeking a professional support specialist in Annapolis, Maryland, to assist with value-based payment programs and population health. This role involves performing strategic... ...analyses, supporting clinical integration, and providing project management...Work at office
$90.31k - $135.46k
Position Objective Join our analytics team and help us enable our healthcare providers to improve... ...opportunity to think globally about the health of our patient populations and drive new... ..., Business Objects, and the Microsoft BI Stack. Gains a detailed understanding of...Business intelligenceFull time- Hmixray is seeking a mid-level RCO Sr. Business Analyst to join our Strategic Initiatives Team in Maryland. This role requires strong analytical skills, advanced proficiency in Power BI, and collaboration across departments to drive improvements in workflows and financial...Business intelligence
- Fideo Intelligence, a consumer tech analytics team, seeks a Senior BI Analyst to modernize data extraction, automation, and storytelling. You will own... ...-end BI from Snowflake/BigQuery to Looker dashboards, integrating AI APIs to automate reporting, and delivering a single...Business intelligence
$77.3k - $116.7k
Innovation & Growth Analyst Description Textron Systems is part of... ...evaluation. This is a mid-level, analytics-focused role with ownership... ...& Insight Generation Integrate internal and external data sources... ...Excel and, where applicable, BI or data tools to improve...Business intelligenceFull timeWorldwideFlexible hoursShift workDay shift$75.9k - $113.84k
...!****When you become part of the Chapters Health Team, you’ll realize it’s more than a job.... ...communicate in English (verbal and written); bi-lingual in Spanish preferred* Ability to... ..., maintaining a strong position against fraud and abuse.* Comply with Company policies,...Business intelligenceFraudLocal areaImmediate startRelocation packageNight shift$110k - $135k
...and devices. Summary The Senior Brain Health Analyst (SME) provides expert-level scientific... ...research projects to ensure scientific integrity and alignment with the client\'s scope... ...BIRCO, JTAPIC) Exceptional organizational, analytical, and communication (verbal and written)...Contract workFor contractors$100k - $139k
...is seeking a Cyber Data Analytics Engineer to work with... ...hand-in-hand with data analysts & data scientists to ready... ...knowledge at least one BI/visualization tool (... ...levels. We prioritize the health, well-being, and... ...Systems will never request payment, extend offers without...Business intelligenceContract workFor contractors- ...seeking to hire a Junior Contract Analyst in support of our Defense Health Agency (DHA) Team. The Defense Health... ...in collecting, review, and assess payment‑related information relative to:... ...file. Supported Technologies: Integrative Acquisition Environment DOD acquisition...Contract workTemporary workFor contractorsFlexible hours
- Requisition #:674416 Location:Johns Hopkins Health System, Baltimore, MD 21201 Category:Marketing Schedule:Day Shift Employment Type... ...the following link: Summary The Physician Liaison/Record Integrity Analyst, under the leadership of the HIM Supervisor/Manager, performs...Full timeWork experience placementLocal areaDay shift
- ...Department of Labor, Licensing and Regulation is seeking a Director of Program Integrity to lead the fraud prevention program for FAMLI, ensuring solvency of the Trust Fund. The role emphasizes data analytics, cross-functional coordination, and policy design to strengthen...Fraud
$85k - $95k
...Business Intelligence Analyst to completely modernize... ...a wizard with SQL and BI tools, knows how to connect... ...mentor the existing analytics team on how to use generative... ...insights, and system integrity. Shift Timings: EST... ...entertainment, connectivity, health, cybersecurity and...Business intelligenceWorldwideFlexible hoursShift work- ...is seeking an Operations Process & Data Analyst to join the Security and Electronic Systems unit. The role focuses on analytics, data integration, and process improvements across federal... ...and experience with SQL, R, Python, Power BI and Tableau. #J-18808-Ljbffr M.C. Dean,...Local area
- The Johns Hopkins Health System seeks a Physician Liaison/Record Integrity Analyst to perform qualitative and quantitative analyses of hospital records for completion and compliance with policies, TJC, and CMS. You will audit documentation, report results to Medical Staff...
- ...recommend operational improvements Source, validate, transform, and integrate data from workforce management, contact center, vendor,... ...Ability to work independently as well as part of a team Strong analytical and problem-solving skills to effectively communicate with technical...Shift work
$23.3 - $30.41 per hour
...Description: PROGRAM ANALYST ASSOCIATE Support mission... ..., or other approved payments. Assist employees with... ...Strong organizational, analytical, and time-management... ...plan options, some with Health Savings Accounts,... ...protect against identity fraud. You are expected to be...FraudHourly payTemporary workWork at officeImmediate startRemote workWork from homeWorldwideFlexible hours$210k - $240k
...most pressing global health challenges. Throughout... ...Conflicts of Interest, Fraud, Corruption, Discrimination... ...a culture of respect, integrity, accountability, and... ...of HR systems, data analytics, and digital... ...asks job applicants for payment or financial information...FraudWork at officeLocal areaWorldwide- ...Director of Program Integrity to lead the program’s fraud prevention efforts... ...program’s financial health and sustainability.... ...with strong data analytical skills to detect claim... ...to prevent claim payments from ending up in the... ...Integrity data analysts, investigators, and...FraudPermanent employmentFull timeFlexible hours
- CVS Health is seeking a backend capability product specialist to own the backend platform, API ecosystem, and third‑party integration layer of our SaaS product suite. This role sits at the intersection of engineering, business strategy, and market intelligence, driving...Business intelligence
- ...IV (UI Lead Data Analyst). This recruitment... ...provides advanced analytical support to the Division... ...and data integration activities. This role... ...workload forecasting, fraud detection, and... ...solutions (Power BI, QuickSight, etc).... ...Comprehensive, subsidized health, dental and...FraudPermanent employmentFull timeWork at officeFlexible hours
- The Boeing Intelligence & Analytics (BI&A) in Annapolis Junction, MD is seeking a Senior Software Engineer to design, develop and maintain... ..., contribute to software design decisions, and ensure integration across hardware platforms. A TS/SCI with polygraph is required...Business intelligence
$55 - $65 per hour
...investigation, environmental, health and safety, and specialty... ...specializing in handling insurance fraud and arson cases and providing... ...standards, safety, and integrity. You will work collaboratively... ...Strong interpersonal skills Good analytical and interpretive skills...FraudFull timePart timeWork at officeLocal areaRemote work$27.02 per hour
Company : Highmark Health Job Description : JOB SUMMARY... ...while maintaining the integrity and efficiency of our... ...detail, possess strong analytical skills, and be... ...numerous FEINs on a weekly/bi-weekly/monthly basis, ensuring... ...& Off-Cycle Payments: Handle garnishment inquiries...Business intelligenceFor contractorsWork at officeLocal area$53.9k - $89.8k
..., a global provider of information-based analytics and decision tools for professional and business... ...use case. About the Role The Legal Analyst supports the analysis, editing, and... ...; businesses and governments prevent fraud; consumers access financial services and...FraudFull timeWork at officeImmediate startWork from homeWorldwideFlexible hours$30.26 - $42.37 per hour
...women's and children's health and physical rehabilitation... ...identifies and resolves analytical problems, troubleshoots... ...results and specimen integrity; seeks guidance when necessary... ...identification, or payment via email or text. If you suspect fraud, please contact us at [click...FraudFull timeWork experience placement
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