Analyst - Senior (Claims)
Blue Cross Blue Shield of Michigan
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.QualificationsBachelor'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.Department PreferencesProven experience processing Facets BCNA claims across Facility, Professional, and Home lines of business. Understanding of Medicare Advantage plan structure and CMS regulations & guidance.All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.Full timePosting Date: 2026-10-06
$127k - $150k
..., and operationalizing scalable healthcare data platforms and integration pipelines across claims, payments, member, provider, eligibility, medical, and pharmacy domains. Senior Data Engineer responsible for designing, developing, and operationalizing scalable healthcare...SeniorClaimsLocal areaVisa sponsorship$78.17k - $103.86k
...Description Syms Strategic Group (SSG) is seeking a talented Senior Business Analyst Location: Remote Department: Veterans Affairs... ...Health Agency (VA, DHA, HHS, etc.) Healthcare billing and claims processing application knowledge Formal Education Master’...SeniorClaimsFull timeFor contractorsRemote work- ...Job Description Job Description Senior Discovery Business and System Analyst Employment Type: Full-Time, Executive-Level Department: Legal... ...marketing materials from industry solution providers that claim to satisfy the identified business requirements; -...SeniorClaimsFull timeFor contractorsWork at officeFlexible hours
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$96.4k
...tasks. Administers legal aspects of a worker’s compensation, tax, civil liability, or other areas, as assigned. Investigates various claims against the City and recommends appropriate legal action. Reviews insurance coverage and related contracts to ensure proper...SeniorClaims- ...not just report on it. We are looking for a seasoned workforce analyst who can build and own the models that drive hiring, coverage, effecti... ...the single source of truth for workforce planning updates to senior leadership. Maintain a real-time view of open roles,...SeniorTemporary workLocal areaRemote workShift work
$91k - $121k
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$73.15k - $96.2k
...Zenith Analytics Senior Analyst Working closely with both the Business Planning and Activation teams, Analytics designs the data strategy to tie our clients' marketing to real-world business goals. We then mine that data to optimize campaigns and tell the stories that...SeniorTemporary workFreelanceWork at officeFlexible hours- ...to support our Michigan market expansion. The role requires knowledge of No-fault and auto coverage, with responsibilities across claims and other departments. The position offers a collaborative, hybrid work environment in Southfield, MI, with a competitive salary...SeniorClaims
- ...State Farm, Detroit Claim Litigation Office, seeks an Attorney in a hybrid role combining in-office and remote work. You will own files, manage case development, and participate in litigation events while collaborating with colleagues and clients. Qualified candidates...SeniorClaimsWork at officeRemote work
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$116.2k - $229.1k
Position Summary Dayforce Integration Data Management - Senior ConsultantOur Human Capital practice is at the forefront of transforming the nature of work. As converging forces reshape industries, our team uniquely addresses the complexities of work, workforce,...SeniorLocal areaVisa sponsorship- ...Senior Vice President, Benefits About the Company Global risk management firm helping clients navigate complex risks with creative... ...solutions specialty wholesale strategic risk analytics claims advocacy bermuda market access intermediaries group...SeniorClaims
- ...OVERVIEW OnTrac is seeking highly skilled and experienced Senior Software Engineers to join a contractor program supporting a healthcare... ...7 FHIR experience Familiarity with PBM data domains such as claims, eligibility, formulary, and prior authorization Experience...SeniorClaimsFor contractorsRemote work
$120k - $215k
...like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.Impact You'll MakeAs a Senior Manager, you’ll play a leadership role in delivering complex intellectual property damages analyses while shaping engagement strategy...SeniorClaimsFull timeLocal areaFlexible hours- Grant Thornton is seeking a Compensation Senior Associate to join our team. The role supports the design, administration, and evaluation of compensation programs through data-driven analysis and market insights. This position partners with HR Business Partners, Talent...Senior
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$105.4k - $207.8k
Position Summary As a Senior Consultant in Deloitte’s Digital Trust & Privacy practice, you will support the design and implementation of privacy technology solutions that help organizations address regulatory requirements, strengthen data governance, and enable...SeniorLocal area- EXL Risk Control is seeking experienced consultants to conduct on-site surveys, evaluate risks, and report findings to insurance clients. You will manage assignments, secure timely appointments, and travel to various commercial sites to assess risk across multiple lines...Senior
$80k - $101k
...Ability to communicate with internal and external customers on issues of moderate to considerable importance, up to and including senior management Demonstrated ability to foster and maintain relationships with an ability to work as part of a cross functional team Strong...SeniorWork at officeLocal area$116.2k - $229.1k
Position Summary Join Deloitte’s Employer Health team as a Senior Consultant, Pharmacy Consulting, where you will advise employers... ...evaluation, negotiation, and implementationAnalyze pharmacy claims, utilization, and financial data; prepare self-insured financial...SeniorClaimsContract workLocal areaVisa sponsorship- ...diverse portfolio of matters involving general liability, premises liability, property damage, subrogation and other third-party claims . \n \n THE OPPORTUNITY: \n \n This is more than a traditional litigation position. The role offers an opportunity to:...SeniorClaims
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