Senior Business Analyst, Government Programs Operations Claims & Encounters
$135k - $146kCapital Rx
Hybrid (Local to New York, NY, Denver, CO or Charlotte, NC) Position Summary The Business Analyst provides support gathering and documenting business and reporting requirements that align with state and federal guidelines. This individual will analyze complex problems and issues using available information from both internal and external sources. Other responsibilities will include creating specifications documents for business processes, reports, data extracts, and analyses based on business needs. Identify and interpret trends in datasets to find possible outliers or patterns that can be used to drive process improvements. Collaborates with internal and external cross‑functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, clinical operations) to design, refine, automate, and maintain operational capabilities. Position Responsibilities Monitors for changes in existing business processes and updates documentation accordingly – Finds new opportunities for process developments and improvements Intake, analyze and manage requests from stakeholders Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team Drives root‑cause analysis and resolution of data and processes issues/errors by partnering with key stakeholders Supports analytical, problem‑solving functions by defining and documenting specifications pertinent to all departmental processes Analyzes business workflow and system needs for conversions and migrations to ensure that government submissions, recovery, and cost savings regulations are met Prepares end user documentation and training materials as needed Supports government data submission processes by analyzing complex data issues using data from internal and external sources Improves government data submission processes by reviewing and synthesizing state and federal resources, consolidating into comprehensive business requirements documents Supports creation of intake request to enhance existing processes by gathering requirements and level setting with stakeholders on required processes Develops and sets up performance metrics for stakeholder distribution Performs root cause analysis of government data processing and submission issues; develops recommendations based on data and industry knowledge Minimum Qualifications 3+ years of healthcare experience 3+ years of business process analysis, preferably in healthcare 3+ years of experience with Government Exchange programs Demonstrable knowledge of SQL, Excel, and flow‑charting tools Experience with implementation/project management Experience working with cross‑functional teams Extremely flexible, highly organized, excellent communication and able to shift priorities easily Attention to detail & commitment to delivering high‑quality work product Comfort or experience in a fast‑paced, growing environment Intellectual and professional curiosity Familiarity with the agile framework/Certified Scrum Product Owner preferred Bachelor's degree in Business Administration, Data Analytics, Computer Science or 3+ years of relevant experience Compensation New York, NY: $135,000 – $146,000 USD Denver, CO: $125,000 – $135,000 USD Charlotte, NC: $115,000 – $125,000 USD EEO Statement All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non‑compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Capital Rx
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$155k - $165.2k
...Charlotte, NC) Position Summary The Senior Manager, Government Programs Operations is responsible for the overall implementation... ...requirements for Exchange lines of business. This role leads the delivery of regulatory reporting, claims operations support, audit readiness,...OperationsSeniorClaimsLocal areaFlexible hoursShift work$120k
Senior Technical Business Systems Analyst Senior Technical Business Systems Analyst... ...than 12,000 local governments, schoo... Show... ...and on-demand programming, smart home installation... ..., Billing and Claims in the future....... ...critical outcomes, operational advancement... Show...OperationsSeniorClaimsHourly payFull timeContract workWork at officeLocal areaWork from home$107k - $126k
...conform with the United States Government Space Technology Export... ...our team. The Process Analyst supports operational scalability and organizational... ...continues to grow across programs, teams, and sites. Job... ...Supply Chain, Manufacturing, Business, or related field; or equivalent...OperationsSeniorPermanent employmentFull timeWork experience placementLocal area- ...high‑touch services. Business Analyst - Workforce... ...reporting). Translate program and policy needs into... ...repeatable financial operating model for complex, compliance... ...Network as an innovative, government‑funded solutions... ...workers' compensation claims management; (g)...OperationsClaimsFor contractorsSecond jobWork at office
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$94k - $112k
...the United States Government Space Technology Export... ...experienced Senior Import Compliance... ...our global import operations, customs compliance... ...across aerospace programs and supply chains.... ...while supporting business objectives in global... ...preferential trade claims. Review and validate...OperationsSeniorClaimsPermanent employmentFull timeContract workTemporary workWork experience placementLocal area$86.3k - $118.7k
...community The Senior Compliance Professional... ...adherence to government regulations and... ...Pharmacy and Part D programs. The Senior... ...Professional will analyze business requirements,... ...with Humana operational leaders and external... ...and/or claims processing within...OperationsSeniorClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...of our caring community The Senior Encounter Data Management Professional... ...data quality, compliance, and operational performance. This role uses... ..., and areas of concern to business stakeholders. Serve as the... ...experience in Medicare and Medicaid claims, encounters, auditing, or...OperationsSeniorClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome office
- Utility Development Program Manager - On-Site Generation page is loaded##... ...contracts and negotiations, operations leaders managing load growth... ..., to the employer or the government, or against any individuals... ...complaint or discrimination claim.The "Know Your Rights" Poster...OperationsClaimsFor contractorsImmediate startWorldwideFlexible hours
$76k - $95k
...), which consolidates all claim administration-related workflows... ...Position Summary The Government Programs Analysis & Efficiencies Analyst will play a role in supporting the operational success of Medicare,... ...regulatory requirements and business objectives. Position Responsibilities...OperationsClaimsLocal areaFlexible hoursShift work$69.2k - $100k
...Platform (EHP), which consolidates all claim administration-related workflows in... ...Denver, CO area) Position Summary The Government Programs Operations Specialist (MPPP) provides... ...functionality and ensure outcomes meet business requirements. Support quality assurance...OperationsClaimsLocal areaRemote workFlexible hours$107.25k - $164.01k
...created to support the US Government. Federal Program Manager will oversee the management... ...contract deliverables for operational effectiveness,... ...defining and implementing business process improvements. Ability... ...any complaint or discrimination claim. #J-18808-Ljbffr...OperationsClaimsContract workWork at officeFlexible hours$140.3k
...Fraud Investigations Analyst Gusto is seeking a... ...account takeover, business email compr... $21.00 hourly Senior Field Examiner... ...in the Division of Operations Management and reports... .... $28.00 hourly Claims Adjuster Ready to... ...Plans Enablement Program Management...OperationsSeniorClaimsHourly pay$140k - $175k
..., is recruiting for a Senior Cost Estimator with 10... ...consulting, engineering, and operations firm, expanding our... ...and potential claims. Who you are Bachelor’... ...and Flexible Holiday Program Company Paid Disability... ...of those an employee encounters while performing the essential...OperationsSeniorClaimsFull timeContract workFor contractorsCasual workLocal areaRemote workFlexible hours- ...Drive operational excellence by improving processes, standardizing workflows, and optimizing... ...operational efficiency, and successful program execution in a fast-paced aerospace environment... ...Operations, Supply Chain, Engineering, Business, or related field. 8+ years of...OperationsSenior
$62k - $98k
...Business Analyst Denver, Colorado, United States; New York, New York, United... ...), which consolidates all claim administration-related... ...team enables Judi Health's operational and clinical teams to be more... ...operational tasks, empower clinical programs that drive down costs for...OperationsClaimsWork experience placementLocal areaRemote work- Judi Health is seeking a Benefits Manager to oversee the day‑to‑day operations of our group benefits programs. You will ensure compliance, assist with navigation of benefits and claims, and work with vendors to optimize programs. The role involves reviewing enrollments...OperationsSeniorClaims
$57.78k - $85k
...Overview ROPS’ (Revenue Operations) supports the... ...and submitting claims and coordinating with... ...Class. As an Analyst within ROPS you will... ...player in enhancing business outcomes for various... ...including senior leaders Commitment... ...Professional development programs: DaVita offers a...OperationsClaimsWork experience placement$60k - $90k
...The Business Analyst plays a critical role supporting... ...integration, and operational improvement.... ...Responsibilities Project and Program Leadership... ...to senior management and stakeholders... ...competitive benefits, plus claim part ownership?... ...and local laws governing nondiscrimination...OperationsClaimsTemporary workInternshipLocal areaFlexible hours- Prime Therapeutics is seeking a Senior Treasury Claims Analyst to support the claim payment process... ...Accounting, Finance, IT, and Claims operations. The role requires deep analytical... ...with Pharmacy Networks and Government Programs. Remote opportunity available for...OperationsSeniorClaimsRemote job
- ...is seeking a leader to oversee audit and training programs across all lines of business related to the claim cycle. You will coordinate training activities to... ...regulations and standards, and work with the VP and operations management to foster a high performing unit...OperationsSeniorClaims
$126k - $170k
...the opportunity The RFP Program Manager owns the end-to-end... ...positioning and standards. You will operate at the intersection of Sales... ...~ Familiarity with SaaS business models strongly preferred ~... ..., fake email addresses claiming to be from our company, or social...OperationsSeniorClaimsFull timeWork at officeLocal areaWorldwide$51.75k - $98.9k
...contribute to the company’s success. As a Business Analyst Senior within PNC's Retail Lending... ...to ensure the card processing system operates effectively for our internal partners... ...educational assistance, including select programs fully paid; a robust wellness program...OperationsSeniorFull timeTemporary workWork experience placementWork at office$117.6k
...The Claims Analyst handles complex and high exposure bodily injury and... ...self‑administered liability program. Investigates and adjusts claims... ...,600.00 yearly – Full‑time. Senior Claims Specialist –... ...HomeCare. Supports home‑care operations, handles caregiver scheduling...OperationsSeniorClaimsHourly payFull timeContract workRemote work- ...The Business Analyst, Pricing and Underwriting , is responsible... ...to inform daily operations and executive... ...Analyze pharmacy claims, drug pricing, rebate... ...analytical support to senior management for strategic... ...or other applicable programming language (Python/VBA/...OperationsClaimsFull timeTemporary workWork at officeRemote workWork from home
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Bank of America is seeking a Workers' Compensation Claim Specialist in Greenwood Village, CO. The role manages Lockheed Martin's Workers' Compensation and DBA insurance programs and provides general workers' compensation and DBA management. Schedule 8:00am-4:30pm (MST)...SeniorClaimsFull time$81.6k - $143.87k
Description: Join the Lockheed Martin Production Operations One Lockheed Martin Transformation (1... ...Technology (IT) team as an IT Business Analyst (ITBA) supporting Material Requirements... ...Spending Accounts, Employee Assistance Program, Education Assistance, Parental Leave,...OperationsSeniorRemote jobFull timeTemporary workWork at officeRelocationFlexible hoursShift work3 days per week$65k - $75k
...is currently hiring for a Senior Program Analyst to support enterprise observability... ...critical federal operations. This position provides programmatic... ...teams, stakeholders, and government customers while supporting... ...across technical and business teams. Support planning, execution...OperationsFull timeCurrently hiringWork at officeRemote workFlexible hours
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