Senior SQL developer- Healthcare Claims
Core Career Advisors
We are seeking a strong skilled SQL developer with python scripting experience in the healthcare industry. The ideal candidate should have several years of experience in data analysis and data modeling using SQL, Python, and data visualization tools such as PowerBI, SSRS, Qlik. Experience with CMS (Center for Medicare and Medicaid) and Value Based Care programs is highly preferred with an emphasis on knowledge with claims data (CCLF) and electronic medical records (EMRs). This is not a data engineer position. Key Responsibilities Estimate impact with rigorous retrospective analyses (LOS, readmissions, mortality, reimbursement). Contribute into building end-to-end data modeling of clinical and claims data. Productionize efficient, reusable, and reliable SQL code to meet business requirements and help to define technical requirements as needed. Develop, test, and maintain reporting in Power BI driven from electronic medical records data, claims data, HIE data, Salesforce data and other external data sources. Collaborate with cross-functional teams to understand and define, design, and deliver new reports, dashboards, features and enhancements. Create comprehensive reports and data visualizations using Power BI to support decision-making processes. Ensure the performance, quality, and responsiveness of reporting tools. Maintain up-to-date knowledge of emerging technologies and industry trends. Participate in code reviews and contribute to a culture of continuous improvement. Ensure compliance with healthcare regulations and standards, including HIPAA. Required Qualifications Bachelor’s degree in computer science, Information Technology, or a related field, or equivalent practical experience. Six plus years of experience in working with Medicare Shared Savings Program Strong understanding of CCLF claims and EMR data structures. Required Proficiency in back-end technologies such as Node.js, Python, Ruby, Java, or .NET. Experience with database management systems such as Azure, SQL, and MySQL. Expertise in report writing and data visualization using Power BI in the healthcare industry. Strong understanding of healthcare regulations and standards. Excellent problem-solving skills and attention to detail. Strong communication and collaboration skills. Ability to work in the Costa Mesa office 1-2 days per week (at discretion of hiring manager). Preferred Qualifications Strong understanding of CMS and Value Based Care programs such as MSSP. Good understanding with Azure, MySql, MSSQL and Data Factory. Knowledge of healthcare interoperability standards (e.g., HL7, FHIR). Experience with DevOps practices and tools (e.g., Docker, Kubernetes, Jenkins, Github). Familiarity with Agile development methodologies. Familiar with LLM and AI technology solutions in healthcare. #J-18808-Ljbffr Core Career Advisors
- Core Career Advisors is looking for a skilled SQL Developer with Python scripting experience in the healthcare industry. This role demands several years of experience... .... The ideal candidate will work on clinical and claims data, ensuring compliance with healthcare...SeniorClaimsWork at office
$45.39k - $88.51k
Molina Healthcare in California is seeking a Claims Supervisor to lead the claims activities team. Responsibilities include supervising claims processing, managing team performance, and analyzing claims reports to improve efficiency. Ideal candidates will have over 5 years...SeniorClaims- ...Incorporated is seeking talented individuals to join their Ambient AI team working on transforming healthcare. The role involves building AI solutions from patient visits to claims while contributing to a platform trusted by hundreds of thousands of clinicians. Candidates...SeniorClaims
$80k - $120k
...we’re on a mission to improve the healthcare experience for everyone—starting with... ...decision-making.* Research and develop reports and analysis for senior management; effectively communicate... ...score reporting with Cozeva, internal claims and Power BI, organizing and managing...SeniorClaimsLocal area- ...6 Job Type: Any Required Skills: majeco developer, underwriting, +9 Job Location: USA Remote... ...for select industries like Insurance, Healthcare and Financial Services. Our Headquarters... ...expertise in configuring Policy, Billing, or Claims modules . Key Responsibilities Configure...SeniorClaimsPermanent employmentPart timeRemote work
- At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed... ...revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs....SeniorClaimsImmediate start
$90k - $145k
As an Analyst in our Healthcare and Life Sciences practice, you will serve as a subject matter... ...tools such as Power BI, Tableau, SQL, or comparable platforms used in RCM analytics... ...Cerner, Athenahealth) and clearinghouse/claims data environments. You are familiar with...SeniorClaimsFull timeContract work$21 - $33 per hour
...assistance counselors guide patients through their healthcare financial obligations. Position Summary The Senior Coordinator, Financial Counseling is responsible... ...accounts that may result in patient balance or denied claims. Escalate high-risk accounts to leadership or...SeniorClaimsHourly payTemporary workWork at officeLocal areaImmediate startFlexible hours$100k - $120k
Hispanic Alliance for Career Enhancement is looking for a Sr. Claims Specialist in California to manage complex medical malpractice claims. The ideal candidate will analyze claims, offer resolutions, and maintain high levels of customer service. A Bachelor's degree and...SeniorClaims$243.8k - $304.8k
Senior Director, Clinical and Translational Research Remote, USA Omada Health is on... ...observational cohort studies, economic models, healthcare claims analyses, and real‑world evidence (RWE)... ..., including Sales and Marketing, to develop compelling and evidence‑based value...SeniorClaimsRemote jobLocal areaWork from homeFlexible hours- ...enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At... ...clinical documentation review before submission of chart for claim and diagnoses accuracy. Maintains a general knowledge of diagnoses...SeniorClaimsFull timePart timeWork at officeLocal areaWork from homeHome office
$142k - $213k
A health care organization is seeking a Senior Manager, Operations - Applications & Analytics to lead claims-related services. This role involves overseeing processing, auditing, and improvement initiatives while ensuring compliance and satisfaction. Candidates should...SeniorClaims$95k - $131k
...results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to... ...solutions. Lyra Health is seeking a Senior GTM Enablement Specialist to join our... ...where you will be directly responsible for developing and delivering enablement programs that...SeniorClaimsFull time- One80 Intermediaries Inc. seeks a Senior Claim Data Analyst to lead analytics initiatives across... ..., analyzing claim data for trends, and developing performance monitoring dashboards. The... ...claims analytics, with strong skills in SQL and data visualization tools. A proactive...SeniorClaimsRemote job
$200k
...with measurable evidence supporting those claims. Afternoons are dedicated to deeper... ...Professional-level written communication with senior leaders, high-net-worth clients, or... ...level administrative support. Experience developing or refining enrollment workflows, standard...SeniorClaimsFull timeRemote workRelocationVisa sponsorshipRelocation package$60k
Progressive Insurance is seeking a Claims Specialist in California to investigate intricate large-loss injury claims valued over $60k. In this hybrid role, you will consult with various stakeholders to determine coverage and claims value. Ideal candidates have significant...SeniorClaims- Chumashcareers is seeking a dedicated Risk Manager to oversee the risk management team. This role includes managing insurance and claims, ensuring compliance with regulations, and fostering a safe work environment. Candidates should have a Bachelor's degree and five years...SeniorClaims
- ...challenges. Position Overview The Senior Medical Affairs Specialist in... ...product and marketing claims matrices in the Veeva Promotional... ...and Clinical Affairs to develop new claims for inclusion in product... ...to medical inquiries from healthcare professionals in the U.S., Canada...SeniorClaimsWork at officeRemote workHome office
- ...administrative controls to reduce workers’ compensation loss potential Develop safety and health service plans and perform ongoing... ...strong understanding of experience modification, underwriting, and claims practices Working knowledge of return to work program features...SeniorClaimsWork experience placementFlexible hours
- ...California Joint Powers Authority (JPA), is seeking a Senior Risk Control Specialist to manage PERMA's risk... ...for trend identification, collaborate with claim management teams in the design of loss control programs, develop reports, and provide excellent member service related...SeniorClaimsFull timeRemote work
- A state government agency is seeking a Senior Accounting Officer (Supervisor) to oversee Claims Processing and Benefit Payment Control. This role entails leadership, managing staff, and ensuring the integrity of the Unemployment Insurance Trust Fund. Candidates must have...SeniorClaims
- A leading claims management service provider is seeking a Disability Representative Sr to provide effective case management and make complex claims determinations. The ideal candidate should have a background in disability case management, strong analytical skills, and...SeniorClaims
- CCMSI is seeking a Workers’ Compensation Claim Specialist in Concord, CA. The role involves managing a portfolio of claims, leading investigations, and ensuring timely resolutions. Candidates should have over 5 years of claims handling experience and strong analytical and...SeniorClaims
$90k - $110k
A leading insurance agency in California is seeking a Property & Casualty Claims Analyst. In this role, you will manage the claims process, analyze complex issues, and provide exceptional client support. The ideal candidate has at least 5 years of experience in the Property...SeniorClaims$90k - $115k
A leading insurance firm is seeking a Senior Workers' Compensation Claims Specialist to manage complex claims in Los Angeles. Candidates should have 5-7+ years of experience in claims adjustment, particularly in California, and possess strong negotiation skills. This remote...SeniorClaimsRemote job$135k - $145k
Strategic Comp is looking for a Senior Claims Manager to oversee claims processes in California while working remotely. This role involves managing a team and ensuring proactive resolutions for claims, with responsibilities including team development and oversight of claims...SeniorClaimsRemote job$102k - $140.5k
...twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life‑changing mental... .... About the Role We are seeking an experienced Salesforce Developer to help maintain and enhance our Salesforce instances and processes...SeniorClaimsRemote work$135k - $145k
Summit Consulting is hiring a Senior Claims Manager to oversee a team of claims professionals primarily from home within the Pacific region. This role involves managing daily operations and coaching staff to achieve optimal claims outcomes. The ideal candidate will have...SeniorClaimsRemote job$7,873 - $9,861 per month
...Manager III in Inglewood. This role provides leadership to the UI Center, coordinating and overseeing multiple functions including claims filing and determination. Applicants should possess strong organizational skills, UI program knowledge, and experience in human resource...SeniorClaimsWork at office- LHH is seeking an experienced Workers’ Compensation Claims Specialist for a remote position focused on managing a high-volume desk for California claims, including litigated matters. Ideal candidates will have over 5 years of experience in California workers’ compensation...SeniorClaimsRemote job
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