JouléNewSenior Sourcing Supplier Data Analyst JouléSenior Sourcing Supplier Data AnalystSan Jose, CA$48–$55.61 / hourThis contract role is ideal for a highly analytical procurement professional who thrives in supplier negotiations, cost modeling, RFQs, and cross-functional collaboration while leveraging AI and market insights to drive measurable value. oin a fast-paced, innovation-driven medical technology organization where strategic sourcing and data-driven decision making directly impact cutting-edge products and global operations.
Pinnacle Technical ResourcesNewBI Data Analyst - 142507 Pinnacle Technical ResourcesBI Data Analyst - 142507Sunnyvale, CaliforniaContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. The ideal candidate will have 5+ years of hands-on experience using SQL, Tableau, and Python to deliver data-driven insights, build interactive dashboards, and support business decision-making.
Pinnacle Technical ResourcesBusiness Analyst III Pinnacle Technical ResourcesBusiness Analyst IIISanta Clara,, CaliforniaContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. Successfully placed or hired candidates would only be asked for banking details after accepting an offer from us during our official onboarding processes as part of payroll setup.
Pinnacle Technical ResourcesSAP Business Systems Analyst Quote to Revenue Pinnacle Technical ResourcesSAP Business Systems Analyst Quote to RevenueSanta Clara,, California$80–$85 / hourContractorThe specific compensation for this position will be determined by a number of factors, including the scope, complexity and location of the role as well as the cost of labor in the market; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. The ideal candidate will play a critical role in analyzing, designing, and implementing SAP solutions to optimize business operations and support revenue generation.
Pinnacle Technical ResourcesOPD Product Manager Analyst Pinnacle Technical ResourcesOPD Product Manager AnalystCupertino,, California$55–$60 / hourContractorThe specific compensation for this position will be determined by a number of factors, including the scope, complexity and location of the role as well as the cost of labor in the market; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Successfully placed or hired candidates would only be asked for banking details after accepting an offer from us during our official onboarding processes as part of payroll setup.
Pinnacle Technical ResourcesPrincipal Functional Analyst - OVC Pinnacle Technical ResourcesPrincipal Functional Analyst - OVCIrvine, California$130,000–$150,000 / yearThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. Successfully placed or hired candidates would only be asked for banking details after accepting an offer from us during our official onboarding processes as part of payroll setup.
Ellisor GroupNewQC Operations Analyst Ellisor GroupQC Operations AnalystSan Francisco, CA$80,000–$150,000 / yearClient is re-writing the risk model for the non-QM mortgage market by combining data analytics, proprietary risk intelligence, and Loan Defect Insurance to turn mortgage manufacturing risk into quantifiable, insurable outcomes for lenders, investors, and RMBS issuers. • Coordinate transferring of loan file documentation between sellers and counterparties, requesting, tracking, and preparing documentation packages ahead of QC review and TPR submission.
Ellisor GroupNewMortgage Data Analyst Ellisor GroupMortgage Data AnalystSan Francisco, CA$100,000–$135,000 / yearClient is re-writing the risk model for the non-QM mortgage market -combining data analytics, proprietary risk intelligence, and Loan Defect Insurance to turn mortgage manufacturing risk into quantifiable, insurable outcomes for lenders, investors, and RMBS issuers. The Mortgage / Data Analyst is the person who makes SAI's outputs defensible to the outside world -bridging model outputs and real-world loan performance through surveillance reporting, model validation, and institutional counterparty deliverables.
Solugenix CorpSIU Investigative Analyst III Solugenix CorpSIU Investigative Analyst IIILos Angeles, CA$32.30–$41.99 / hourTemporaryContractorFull timeUses knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability, reimbursement methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources. After making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
USAANewSIU Investigator Intermediate - Field USAASIU Investigator Intermediate - FieldLos Angeles, CA$77,120–$147,390 / yearAs a dedicated SIU Investigator, you will, within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
ROERS COMPANIESNewAsset Manager - LIHTC ROERS COMPANIESAsset Manager - LIHTCPlymouth, CA$102,400–$134,800 / yearMonitor the lease-up process of LIHTC assets in the Roers Companies portfolio, ensuring adherence to proforma and compliance with all applicable regulations (working with the internal compliance team). Work with Capital Planning to create a Capital Plan for the project life cycle, then ensure it is followed or variances in the plan are communicated during budgeting season to leadership.
LanceSoft IncSr. Workers' Compensation Claims Analyst LanceSoft IncSr. Workers' Compensation Claims AnalystLos Angeles, CA$30–$45 / hourWorkers' Compensation Claims Analyst who has extensive experience in complex workers compensation claims handling in accordance with state law and labor code, as provided in the Scope of Services and who can perform duties of a Sr. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship.
Ultimate Staffing ServicesHealth Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerPasadena, California$24–$28 / hourCommunicate professionally with members and providers to resolve inquiries, follow up on pended claims, and complete corrections or adjustments. This position is ideal for someone who enjoys problem‑solving, working with complex benefit plans, and collaborating with both internal teams and external partners.
Kawasaki Motors Corp., U.S.A.Warranty Claims Data Analyst Kawasaki Motors Corp., U.S.A.Warranty Claims Data AnalystFoothill Ranch, CA$75,000–$80,000 / yearPart timeServes as back up to other warranty team members that may include the following tasks: Processes product registrations, customer updates, vehicle status changes, labor rate updates, and KPP extended service contract sales. Acts as a liaison for the Warranty department to consult with the Quality Assurance department and our Consumer Services and Product Support Hotline teams in regards to sharing information on trending warranty issues.
PDS HealthNewAnalyst III, Epic Application Professional Billing and Claims PDS HealthAnalyst III, Epic Application Professional Billing and ClaimsIrvine, California$103,000–$133,000 / yearOwns highly complex projects, such as multi-module implementations or enterprise-wide systems upgrades; leads medium-scale projects, including scoping, design, implementation, testing and go-live support. This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle operations by collaborating with finance, billing, and operational teams.
Sutter HealthEpic Support Analyst III, Resolute HB PB Claims and Remittance Sutter HealthEpic Support Analyst III, Resolute HB PB Claims and RemittanceSacramento, CA$45.60–$68.40 / hourTotal compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Ensures timely resolution of problems, ensures customers are informed of unresolved issues, and engages other analysts directly to resolve challenging issues.
University of California, IrvinePharmacy Claims Analyst - Pharmacy Admin - FT Day Shift University of California, IrvinePharmacy Claims Analyst - Pharmacy Admin - FT Day ShiftOrange, CaliforniaListed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
University of CaliforniaPharmacy Claims Analyst - Pharmacy Admin - FT Day Shift University of CaliforniaPharmacy Claims Analyst - Pharmacy Admin - FT Day ShiftIrvine, CA2025 University of California, Irvine, UCI Health, and UC Regents. Sign-up to be notified of hiring events, newly posted job opportunities, and much more.
Blue Ribbon Global TechnologiesNewEpic Application Analyst - Tapestry Claims Blue Ribbon Global TechnologiesEpic Application Analyst - Tapestry ClaimsLos Angeles, CAStrong interpersonal skills, with the ability to effectively train, support, and work collaboratively with business owners, team members, and management. Strong written and verbal communications skills, with the ability to convey technical information to all levels of application users in a specific, clear, and concise manner.
MedPOINT ManagementClaims Reporting Coordinator MedPOINT ManagementClaims Reporting CoordinatorSherman Oaks, CAThe reporting coordinator is responsible for ensuring accurate, timely, and efficient reporting and input of data related to all claim functions. · Prepares universe reports for health plan audits, Monthly Timeliness Reports, Medicare reporting and other Health Plan or regulatory requests.
Computer Task Group, IncEpic PB Claims Computer Task Group, IncEpic PB ClaimsSan Mateo, California$75–$85 / hourDescription: CTG is seeking a certified Epic Professional Billing (PB) Claims Build Analyst with 3+ years of hands-on build experience to support the design, configuration, and optimization of Epic billing and claims workflows. About Us: CTG, a Cegeka company, delivers IT and business solutions that enhance clients’ digital agility, empowering them to seize new opportunities and overcome any challenge.
bdo consultingDirector, Forensics - Building Property Claims Recovery bdo consultingDirector, Forensics - Building Property Claims RecoveryLos Angeles, CA$190,000–$269,000 / yearDocuments, reviews, and analyzes schedules, contracts, change orders, correspondence, daily reports, meeting minutes, monthly reports, and any additional documents related to the project/file . The annual allocation to the ESOP is fully funded by BDO through investments in company stock and grants employees the chance to grow their wealth over time as their shares vest and grow in value with the firm’s success, with no employee contributions.
County of RiversideVictim/Witness Claims Technician County of RiversideVictim/Witness Claims TechnicianRiverside, CAFull timeAbility to: Accurately gather, record, and evaluate data necessary for determining Restitution Fund benefits; review police reports and medical reports to extract pertinent information; learn, interpret, and apply policies and regulations of the State Board of Control Restitution Fund; organize work and maintain systematic, detailed, and accurate records; make basic arithmetical computations; identify problems requiring referral to other department staff; maintain effective working relationships with others. Experience: Three years of clerical experience which must have included either (1) At least one year in a medical setting which involved working with medical terminology (completion of 6 semester or 9 quarter units of coursework in medical terminology may be substituted for six months of the required specialized experience in a medical setting); * Proof of education must be uploaded with application, if using for consideration.
CollectiveHealth IncLead Full Stack Software Engineer, Claims CollectiveHealth IncLead Full Stack Software Engineer, ClaimsSan Francisco, CA$168,000–$210,000 / yearTeam Collaboration: Work closely with cross-functional teams, including developers, and product managers, to gather requirements and ensure solutions meet business needs. Lead full-stack development and support of services across backend (Java/Spring Cloud), integration platforms (Kafka, Mulesoft), and frontend (React/Angular/GraphQL etc.).
Ultimate Staffing ServicesNewSr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
Crystal StairsClaims Processor Crystal StairsClaims ProcessorLos Angeles, CAThe Claims Processor will provide excellent client service by accurately processing provider claims in a timely manner while adhering to the contractual requirements of the California Department of Education and LA County Department of Public Social Services as well as Crystal Stairs, Inc. policies and procedures. An AA/AS Degree in Accounting, Business, or Human Services preferred/or a minimum of two years of verifiable college coursework with a focus on accounting or business; verifiable work experience may be substituted for college level education.
Zenith American SolutionsCustomer Service Claims Processor Zenith American SolutionsCustomer Service Claims ProcessorSan Francisco, CAFull timeThe Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Alura Workforce SolutionsClaims Processor I Alura Workforce SolutionsClaims Processor IRancho Cucamonga, CAREQUIREMENTSTwo (2) years of experience as a Data Entry Processor Data Entry Processor experience preferably in an HMO or Managed Care setting. This includes validating member coverage, clearing system edits and categorizing a claim type to ensure the claim routes to the appropriate workgroup for adjudication.
Carmona's Appliance CenterWARRANTY CLAIMS PROCESSOR Carmona's Appliance CenterWARRANTY CLAIMS PROCESSORRedding, CAWe are seeking a detail-oriented Warranty Claims Processor which is responsible for the successful submission of warranty claims to include pre-approval, proof of purchase, extended warranty, and any documentation for successful claims. · Prolonged Sitting: This role involves extensive periods of sitting at a desk and working on a computer (up to 8 hours).
Kaiser PermanenteNewOHS Claims Processor I (Bilingual) Kaiser PermanenteOHS Claims Processor I (Bilingual)Los Angeles, CAOrdering and photocopying medical records; temporarily cover other desk/functions due to vacation and workload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills in the required KP computerized systems, provides personalized and professional patient/employer/carrier services. Promotes, ensures and improves customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.
Impresiv HealthSenior Test / QA Analyst Impresiv HealthSenior Test / QA AnalystHuntington Beach, CARemoteThe ideal candidate is highly analytical, detail-oriented, and experienced leading testing efforts across complex payer environments involving medical, pharmacy, and dental/vision claims. Perform testing and validation of HIPAA-compliant EDI transaction sets including 837, 835, 270/271, 276/277, and 834 transactions.
Partnership HealthPlan of CaliforniaSenior Health Data Analyst I Partnership HealthPlan of CaliforniaSenior Health Data Analyst IFairfield, California$103,059.95–$133,977.94 / yearThe job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. Maintains in-depth knowledge of health plan operations, including claims processing, utilization management, quality improvement activities and pay for performance programs.
Ampcus IncorporatedApplication Analyst CareConnect, Tapestry Ampcus IncorporatedApplication Analyst CareConnect, TapestryLos Angeles, CA$88.79–$93.79 / hourThe Tapestry Application Analyst supports Medicare Advantage Operations by managing and maintaining Tapestry system configuration related to claims processing, provider contracts, fee schedules, pricing, authorizations, responsibility mapping, and regulatory business rules. This role works closely with configuration leadership, IS teams, operational departments, and external vendors to ensure compliant and accurate system functionality aligned with CMS and California regulatory requirements.
AxelonNewApplication Analyst AxelonApplication AnalystLos Angeles, CARemote$70–$90 / hourAs an integral member of the Medicare Advantage Operations team, the Tapestry Application Analyst plays a critical role in supporting the implementation and execution of organizational strategies related to Tapestry functionality-- including, but not limited to, AP claim life cycle, provider contracts, Optum PPS Pricing, fee schedules, responsibility mapping, authorization requirements, and overall configuration. The Tapestry Application Analyst will partner with the internal IS team, other operational department teams, and external vendors, as appropriate, to ensure the operational areas are configured in adherence with ***s contract provisions as well as all CMS and California regulatory requirements.
Axelon Services CorporationApplication Analyst Axelon Services CorporationApplication AnalystLos Angeles, CARemote$70–$90 / hourAs an integral member of the Medicare Advantage Operations team, the Tapestry Application Analyst plays a critical role in supporting the implementation and execution of organizational strategies related to Tapestry functionality-- including, but not limited to, AP claim life cycle, provider contracts, Optum PPS Pricing, fee schedules, responsibility mapping, authorization requirements, and overall configuration. The Tapestry Application Analyst will partner with the internal IS team, other operational department teams, and external vendors, as appropriate, to ensure the operational areas are configured in adherence with *** s contract provisions as well as all CMS and California regulatory requirements.
University of CaliforniaEnterprise Risk Management Analyst - Davis, CA, Job ID 83947 University of CaliforniaEnterprise Risk Management Analyst - Davis, CA, Job ID 83947Davis, CA$25.43–$34.20 / hourMisconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. Internal Candidates*: To apply as an internal UC ANR employee, please go to: https://ucphrprdpub.universityofcalifornia.edu/psp/ucphrprd/EMPLOYEE/HRMS/c/HRS_HRAM_EMP_FL.HRS_CG_SEARCH_FL?Page=HRS_APP_JBPST_FL&Action=U&FOCUS=Employee&SiteId=18&JobOpeningId=83947&PostingSeq=1.
CenCal HealthNewSenior Financial Analyst - Provider Contracts CenCal HealthSenior Financial Analyst - Provider ContractsSanta Barbara, CA$120,970–$181,455 / yearThis role utilizes advanced SQL, claims data analysis and financial modeling techniques to assess the financial impact of provider contracts including fee for service, capitation, and value based arrangements, while ensuring alignment with state regulatory requirements, quality initiatives, and organizational affordability objectives. Serving as a subject matter expert in provider reimbursement and value based payment analytics, this position supports data driven contracting, negotiation, and provider performance strategies through close collaboration with Provider Contracting, Provider Relations, Quality, and IT/Data Analytics departments.
Inland Empire Health PlanProduct Configuration Quality Analyst Inland Empire Health PlanProduct Configuration Quality AnalystRancho Cucamonga, California$80,059.20–$106,059.20 / yearBachelor’s degree in IT or Business from an accredited institution requiredIn lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position: one (1) year of general healthcare experience plus three (3) years of claims analysis experience is required. The Product Configuration Quality Analyst utilizes quality auditing tools, identifies trainings needs, and collaborates on effective and efficient methods for accurate and quality system configuration.
US Tech Solutions, Inc.Non-Clinical - Information Technology/Application Analyst- #26-12121 US Tech Solutions, Inc.Non-Clinical - Information Technology/Application Analyst- #26-12121Los Angeles, CA 90024, CA$70–$80 / hourAs an integral member of the Medicare Advantage Operations team, the Tapestry Application Analyst plays a critical role in supporting the implementation and execution of organizational strategies related to Tapestry functionality-- including, but not limited to, AP claim life cycle, provider contracts, Optum PPS Pricing, fee schedules, responsibility mapping, authorization requirements, and overall configuration. The Tapestry Application Analyst will partner with the internal IS team, other operational department teams, and external vendors, as appropriate, to ensure the operational areas are configured in adherence with contract provisions as well as all CMS and California regulatory requirements.
HJ StaffingNewSenior Test / QA Analyst HJ StaffingSenior Test / QA AnalystHuntington Beach, CARemoteEDI & Transaction Testing: Perform robust testing and validation of HIPAA-compliant EDI transaction sets including 837P/837I, 835, 270/271, 276/277, and 834 transactions. The ideal candidate is highly analytical, detail-oriented, and has a proven track record of leading testing efforts across complex payer environments involving medical, pharmacy, and dental/vision claims.
CSAA Insurance GroupNewCommercial Insurance Analyst - Remote CSAA Insurance GroupCommercial Insurance Analyst - RemoteHome Teleworkers, CARemote$110,700–$123,000 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers, Nebraska - Home Teleworkers {+ 20 more}. Pursuit or completion of industry-relevant continuing education, including graduate degrees, MBS, risk and insurance designations from The Institutes (AINS, AIC, ARM, CPCU, etc.), or actuarial exams and designations (ACAS, FCAS, CERA).
The Intersect GroupSIU Investigative Analyst III (ATL) The Intersect GroupSIU Investigative Analyst III (ATL)Los Angeles, CARemote$32–$41.99 / hourYou will act as a subject matter expert, overseeing reporting processes, analyzing fraud patterns, and collaborating with internal teams and regulatory agencies to strengthen program integrity. Our client supports large scale public healthcare programs and emphasizes compliance, accountability, and innovation to protect critical resources.
Integrated Resources, IncReal World Evidence (RWE) Analyst Integrated Resources, IncReal World Evidence (RWE) AnalystSanta Monica, CA$81–$86.33 / hourJob Description: The RWE Analyst will contribute to the Client Real-World Evidence/Health Economic Outcomes Research (RWE/HEOR) Team as part of an effort to contribute to the strategies of the broader Client Evidence Generation Team, which will include the conduct of timely, relevant, and rigorous analysis of real-world data (RWD) to address critical research questions and contribute to cross-functional initiatives. The RWE Analyst will be responsible for developing, reviewing, and providing feedback on study documents, such as protocols and statistical analysis plans, and executing planned data analyses using administrative claims, electronic health record (EHR), and observational registry databases.
North East Medical ServiceEPIC APPLICATION ANALYST - MSO North East Medical ServiceEPIC APPLICATION ANALYST - MSOBurlingame, CACollaboration and Communication: • Collaborate with cross-functional teams, including Claims, Utilization Management (UM), Provider Network Operation (PNO), Case Management (CM), Eligibility and Capitation management, EDI transmission, VBC administrators, and IT professionals. This position involves working closely with end-users, IT teams, and other stakeholders to ensure the effective use of Epic Tapestry software to enhance the medical management workflow efficiency in managed care business operation.
Quinn CompanyParts Inventory Analyst Quinn CompanyParts Inventory AnalystCity of Industry, California$20.59–$22 / hourProcess Vendor Orders: Handle miscellaneous vendor orders, follow up with stores and customers on order issues, and resolve emergency order exceptions quickly and accurately. Review & Adjust Demand Reporting: Analyze Unadjusted Demand and Daily Returns reports; adjust demand history and submit return requests to CAT as needed.
PeopleNTech LLCTapestry UM Analyst PeopleNTech LLCTapestry UM AnalystSanta Clara, CAConfigure and optimize Tapestry UM workflows for prior authorizations (e.g., medical, behavioral health, pharmacy-to-medical crossovers) and referrals (in- and out-of-network), including routing rules, WQs, templates, smart text, decision trees, and notification logic. You will partner with UM leadership, clinical reviewers, provider relations, care management, claims, and integration teams to enable compliant, efficient, and transparent UM determinations that reduce administrative burden and improve member and provider experience.
The Fountain Group LLCSr. Analyst - III* The Fountain Group LLCSr. Analyst - III*Tampa, CARemotePhD, MD, ScD, PharmD, or related doctoral degree in Epidemiology, Outcomes Research, Biostatistics, Medicine, or similar field with 8+ years of relevant experience; OR Master’s degree with 10+ years of relevant experience. Strong expertise in observational study design, causal inference, real-world data sources (claims, EHR, registries), bias/confounding, and sensitivity analyses.
Net2SourceReal World Evidence (RWE) Analyst Net2SourceReal World Evidence (RWE) AnalystSanta Monica, CARemote$85–$86.33 / hourThe RWE Analyst will contribute to the Kite Real-World Evidence/Health Economic Outcomes Research (RWE/HEOR) Team as part of an effort to contribute to the strategies of the broader Kite Evidence Generation Team, which will include the conduct of timely, relevant, and rigorous analysis of real-world data (RWD) to address critical research questions and contribute to cross-functional initiatives. The RWE Analyst will be responsible for developing, reviewing, and providing feedback on study documents, such as protocols and statistical analysis plans, and executing planned data analyses using administrative claims, electronic health record (EHR), and observational registry databases.
ICONMA, LLCContractor - Real World Evidence (RWE) Analyst ICONMA, LLCContractor - Real World Evidence (RWE) AnalystSanta Monica, CA$81.33–$86.33 / hourResponsibilities:The RWE Analyst will contribute to the Kite Real-World Evidence/Health Economic Outcomes Research (RWE/HEOR) Team as part of an effort to contribute to the strategies of the broader Kite Evidence Generation Team, which will include the conduct of timely, relevant, and rigorous analysis of real-world data (RWD) to address critical research questions and contribute to cross-functional initiatives. The RWE Analyst will be responsible for developing, reviewing, and providing feedback on study documents, such as protocols and statistical analysis plans, and executing planned data analyses using administrative claims, electronic health record (EHR), and observational registry databases.
Shiftcode Analytics, IncEpic Application Analyst Shiftcode Analytics, IncEpic Application AnalystOakland, CADeveloping an understanding of operational needs to set the direction for the organization's workflows by attending site visits and other integrated sessions. Holding weekly communications with team members to discuss the status of deliverables, shared issues, end user concerns, budget, and upcoming milestones.