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Emblemhealth jobs - Edison, NJ

Viewing 1 - 10 of 51 jobs

  • Lead Business Data Analyst

    Emblemhealth - New York, NY

    Execute a variety of complex analytical exercises to provide operations and medical management with actionable, high quality quantitative information that drives effective business decision making, enables interpretation of current, past...

    12 days ago from Money Jobs

  • Hospital Review Analyst

    Emblemhealth - New York, NY

    Summary: Reviews coding data on institutional (hospital) and professional (medical) claims and clinical information on medical records to ensure compliance with American Hospital Association, American Medical Association, Centers For...

    23 days ago from MiracleWorkers.com

  • Sr. Technical Analyst

    Emblemhealth - New York, NY

    Designs and develops computer application solutions to support complex business processes to support Provider Network and Data Management systems. Establishes standards and assigns, directs and coordinates the work of the assigned...

    30+ days ago from Sologig

  • Dir.,Payment Reconciliation

    Emblemhealth - New York, NY

    to end business process of payment reconciliation for all EmblemHealth medical and hospital claims across all legacy platforms. • Develop system and process workflows and controls to address all reconciliation request avenues and all...

    12 days ago from Money Jobs

  • Sr. Rates Specialist

    Emblemhealth - New York, NY

    Summary: Ensure that all facility contracts received are logged, reviewed and loaded accurately in the contracting system (Qcare). Respond accurately and timely to contract configuration inquiries and discrepancies from internal business...

    12 days ago from Money Jobs

  • Credentialing Specialist

    Emblemhealth - New York, NY

    Conduct activities related to initial credentialing, recredentialing, delegation, facility credentialing and ongoing provider file maintenance. Conduct all processes to remain compliant with all applicable regulatory/accreditation agencies...

    15 days ago from Money Jobs

  • Lead Operations Reporting Analyst

    Emblemhealth - New York, NY

    Summary of Position The Lead Operations Reporting Analyst for Special Populations will develop, manage, and monitor a variety of complex analytical and reporting capabilities required to ensure efficient operational execution and to...

    10 days ago from EmblemHealth

  • Grievance & Appeal Specialist

    Emblemhealth - New York, NY

    Responds to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA, CMS, NY State and other regulations. Types of correspondence handled by the individual will include, but is...

    17 days ago from EmblemHealth

  • Dir., Testing

    Emblemhealth - New York, NY

    Summary: Oversees the planning, assists with definition of requirements, testing, implementation, management and improvements of all QCARE applications to process professional and facility claims for the Enterprise. Works with internal...

    26 days ago from EmblemHealth

  • Sr. Actuarial Analyst

    Emblemhealth - New York, NY

    Summary: Provides support in the Actuarial Department for reporting, rate filing, fee schedule analysis, and other actuarial support as needed. Accountabilities: • Collects premium, claims, enrollment, and/or administrative expense data...

    27 days ago from EmblemHealth

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