132 program analyst jobs found

Overview Navitus Health Solutions is seeking an Analyst, Tech. Operations Government Programs to join our team!   The Analyst, Tech. Operations Government Programs has responsibility for executing Government Programs processes accurately, efficiently, and in compliance with CMS regulations.   This role is located out of our Appleton, WI Office   Is this you? Find out more below! Responsibilities How do I make an impact on my team?   Assignments may include one or more of the following: Employer Group Waiver Plan (EGWP) enrollment administration and oversight, Retro-eligibility processes, Financial Information Reporting (FIR), Plan Finder Submission, Coordination of Benefits (COB), Reject Management, Prescription Drug Event (PDE) error management and reconciliation, Medicaid Encounter Data, Affordable Care Act (ACA) Claims Submission, Explanation of Benefits (EOB), Retiree Drug Subsidy (RDS), and Claim Auditing Oversee the schedules for the processes assigned,...

Overview Due to growth, we are adding a Analyst, Pharmacy Contract Audit to our team!   The Analyst, Pharmacy Contract Audit is responsible for the oversight of Navitus’ contractual pharmacy network reimbursement accuracy. The individual in this position is expected to make independent assessments to confirm Navitus is conforming to contractual reimbursement obligations contained in Retail, Specialty, and Mail Order pharmacy agreements. The Analyst will continually review and monitor claims data, create, and update procedures, audit networks for price change accuracy, monitor compliance with Navitus pharmacy provider contracts, communicate findings, and work with applicable teams to remediate errors. The Analyst works closely with inter and intra-departmental resources to interpret and understand contractual terms, client network selections, and how they are operationalized in applicable systems. The Analyst will be knowledgeable of business operations, utilizing...

Overview Navitus Health Solutions is seeking a Reimbursement Analyst, Pharmacy Network to join our team!   The Analyst supports and evaluates agreements with providers and the Maximum Allowable Cost (MAC) program through financial price modeling, analysis, and reporting. This position will communicate and work cross functionally with other teams on generic trends and generic drug discount change effects. Provider and network performance will be analyzed in support of network development, contracting negotiations, and RFP proposals.  The Analyst, under the direction and supervision of the Provider Services leadership, is responsible for maintaining a competitive and market leading MAC program. The Analyst will also be responsible for managing and responding to pharmacy pricing inquiries in compliance with Navitus response protocol. This position will help monitor and evaluate state MAC requirements to ensure Navitus remains compliant with MAC management and inquiry. The...

Overview Due to growth, we are adding an Analyst, Contract Operations to our team .   This role is ideal for a data-driven professional with experience in pharmacy benefit management (PBM), managed care, pharmaceutical contracting, or healthcare analytics. A successful candidate will possess strong analytical skills, a solid understanding of pharmacy claims and manufacturer contracting, and the ability to translate complex data into actionable business insights.   The PBM Contract & Rebate Analyst supports the administration and optimization of Lumicera's pharmaceutical manufacturer discount and contracting programs. They are responsible for operational aspects of Lumicera’s discount programs including, but not limited to contract compliance through direct pharmaceutical manufacturers, third party entities, contract optimization, contract reconciliation and reporting, sales and request for proposal (RFP) support, internal and external audit support, and client...

Overview Lumicera Health Services is seeking a Supervisor, Pharmacy Quality to join our team!    The Supervisor, Pharmacy Quality, is responsible for managing the effectiveness of the Specialty Pharmacy Quality Management Program. The Supervisor, Pharmacy Quality identifies, assigns, and supervises the work of the quality analysts and will monitor the performance of the Quality team and individual analysts to make improvements where necessary. The Supervisor, Pharmacy Quality will oversee the evaluations performed by the analysts and collaborate to create improvement plans for agents. The Supervisor, Pharmacy Quality will be responsible for creating project plans for improvements and seeing them through to resolution including reports that support the improvement and outcome-based evaluations after improvements occur.   Is this you? Find out more below! Responsibilities How do I make an impact on my team?   Recommend quality metrics for the specialty...

Overview Navitus Health Solutions is seeking a Analyst, IT Governance to join our team!   The Analyst, IT Governance is responsible for developing and maintaining IT policies, procedures, guidelines, and standards in alignment with ITIL best practices. This role will work directly with application developers, business users, internal IT, and third-party vendors to improve performance, processes, and the overall health of the data. This role will participate in the planning and implementation of policies and procedures to ensure the systems are running optimal and processes are consistent with company goals, industry best practices and regulatory requirements.   Is this you? Find out more below! Responsibilities How do I make an impact on my team? Ensure all environments are managed and maintained to meet service level agreements. Evaluate effectiveness of IT controls to ensure they adequately mitigate risks and comply with requirements. This includes controls...

Description: Employment Type: Full-Time, Hybrid #LI-HYBRID Comprehensive Benefits Package We're committed to supporting your well-being and work-life balance through a robust benefits offering: Health & Wellness Medical, dental, and vision insurance to keep you and your family healthy. Financial Peace of Mind 401(k) with company match, life insurance, and disability coverage. Time Off Generous paid time off (PTO), holidays, and parental leave. Professional Growth Learning and development programs, plus tuition reimbursement to support your career journey. Additional Perks Free Telemedicine Employee Assistance Program (EAP) Wellness initiatives Paid Community Action Volunteer Hours *Parental Leave and Tuition Reimbursement are available after 1 year of service. What you should know about the role This position is accountable for evaluating the financial statements and condition of commercial loan members applying for credit....

Description: Employment Type: Full-Time, Hybrid #LI-HYBRID Comprehensive Benefits Package We're committed to supporting your well-being and work-life balance through a robust benefits offering: Health & Wellness Medical, dental, and vision insurance to keep you and your family healthy. Financial Peace of Mind 401(k) with company match, life insurance, and disability coverage. Time Off Generous paid time off (PTO), holidays, and parental leave. Professional Growth Learning and development programs, plus tuition reimbursement to support your career journey. Additional Perks Free Telemedicine Employee Assistance Program (EAP) Wellness initiatives Paid Community Action Volunteer Hours *Parental Leave and Tuition Reimbursement are available after 1 year of service. What you should know about the role This position is accountable for evaluating the financial statements and condition of commercial loan members applying for credit....

Description: Employment Type: Full-Time, Hybrid #LI-HYBRID Comprehensive Benefits Package We're committed to supporting your well-being and work-life balance through a robust benefits offering: Health & Wellness Medical, dental, and vision insurance to keep you and your family healthy. Financial Peace of Mind 401(k) with company match, life insurance, and disability coverage. Time Off Generous paid time off (PTO), holidays, and parental leave. Professional Growth Learning and development programs, plus tuition reimbursement to support your career journey. Additional Perks Free Telemedicine Employee Assistance Program (EAP) Wellness initiatives Paid Community Action Volunteer Hours *Parental Leave and Tuition Reimbursement are available after 1 year of service. What you should know about the role This position is accountable for evaluating the financial statements and condition of commercial loan members applying for credit....

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession:  Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas:  Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Job Description At Walmart, we're seeking a dynamic and experienced Licensed Manager/ Electrical in Facilities Maintenance Operations, to oversee the predictive and preventative maintenance of our facilities within a regional area. In this role, you'll lead a team of dedicated technicians, ensuring our buildings operate efficiently and sustainably while providing a safe and comfortable environment for our associates and customers. Compensation : $5,000 Sing On Bonus! Salary range: $90,000 - $180,000 Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, geographic location, level of job offer, qualifications, and other job-related factors. Eligible for bonus incentives Benefits & Perks: Beyond competitive pay, you can receive incentive awards for your performance. Other great perks include 401(k) match, stock purchase plan, paid maternity and parental leave, PTO, multiple...

Job Description Job Title: AI/ML Software Engineer, Fairbanks Morse Technology Reports To: Electrical and Controls Engineering Manager Location: Beloit, WI (full-time, on-site) Summary Fairbanks Morse Technology's goal is to create secure, mission-driven, advanced, and reliable technology solutions through artificial intelligence, digital technology, smart engineering solutions, automation, and Advanced IoT Solutions. FMT is looking for an AI/ML Software Engineer to design and build complete software products from customer requirements. This is a developer role for someone who can gather and write down what the customer needs, then build the full application that meets it, and who designs it so it can be reused and expanded to other equipment, customers, and use cases. This rolls will focus is applying AI/ML to predictive maintenance, root cause analysis, and driving action to fix the problem automatically, starting with U.S. Navy shipboard equipment. We are looking for...

Job Summary Oversee and manage the planning, organizing and productivity projects from conceptual stages through production cycles. Investigate current operations practices and scope, develop and implement changes that will improve operational productivity. Modify existing product designs, improve production techniques and develop test procedures. Job Description MAJOR RESPONSIBILITIES: Manage complex assignments to develop new and/or enhanced operating procedures, troubleshoot technical issues and minimize impact to daily operations. Drive new process and procedure development and/or enhancements of existing processes and procedures. Partner with management to determine engineering feasibility, cost effectiveness and demand for new and existing products. Partner with business leaders to identify opportunities, investigate practices, and develop and implement process improvements that will improve operational productivity. Manage project budgets, job estimates, and...

Mechanical/Hardware Engineer This role has been designed as ''Onsite' with an expectation that you will primarily work from an HPE office. Who We Are: Hewlett Packard Enterprise is the global edge-to-cloud company advancing the way people live and work. We help companies connect, protect, analyze, and act on their data and applications wherever they live, from edge to cloud, so they can turn insights into outcomes at the speed required to thrive in today's complex world. Our culture thrives on finding new and better ways to accelerate what's next. We know varied backgrounds are valued and succeed here. We have the flexibility to manage our work and personal needs. We make bold moves, together, and are a force for good. If you are looking to stretch and grow your career our culture will embrace you. Open up opportunities with HPE. Job Description: Job Family Definition: Designs, analyzes, develops, modifies and evaluates materials, mechanical systems, equipment and...

Graduate Electrical Hdwr Engineer I This role has been designed as 'Hybrid' with a requirement that you will work on average 2 days per week from an HPE office. Who We Are: Hewlett Packard Enterprise is the global edge-to-cloud company advancing the way people live and work. We help companies connect, protect, analyze, and act on their data and applications wherever they live, from edge to cloud, so they can turn insights into outcomes at the speed required to thrive in today's complex world. Our culture thrives on finding new and better ways to accelerate what's next. We know varied backgrounds are valued and succeed here. We have the flexibility to manage our work and personal needs. We make bold moves, together, and are a force for good. If you are looking to stretch and grow your career our culture will embrace you. Open up opportunities with HPE. Job Description: Job Family Definition: Designs, analyzes, develops, modifies and evaluates electrical/electronic parts,...

Electrical Hardware Engineering Intern This role has been designed as 'Hybrid' with a requirement that you will work on average 2 days per week from an HPE office. Who We Are: Hewlett Packard Enterprise is the global edge-to-cloud company advancing the way people live and work. We help companies connect, protect, analyze, and act on their data and applications wherever they live, from edge to cloud, so they can turn insights into outcomes at the speed required to thrive in today's complex world. Our culture thrives on finding new and better ways to accelerate what's next. We know varied backgrounds are valued and succeed here. We have the flexibility to manage our work and personal needs. We make bold moves, together, and are a force for good. If you are looking to stretch and grow your career our culture will embrace you. Open up opportunities with HPE. Job Description: Job Family Definition: Students or recent graduates of college, university, or other accredited...

Foods you love. Brands you trust. And a career that empowers you to grow.    At Nestlé USA, we’re all working towards the same goal – to delight and deliver for our consumers. With a rich portfolio of beloved brands, including DiGiorno, Toll House, and Coffee mate, in 97% of U.S. households, we have a unique opportunity – and responsibility – to be there for every moment in our consumers’ lives.   Joining Nestlé means becoming part of an inclusive workplace that inspires innovation, encourages strategic thinking and creativity, and celebrates your achievements. No matter where you work within the organization, you are empowered to challenge the status quo, embrace risk-taking, and pioneer new ideas. Our supportive and collaborative environment encourages bold ambitions and continuous learning so that everyone can grow and thrive.   This position is not eligible for Visa Sponsorship.     The Safety Health & Environmental Specialist promotes excellence in Safety, Health,...

Careers With Purpose Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Facility: Marsh Med Ctr Minocqua Location: Minocqua, WI Address: 9576 WI-70, Minocqua, WI 54548, USA Shift: 12 Hours - Night Shifts Job Schedule: Full time Weekly Hours: 36.00 Salary Range: 31.50 - 44.00 Pay Info: This position may be eligible for a sign on bonus up to $20,000! Job Summary The scope of work for a respiratory therapist includes assessment, therapeutic intervention and education for patients with cardiopulmonary disorders and/or sleep disorders or associated complications. Respiratory therapists assess individuals to prevent, detect, monitor and manage disease and complications. Respiratory therapists provide therapeutic interventions to directly impact cardiopulmonary health as well as overall health status...

Careers With Purpose Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Facility: Marsh Med Ctr Weston Location: Weston, WI Address: 3400 Ministry Pkwy, Weston, WI 54476, USA Shift: Varies Job Schedule: Full time Weekly Hours: 36.00 Salary Range: 31.50 - 44.00 Pay Info: This position may be eligible for a sign on bonus up to $20,000! Job Summary The scope of work for a respiratory therapist includes assessment, therapeutic intervention and education for patients with cardiopulmonary disorders and/or sleep disorders or associated complications. Respiratory therapists assess individuals to prevent, detect, monitor and manage disease and complications. Respiratory therapists provide therapeutic interventions to directly impact cardiopulmonary health as well as overall health status according to...

Department: 10184 Advocate Aurora Health Corporate - WI Division Leadership Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Typically, Monday through Friday days, may have off hours as needed Pay Range: $75.40 - $120.65 Major Responsibilities: Lead strategic initiatives team focused on aligning stakeholders, developing actionable roadmaps, designing solutions, resourcing, and executing key strategic initiatives.   Drive execution of strategic initiatives by conducting assessments, translating strategic concepts into designs, prototyping models, and recommending opportunities for scaling.   Partner with leaders in setting priorities, developing action plans, and setting up appropriate project management systems for execution.   Conduct comprehensive strategic assessments, create...