UNKNOWN

FEED

Uses regular judgement and discretion to collaborate with customers to understand data, reporting, and analytical capability needs, gather project and data specifications, create data sets, operational reports, and analytical deliverables to translate high-level business data needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities), analyze data to determine business problems, trends, or opportunities for process improvements, create/execute test cases, provide root cause analysis and corrective action plan, verify delivery of customer data needs, and ensure quality delivery. Collaborate effectively with cross-functional teams, leveraging diverse data skills and perspectives to proactively identify and address data-related challenges across project phases, driving data-driven insights and solutions to ensure successful project delivery.

Highmark provides millions of people with the security of quality health insurance
Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.
Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.
Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

Highmark Inc

Solutions Analyst - Medicaid Operations Reporting

Apply a broad knowledge of concepts and principles to develop analytical frameworks, approach and methodology best practices to analyze complex strategy issues, often applying ingenuity and originality to develop unique solutions. Under the guidance of Strategy Consultants and Leadership, participate in & lead small to medium sized strategy projects/ work streams with the help of internal or external strategy consulting resources.

Associate Strategy Analyst - Member Satisfaction

Collaborate with Clinical Strategy Consultants, Health Management Strategy Consultants, Client Managers and other internal departments to prepare data analyses and deliverables that represent clinical management strategies and clinical capabilities to existing clients and potential clients. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Clinical Strategy Analyst

Provide assistance and, depending on skill and experience, lead with interpretation of raw data, statistical results or otherwise compiled information, identify follow-up action items and prepare or assist in the preparation of written reports and/or oral presentation of findings to internal and external audiences, customer managers, clinical staff, compliance agencies, group accounts, providers, agent plans, and brokers. Performs modeling of data sources and flows, works with data management staff to define an operational framework that will define, develop and implement policies and security frameworks to ensure precise and secure delivery of knowledge and information.

Lead Decision Support Analyst

FULL_TIME

Qualifications: A Bachelor’s degree with a concentration in Criminal Justice, Security and Intelligence, or a Business-related field is preferred, equivalent years of related experience in lieu of a degree or a combination of education/experience will be considered. Minimum of 5 years of experience conducting analysis aligned with the intelligence cycle, including planning, collection, organization, analysis, reporting, and feedback integration, or at least 5 years of substantial criminal investigative experience.

ViaPath Technologies

Senior Criminal Intelligence Analyst

[AW]-iCims

In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Corrects issues, conducts routine maintenance, updates systems with new functionality to meet the end user"s needs, and implements new technologies.

Epic ClinDoc Systems Analyst

In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Provide daily oversight of credentialing delegates to ensure that the delegated entities meet all NCQA, DPW, and DOH, policies and procedures related to GHP's delegated program.

Credential Delegation Analyst

Responsible for the necessary calculations, including (but not limited to) current calculations, deferred calculation roll forwards, effective tax rate reconciliations, tax account roll forwards, uncertain tax positions, etc., supporting the tax provisions (monthly/quarterly/year-end) for which detailed work papers and documentation are maintained to back-up such calculations. Responsible for researching various legislation summaries, tax journals and tax-related publications, as well as on-line databases, and provide pertinent information to impacted areas/parties.

Senior Tax Analyst

In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Bachelor's degree in finance, accounting, business administration, economics, statistics, or related field (OR) 6 years of related and progressive experience in lieu of Bachelor"s degree.

Senior Finance Operations Analyst

Epic Orders Systems Analyst

The ERM team is responsible for coordinating and supporting internal and external audits and risk assessments, management and oversight of the disaster recovery and business continuity programs, access certification and incident triage and response. The role will directly support program execution, work collaboratively with leaders at all levels to ensure a clear view of risks, effective performance of key controls, and that any opportunities for improvement are documented, prioritized and tracked to completion.

Ascensus LLC

Risk Analyst

Primary responsibilities include providing correction services to Ascensus and FuturePlan clients through IRS and DOL correction programs, completing Microsoft Excel calculations for clients, audit and deliver correction packets for clients, providing in-house and external consulting to clients, technical research, analysis and special projects as assigned. Experience, Skills, Knowledge Requirements - Special Consideration given for Microsoft Excel proficiencies, knowledge with core code logic and system architecture for BOT tool creations and enhancements (e.g., tool to run DOL calculator instead of manual entry), and knowledge of both Ascensus and FuturePlan internal tools and programs (e.g., ARK, Salesforce, AXIS).

ERISA Analyst

Responsible for ensuring departmental desk-level procedures, risk assessment methodology, assessment procedures, questionnaires, training, etc. are updated periodically and is accountable for monitoring compliance with departmental metrics, internal control activities, contractual obligations, regulatory requirements, and responding to customer inquiries / audits. The incumbent will partner with the organizational risk and business partners, the technology organization, and global delivery teams to meet Highmark Health's mission requirements in a manner consistent with the enterprise risk appetite.

Lead Risk and Compliance Analyst

Coordinate with impacted departments to identify necessary changes to policies, procedures, processes, and technology based on the identification of legislative, regulatory, sub-regulatory, and licensing / accreditation requirements from the Regulatory Guidance team; Translate and communicate compliance requirements into business and technical requirements for impacted stakeholders and systems. This job is responsible for leading large projects and initiatives related to the risk case management and intake activities of Highmark Health in support of a broad range of frameworks and oversight bodies including NIST, HITRUST, PCI, HIPAA, SOC, MAR, CMS, JCAHO, NCQA, the BCBSA, etc.

Senior Regulatory Implementation and Assurance Analyst

Qualifications: A Bachelor’s Degree with a concentration in Criminal Justice, Security and Intelligence, or a Business-related field is preferred, equivalent years of related experience in lieu of a degree or a combination of education/experience will be considered. Minimum of 2 years of experience conducting analysis aligned with the intelligence cycle, including planning, collection, organization, analysis, reporting, and feedback integration, or at least two years of substantial criminal investigative experience.

Criminal Intelligence Analyst

Participate in Highmark's Actuarial Executive Development Program and is expected to make continued progress towards actuarial credential and apply actuarial techniques and statistical analysis to several functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Senior Actuarial Analyst

In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. This job directs all phases of insurance product-related projects, providing subject matter expertise and consultation, while ensuring robust regulatory compliance and adherence to internal policies across all aspects of product management.

Lead Product Analyst - Ancillary Products

Working closely with business stakeholders, product teams, and technology partners, you will help drive data quality, reporting, and analytics initiatives that enhance operational effectiveness and business outcomes. Backed by over 25 years of experience and approximately $7.0 trillion in platform assets, Envestnet is trusted by over one third of financial advisors across leading banks, wealth managers, brokerages, and RIAs.

YEAR

Envestnet Inc

Senior Data Analyst

Depending on role develops and/ or maintains processes and performs complex calculations to support the short and long term strategic plans and operating budgets, supports monthly close or contracting process and the generation of the monthly and/or annual financial statements. Stays abreast of issues impacting the healthcare industry and/or third party payor regulations/requirements, sponsored project research, especially those that have a financial impact to AHN and communicates those issues to team and management.

Financial Analyst Senior

Analyzes competitor pricing, market share and margins and tracks client buying patterns to understand, develop and recommend effective strategies for the company's offerings. The team sets portfolio pricing strategy and governance, partners with Sales, Relationship, Finance, Legal, and Product to improve win rate while ensuring pricing decisions meet strategic objectives.

Fraud Analyst Jobs in Pennsylvania

Solutions Analyst - Medicaid Operations Reporting Highmark Inc

Associate Strategy Analyst - Member Satisfaction Highmark Inc

Clinical Strategy Analyst Highmark Inc

Lead Decision Support Analyst Highmark Inc

Senior Criminal Intelligence Analyst ViaPath Technologies

Epic ClinDoc Systems Analyst Highmark Inc

Credential Delegation Analyst Highmark Inc

Senior Tax Analyst Highmark Inc

Senior Finance Operations Analyst Highmark Inc

Epic Orders Systems Analyst Highmark Inc

Risk Analyst Ascensus LLC

ERISA Analyst Ascensus LLC

Lead Risk and Compliance Analyst Highmark Inc

Senior Regulatory Implementation and Assurance Analyst Highmark Inc

Criminal Intelligence Analyst ViaPath Technologies

Senior Actuarial Analyst Highmark Inc

Lead Product Analyst - Ancillary Products Highmark Inc

Senior Data Analyst Envestnet Inc

Financial Analyst Senior Highmark Inc

Senior Pricing Analyst Envestnet Inc

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