46 analyst risk operations jobs found

UNC Health Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Assists in the interpretation, communication, tracking and implementation of CMS (Medicare and Medicaid), Tricare and private payer policies that directly impact provider billing. Plays a critical role in researching, analyzing and conveying federal, state, and private policies that impacts Medicare, Medicaid, and commercial coverage, compliance and billing, along with becoming an expert on key issues related to changes in health care policy, including but not limited to health care reform. Responsibilities: 1. Responsible and accountable for reviewing all relevant payer policy alerts (e.g. bulletins) and/or Notices of Proposed Rule Making and Final Rules. 2. Analyze payer policy changes to identify potential operational, billing, coding, or reimbursement impacts. 3....

Sharp HealthCare Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $50.720 - $65.450 - $73.310 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do Under the direction of the Manager/Supervisor/Ops Coordinator is responsible for directing day-to-day activities of the department; supervision of the technical and support staff. To perform a wide variety of technical...

UNC Health Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. The Performance Improvement Department at UNC Rex Hospital is seeking an experienced nurse to join their team as a Quality Assurance Specialist. This position will lead quality assurance work with a focus on high risk areas. This would include but is not limited to: Clinical chart review and auditing of practice Trending and tracking performance Providing real time feedback to teammates Identifying key priority areas and summarizing opportunities to share with key stakeholders and executive leaders Summary: Oversees data collection and submission programs for public reporting projects, ensuring data integrity, timeliness of submission, and that all regulatory requirements are met. Responsibilities: 1. Provides leadership and consultation for programs of...

CSL The Opportunity Join a company that finds solutions to complex challenges. With expertise in influenza science and beyond, our team works on the latest research and pioneering technologies to improve the manufacturing process and the effectiveness of influenza vaccines. We operate as one integrated global organization drawing together expert staff from different countries to collaborate. Together, we are working to protect communities from seasonal influenza and global pandemic threats. When you join CSL Seqirus, you join a team dedicated to making a difference in people's lives. It's a feeling of possibility, creativity, and purpose to deliver our promise. Role Summary The Manager, Contract Administration is responsible for commercial contract drafting, contract administration, and execution of CSL Seqirus US Commercial contracts to ensure sales goals are met for US CSL Seqirus vaccines. The position reports to the Director, Contract Development and...

Point32Health, Inc. Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about...

Kaiser Permanente Job Summary: Implements and provides guidance to team on best practices for conducting assessments and determining diagnoses. Provides guidance and feedback and mentors team on communicating to share results, discuss treatment plans, and provide resources. Mentors across teams on member/patient advocacy, anticipating care issues, implementing feedback, and/or responding to complaints, participates in the development of care experience standards and ensures high-quality care experiences, provides guidance on determining the appropriate services for referrals, and implements standards for sharing information with providers. Provides guidance to ensure quality therapy programs and manages the implementation of new programs across teams, implementing adjustments to improve services, as well as coaching team on implementing improvements to programs, and ensures the optimal utilization of programs. Provides guidance across teams on regulatory policies, standards,...

Aledade As an Analytics Technical Product Manager you will be a key member of the Analytics organization, the team that delivers insights and decision making tools to drive Aledade strategy and support our various lines of business. In this role, you will report to an Analytics leader and serve as a force multiplier for our teams. You will work alongside business owners, product team members, data analysts, designers and engineers to define project goals, solution scope, implementation approach, and rollout plans. You will play a significant part in scoping analytics work, managing stakeholders, and delivering high-quality, high-impact analytics products with the ability to scale. You will support teams of Analytics professionals to help us deliver new analysis and complex data products that power intelligence across our suite of tools. If you're a data-savvy person looking for a product management career within an analytics environment, this is the role for you....

Aledade The Health Plan Performance (HPP) Specialist serves as a critical strategic partner and primary liaison between Aledade and our payer partners. This role is responsible for the end-to-end orchestration of health plan performance strategies, ensuring that our Medicare Advantage, Commercial, and Medicaid contracts are meeting and exceeding financial and clinical benchmarks. Beyond mere oversight, the Specialist acts as a bridge between high-level payer data and on-the-ground execution, translating complex analytics into actionable market strategies that drive shared savings, improve quality scores, and lower the total cost of care. As a subject matter expert, you will navigate a high-visibility environment, collaborating with cross-functional leadership and market field teams to solve complex operational challenges and solidify Aledade's position as a leader in value-based care. Primary Duties Establish goals and track key performance indicators (KPIs) related...

Sharp HealthCare Hours : Shift Start Time: 9 AM Shift End Time: 5 PM AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $67.070 - $86.540 - $96.930 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Six Sigma Black Belt implements Lean Six Sigma philosophy and methodology through the management of performance improvement projects selected by appropriate governing councils. This position manages Six Sigma projects ensuring...

CSL The Opportunity: Reporting to the Senior Director, Head of People Analytics as the Director, People Analytics & Insights, you will lead the design and delivery of enterprise people analytics solutions that enable data-driven workforce planning, talent decisions, and organizational health monitoring across CSL. You will serve as a strategic advisor to HR leaders and business stakeholders, translating complex people data into actionable insights, executive-ready storytelling, and scalable analytics products that support business outcomes. You will will partner closely with HR Centers of Excellence (COEs), HR Business Partners (HRBPs), HR Operations, enterprise data teams, and Legal/Privacy to ensure data quality, governance, compliance, and continuous advancement of analytical maturity across the organization. This is a hybrid role, which offers a combination of an onsite and remote work schedule. #LI-hybrid The Role: People Analytics Strategy, Solution Design...

CSL The Opportunity: Reporting to the Senior Director, Head of People Analytics as the Director, People Analytics & Insights, you will lead the design and delivery of enterprise people analytics solutions that enable data-driven workforce planning, talent decisions, and organizational health monitoring across CSL. You will serve as a strategic advisor to HR leaders and business stakeholders, translating complex people data into actionable insights, executive-ready storytelling, and scalable analytics products that support business outcomes. You will will partner closely with HR Centers of Excellence (COEs), HR Business Partners (HRBPs), HR Operations, enterprise data teams, and Legal/Privacy to ensure data quality, governance, compliance, and continuous advancement of analytical maturity across the organization. This is a hybrid role, which offers a combination of an onsite and remote work schedule. #LI-hybrid The Role: People Analytics Strategy, Solution Design...

CSL The Opportunity: Reporting to the Senior Director, Head of People Analytics as the Director, People Analytics & Insights, you will lead the design and delivery of enterprise people analytics solutions that enable data-driven workforce planning, talent decisions, and organizational health monitoring across CSL. You will serve as a strategic advisor to HR leaders and business stakeholders, translating complex people data into actionable insights, executive-ready storytelling, and scalable analytics products that support business outcomes. You will will partner closely with HR Centers of Excellence (COEs), HR Business Partners (HRBPs), HR Operations, enterprise data teams, and Legal/Privacy to ensure data quality, governance, compliance, and continuous advancement of analytical maturity across the organization. This is a hybrid role, which offers a combination of an onsite and remote work schedule. #LI-hybrid The Role: People Analytics Strategy, Solution Design...

CSL The Opportunity: Reporting to the Senior Director, Head of People Analytics as the Director, People Analytics & Insights, you will lead the design and delivery of enterprise people analytics solutions that enable data-driven workforce planning, talent decisions, and organizational health monitoring across CSL. You will serve as a strategic advisor to HR leaders and business stakeholders, translating complex people data into actionable insights, executive-ready storytelling, and scalable analytics products that support business outcomes. You will will partner closely with HR Centers of Excellence (COEs), HR Business Partners (HRBPs), HR Operations, enterprise data teams, and Legal/Privacy to ensure data quality, governance, compliance, and continuous advancement of analytical maturity across the organization. This is a hybrid role, which offers a combination of an onsite and remote work schedule. #LI-hybrid The Role: People Analytics Strategy, Solution Design...

CSL Primary role Summary : The PSSI Lead supports the processes associated with start-up, site monitoring, oversight and site engagement but strives to identify innovative continuous improvement opportunities with keen business analytics. They are responsible to develop and review KPI s and metrics associated with start-up, site monitoring (onsite, remote and central) and site monitoring oversight. With KPIs established, this role will need to continually monitor performance and critically assess their impact and collaborate with appropriate groups and the SMMO LT to identify trends and resolve issues and delinquencies. The PSSI Lead monitors start-up, site monitoring and oversight processes at enterprise level using dashboards and analytics; and ensures compliance through SMMO & Partner follow-up in collaboration with Clinical Compliance. The PSSI Lead represents SMMO on SOP and process reviews, determines impact and provides recommendations or process improvement...

Unitek Learning Company Description At Brookline College, we are dedicated to our students' success and committed to providing them with our best service from start to finish. Our helpful admission representatives will help students define their goals and choose a program. Our experienced instructors will educate their students and provide hands-on training. Our devoted staff will support and help every student complete their program, and once they graduate, they'll assist the student with their job search. Job Description We are growing and looking for an experienced Surgical Technologist to join our team in shaping the future of the next generation of Surgical Technologists that are flocking to our program!   Looking for flexibility? Tired of being on call and missing out on time with your family? Join us where we enjoy company culture and work life balance.  If you find yourself often helping others, explaining, mentoring, and leading your peers, the natural next step...

Sharp HealthCare Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $43.650 - $56.340 - $63.100 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do To perform a wide variety of technical procedures with quality patient care, assisting Physicians as needed. Required Qualifications Satisfactory completion of formal training program in an AMA approved school and meets...

Sharp HealthCare Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $43.650 - $56.340 - $63.100 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do To perform a wide variety of technical procedures with quality patient care, assisting Physicians as needed. Required Qualifications Satisfactory completion of formal training program in an AMA approved school and meets...

Aledade This individual will be responsible for supporting our broader product team in developing and enabling our product roadmap by deriving insights from internal analytics, the external digital health landscape (benchmarking, drawing insights from patient-facing healthcare, synthesizing key learnings from Medicare-focused players, identifying potential technology solutions), helping to form POVs to support alignment and tradeoff decisions. The product development team at Aledade leads all technology development and integration across built and bought solutions. This role will report to the Director of Product Strategy, with close exposure to those in Product, Design, Analytics, and Technology teams, and beyond. We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or from our offices in Durham, NC; Austin, TX; or Bethesda, MD. Primary Duties: Define and Manage SOPs:...

Lantheus About Lantheus Lantheus (NASDAQ: LNTH) is the leading radiopharmaceutical-focused company, delivering life-changing science to enable clinicians to Find, Fight and Follow disease to deliver better patient outcomes. Headquartered in Massachusetts with offices in New Jersey, Canada, Germany, Sweden, Switzerland and United Kingdom, Lantheus has been providing radiopharmaceutical solutions for nearly 70 years. Today, we’re expanding our portfolio and pipeline across oncology, neurology and cardiology. Through recent acquisitions, along with strategic partnerships across the life sciences ecosystem, we are accelerating our efforts to advance precision medicine and improve patient outcomes around the world. At Lantheus we are purpose-driven, and every employee plays a vital role in our success. We’re dedicated to cultivating a high-growth, forward-thinking culture where innovation thrives and diverse perspectives drive meaningful progress. Join us and be part of a...

Riverside Community Care Riverside Community Care Love What You Do! IT Project Manager We are searching for an IT Project Manager who wants to be part of an organization that makes a difference in the lives of others. In this key role, the IT Project Manager will plan, coordinate, and deliver technology projects that advance Riverside's mission and operational goals. This position oversees projects from initiation through completion, ensuring outcomes are delivered on time, within scope, and aligned with business requirements. The IT Project Manager partners with internal stakeholders, vendors, and cross-functional teams to manage project timelines, budgets, risks, and communications throughout the lifecycle of each initiative. The IT Project Manager will: lead IT projects from concept through implementation, including requirements gathering, budgeting, testing, training, and deployment. ensure projects align with Riverside’s strategic objectives and...