Job Search Results for healthcare payer

Lead FHIR Business Analyst

Insight Global's healthcare client is hiring for a Lead FHIR Business Analyst. Candidates will start in a hands-on role focused on mapping healthcare transactions to FHIR standards. They will analyze... More incoming specs, create detailed mapping documents, and collaborate with engineering teams to validate transformations. They will also author CQL logic to support decision-making workflows and ensure compliance with interoperability regulations. Once the solution moves into production, they will transition into a technical lead role?owning program governance, standards, and release management while mentoring others on FHIR and CQL best practices.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Lead Pricing Analyst

Insight global is looking for a Lead Pricing Analyst to join our large, payer client. This role is pivotal in shaping the strategic direction of the pricing function within the applicable business... More unit. It involves leading in-depth research and analysis to inform dynamic pricing strategies for various products, including the development of sophisticated pricing models tailored to specific product offerings. A key aspect of this position is fostering strong cross-functional partnerships to gather critical market intelligence and product insights essential for strategic pricing decisions. This individual will actively engage with product teams to gain a comprehensive understanding of our offerings, translating that knowledge into innovative pricing approaches. Furthermore, this role is responsible for strategically contributing to and supporting the organization's responses to Requests for Proposals (RFPs), ensuring competitive and profitable bids. This role contributes significantly to strategic financial planning by providing expert recommendations for optimizing pricing and revenue generation across the enterprise. ESSENTIAL RESPONSIBILITIES?Facilitates the completion of all pricing reviews and ensures all pricings are approved per established policies. May work on more complex reviews.?Leverages advanced analytic capabilities to support analysis and reporting within the pricing function. ?Develop strategy and analysis incorporating project management leadership?Drives results and resolves issues through communication with internal partners, locations and divisions.?Ensures all policy and process documentation is up to date including pricing assumptions, average cost rates, overhead percentages, etc.?Serves as an escalation point across the business regarding pricing reviews and serves as a lead to others in members of the pricing team?Other duties as assigned or requested.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Cash Posting Analyst

Insight Global is looking for a Cash Posting Analyst to join one of the nation?s largest nonprofit hospital systems and play a key role in driving revenue cycle accuracy and efficiency. In this role,... More you?ll post and reconcile payments, adjustments, and denials, manage billing and refunds, and perform variance analysis to resolve discrepancies. You?ll ensure accounts are balanced, collaborate with billing and finance teams, and support audits and month-end close. Strong technical and analytical skills are essential, along with expertise in payer rules and remittance formats. This position offers minimal direct interaction (20?30%) and the opportunity to work independently while contributing to a mission-driven organization.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Remote Product Manager

Overview:Lead product management for Salesforce Experience Cloud and Health Cloud solutions, focusing on provider engagement and prescription submission workflows. Collaborate with Field Sales,... More Operations, and internal teams to drive adoption, streamline processes, and enhance provider-facing experiences.Key Responsibilities:Own product roadmap and backlog for provider-facing portals and workflows.Support 1,000+ community users, 50+ field sales reps, and 75 internal operations users.Partner with Field Sales to drive lead generation and reporting workflows; support Ops team in prescription processing.Manage agile ceremonies (grooming, sprint planning, stand-ups) and prioritize stakeholder needs across three major groups.Execute two-week sprints with a team of 4 developers and 1 QA resource.Allocate time across sprint support/documentation (65%), planning (10%), and strategic development for new provider experiences (10%).We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Epic Tapestry Analyst

An employer in the Southern California area is seeking two Epic Tapestry Analysts. The first Epic Tapestry Analyst will be responsible for the build aspect of Epic Tapestry, specifically designing... More the system and building components needed to enable incoming capitation functionality within the platform. (Enrollment Filer and Incoming Capitation R&R within the Tapestry module) This is a new build for the organization, and the role involves creating foundational elements to support capitation processes. Day to day duties include the following: lead the design, implementation, and maintenance of EDI workflows within Epic Tapestry, configure and support Enrollment File interfaces and Incoming Capitation R&R processes, troubleshoot and resolve EDI-related issues, including mapping errors, data discrepancies, and transmission failures, and maintain documentation of workflows, configurations, and operational procedures. They will collaborate with internal stakeholders and external payers to ensure timely and accurate data transmission, participate in testing, validation, and go-live support for new and updated interfaces, and will ensure compliance with HIPAA regulations related to health IT and data exchange. The Analyst will work alongside 2 internal resources to help them build and design the capitation functionality. This opportunity is a 6-month contract to hire opportunity. The second Epic Tapestry Analyst will be focusing on advanced build work but requires deeper technical specialization, including LPP extensions, custom cache development, custom rules implementation for configuration, and providing guidance. The key difference is that the second role demands experience implementing functionality in a live organizational environment, whereas the first role may not have that implementation background but brings extensive experience in enrollment filer build. The second Analyst position is a 6 month contract with possible extensions. Both positions will be fully remote, preferably sitting in California, but can also sit in the following states: Arizona, Illinois, Maryland, Michigan, Montana, Nevada, North Carolina, Texas, Utah, Washington & Wisconsin.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less