health care analyst

Global Mission Support Services LLC

We Are Hiring: Healthcare Data AnalystLocation: Nauru Medical Centre, Republic of NauruNauru Medical Centre is seeking a highly skilled and experienced Healthcare Data Analyst to join our healthcare team. The Healthcare Data Analyst will be responsible for creating, maintaining, and analyzing medical databases to support clinical, administrative, and operational needs. This role involves working closely with healthcare providers, IT teams, and hospital administration to ensure data integrity, compliance with healthcare regulations, and the effective use of data for decision-making, research, and patient care improvement. The analyst will also be expected to explore data, identify trends, and provide actionable insights to guide hospital strategy and improve healthcare outcomes.Key Responsibilities<ul><li>Design, develop, and maintain medical/clinical databases and data pipelines.</li><li>Collect, clean, and standardize healthcare data from multiple sources (government and hospital databases, lab results, patient records, billing, etc.).</li><li>Ensure data accuracy, consistency, and compliance with healthcare standards.</li><li>Collaborate with clinicians and administrators to define reporting, research, and analytics needs.</li><li>Explore healthcare data to identify trends, anomalies, and opportunities for improvement.</li><li>Generate dashboards, reports, and visualizations for clinical, operational, and strategic insights.</li><li>Support hospital research projects with data extraction, structuring, statistical analysis, and reporting.</li><li>Conduct data-driven investigations to answer key business and clinical questions.</li><li>Identify opportunities to improve data collection processes and workflows.</li></ul>Qualifications<ul><li>Bachelor&rsquo;s or Master&rsquo;s degree in Health Informatics, Data Science, Statistics, Computer Science, or related field.</li><li>Experience with healthcare data management, EMR/EHR systems, or medical coding (ICD, CPT, SNOMED).</li><li>Proficiency in SQL and database management.</li><li>Strong skills in data analysis and statistical tools (Excel, Python, R, or similar).</li><li>Experience with BI tools (Power BI, Tableau, etc.) is a plus.</li><li>Knowledge of healthcare data standards and compliance requirements.</li><li>Strong problem-solving and research skills, with the ability to uncover insights from complex datasets.</li><li>Excellent communication skills to work effectively with both technical and non-technical stakeholders.</li></ul>What We Offer:<ul><li>Competitive tax-free salary</li><li>Free accommodation and meals</li><li>12-month contract with possibility of extension</li><li>30 days paid annual leave</li><li>Round-trip airfare</li><li>A unique professional and personal experience in an island healthcare system</li></ul>Apply Now:Submit your CV and supporting documents to talent@gmss.ltdJob Types: Full-time, Contract Contract length: 12 months

Health Care Data Analyst

State of Florida

<div>Requisition No: 865066
Agency: Agency for Health Care Administration
Working Title: 68064297 - MEDICAL/HEALTH CARE PROGRAM ANALYST
 Pay Plan: Career Service
Position Number: 68064297
Salary: $1,833.39 - $2,383.41 Biweekly
Posting Closing Date: 11/17/2025
Total Compensation Estimator Tool

Agency Overview:

The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity.
The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, and empowering consumers through health care transparency initiatives. 

Under the direction of the Agency Secretary, AHCA is focused on advancing Governor DeSantis&rsquo; vision for Florida&rsquo;s health care system to be the most cost-effective, transparent, and high-quality health care system in the nation. 

The Medicaid program provides low-income families and individuals with access to health care.
If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state, AHCA invites you to apply to become an essential member of our team.
As one of Florida&rsquo;s leading state agencies, AHCA&rsquo;s diverse workforce community of more than 1,400 employees is proud of its efforts to serve the people of Florida. 


Agency Objectives:

HIGH QUALITY

Emphasizing quality in all that we do to improve health outcomes, always putting the individual first. 


TRANSPARENT

Supporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions. 


COST-EFFECTIVE

Leveraging Florida&rsquo;s buying power in delivering high quality care at the lowest cost to taxpayers. 


Position Overview:

This is an exciting opportunity to help shape the quality of health care in Florida.
We are seeking to hire a Medical Health Care Program Analyst who desires to work to enhance the delivery of health care services through the Florida Medicaid Program.
This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team based work environment. 

This position is located in the Bureau of Medicaid Program Finance (MPF).
MPF manages and projects Florida&rsquo;s $33.8 billion Medicaid Services budget, oversees financial reporting of the Agency&rsquo;s contracted Medicaid health plans, calculates both institutional and non-institutional Medicaid reimbursement rates, and disburses supplemental payments to Medicaid providers. 


This position is responsible for assisting in the development, coordination, and implementation of the programs relating to Medicaid Hospital DPP, Indirect Medical Education (IME), and School District Administrative Claiming (SDAC).
Prepare Hospital DPP, IME, and SDAC payment requests.
Prepare &quot;adhoc&quot; reports from Public Records and Legislative requests.
Produce Hospital DPP, IME, SDAC, and Threshold models for Legislative Planning.
Also, coordinate with outside vendors and Centers for Medicare and Medicaid Services (CMS) on audit requests and annual reconciliations.
Prepare and distribute Hospital DPP models and analyses of other supplemental payment programs that interact with the Hospital DPP program.
Maintain current and archive versions of Hospital DPP, IME, and SDAC audits and analyses. 

The incumbent is responsible for analyzing cost reports and audits of school district providers and making appropriate adjustments to determine allowable costs.
Calculate reimbursements in accordance with Medicaid reimbursement plans and policies and applicable federal and state rules and regulations.
Identify the need for and obtain additional information and cost data from providers to complete the process of establishing reimbursement rates.
Establish district-specific rates for various Medicaid services.
Prepare cost report computer documents for all school district providers.
The incumbent in this position will act as the MPF team lead for school-based services and will coordinate with other Bureaus within the Agency to implement the Medicaid school-based services programs. 


Interpret State and Federal statutes to determine provider eligibility for participation in supplemental payment programs.
Coordinate data transfers between Florida managed care plans and the Agency for Health Care Administration for model development and program reconciliations. 

Implement policies and procedures of the Agency, as well as the audit and program analysis functions within the section. 

Maintains up-to-date knowledge concerning the Florida Medicaid Program, including pertinent statutes, Florida State Plan for Medicaid, Florida administrative rules and regulations, program manuals, and operations for the Budget &amp; Supplemental Funding Unit.
Review draft policy manuals and administrative rule changes and provide comments to appropriate units. 


This position will report to the Headquarters in Tallahassee. 

This position is not a remote or telework position. 


Benefits of Working for the State of Florida:
Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including:
<ul><li>Health insurance (i.e., individual and family coverage) to eligible employees</li></ul>
<ul><li>Life insurance; $25,000 policy is free plus option to purchase additional life insurance</li></ul>
<ul><li>Dental, vision and supplemental insurance</li></ul>
<ul><li>State of Florida retirement options, including employer contributions</li></ul>
<ul><li>Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida</li></ul>
<ul><li>Ability to earn up to 104 hours of sick leave annually</li></ul>
<ul><li>Nine paid holidays and 1 personal holiday each year</li></ul>
<ul><li>Opportunities for career advancement</li></ul>
<ul><li>Tuition waivers (accepted by major Florida Colleges/universities)</li></ul>
<ul><li>Student loan forgiveness opportunities (eligibility required)</li></ul>
<ul><li>Training opportunities</li></ul>
<ul><li>Flexible Spending Accounts</li></ul>
<ul><li>Shared Savings Program for select medical services</li></ul>
<ul><li>Lower copays for prescription drugs</li></ul>
<ul><li>Health and Wellness discounts</li></ul>

For a more complete list of benefits, please visit https://www.mybenefits.myflorida.com/ 


For more information about the Bureau of Medicaid Program Finance, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml. 


Join us at the Agency for Health Care Administration in fulfilling our mission to provide &ldquo;Better Health Care for all Floridians.&rdquo; 


KNOWLEDGE, SKILLS, AND ABILITIES

Ability to direct and coordinate the planning and implementation of operational and program reviews and program

monitoring activities.

Ability to utilize problem solving techniques.

Ability to understand and apply applicable rules, regulations, policies and procedures pertaining to a health services program.

Ability to prioritize workload.

Ability to develop various reports.

Ability to design, develop and implement research methods.

Ability to manage a health services program.

Ability to assess budgetary needs.

Ability to collect and analyze financial data.

Ability to formulate policies and procedures.

Ability to plan, organize and coordinate work activities.

Ability to communicate effectively verbally and in writing.

Ability to establish and maintain effective working relationships with others.

Knowledge of macros. 


MINIMUM QUALIFICATIONS REQUIREMENTS

Three years of experience using Microsoft Excel, including advanced skills and knowledge of Pivot Tables, V-Lookup, X-Lookup, IF statements, and formatting for publication/mail merge. 


Preference will be given to candidates who have a bachelor's degree from an accredited college or university in a relevant discipline such as mathematics, economics, or a related field. 


LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A 


CONTACT: KATHERINE GHENT 850-412-4101 


BACKGROUND SCREENING
It is the policy of the Florida Agency for Health Care Administration that any applicant being considered for employment must successfully complete a State and National criminal history check as a condition of employment before beginning employment, and, if applicable, also be screened in accordance with the requirements of Chapter 435, F.S., and Chapter 408, F.S. No applicant may begin employment until the background screening results are received, reviewed for any disqualifying offenses, and approved by the Agency. Background screening shall include, but not be limited to, fingerprinting for State and Federal criminal records checks through the Florida Department of Law Enforcement (FDLE) and Federal Bureau of Investigation (FBI) and may include local criminal history checks through local law enforcement agencies.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
VETERANS&rsquo; PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans&rsquo; Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans&rsquo; Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans&rsquo; Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.</div>

MEDICAL/HEALTH CARE PROGRAM ANALYST

Accenture

Skill required: Claims Appeals - Claims Administration 
Designation: Health Admin Services Analyst 
Qualifications:Any Graduation
 
Years of Experience:3 to 5 years
 
About Accenture 
Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song&mdash; all powered by the world&rsquo;s largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com
 
What would you do? To provide support to the clinical team and client team to assist in the promotion of quality member outcomes, to optimize member benefits, and to promote effective use of resources. Supports the procedures that ensure adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective. utilization Management: Gathers information using the appropriate client-specific telephonic screening tools. Conducts pre-review screening under the guidance and direction of US licensed health professionals. Case Management/Disease Management -Provides support functions for wellness programs, health management programs and preventative care opportunities that the member may have as part of their benefits. Gathers information using the appropriate client-specific telephonic screening tools. 
What are we looking for? &bull; Written Communication &bull; Microsoft Excel &bull; Microsoft PowerPoint &bull; Written and verbal communication &bull; Related outsourcing operations experience &bull; Claims reviews/audit experience and data entry experience &bull; Knowledge of utilization management process and ability to interpret and apply member contracts, and member benefits &bull; Knowledge of ICD-9 and CD-IO and CPT codes, preferred &bull; Experience in medical or insurance field, preferred &bull; Requires analysis and solving of increasingly complex problems. &bull; Interaction is with peers within Accenture before updating supervisors. Likely has some interaction with clients and/or Accenture management. &bull; With proper guidance and oversight by Team Lead, may be tapped for precepting, training, mentoring and job shadowing duties &bull; Holds current and unrestricted local (PH) Registered Nurse license. &bull; Bachelor of Science Nursing (BSN) degree &bull; Excellent written and verbal communication skills in English &bull; Must pass American English and alternate language fluency test (&quot;Test&quot;) upon hire (non-US resident) by successfully completing internal written test, For voice accounts, you must pass US Berlitz B2 level or Versant score 58 and above upon hire or upon assuming role. &bull; Proficiency in basic computer knowledge with the ability to learn additional computer programs &bull; A minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting required o Three months is equivalent to 480 hours of working experience as an RN o Work experience as a Registered Nurse means holding an active RN license and providing direct patient care o Clinical setting includes inpatient hospital, outpatient hospital or clinic, or I-year related Accenture or other outsourcing experience or returning Analyst employee &bull; Strong customer service focus o Ability to empathize o Prioritizing customer needs
 
Roles and Responsibilities: &bull; Manages incoming or outgoing telephone calls, e-Reviews, and/or faxes, including triage, opening of cases and data entry into client system. &bull; Determines contract; verifies eligibility and benefits. &bull; Conducts a thorough provider radius search in client system and follows up with provider on referrals given. &bull; Checks benefits for facility-based treatment. &bull; Obtains intake (demographic) information from caller, e-Reviews, and/or from fax. Processes incoming requests, collection of non-clinical information needed for review &bull; performs data entry or contact Into client systems ana routes as appropriate match clinical records with appropriate case. &bull; Consolidate inputs for approval. &bull; Generate the needed letters as directed by client and/or outlined in client s procedure manual &bull; Assign cases/activities and work within client s system to facilitate workflow and productivity goals. &bull; Refers cases requiring clinical review to a nurse reviewer. Performs case checks and reviews to ensure case creation is complete, correct, and &quot;nurse ready&quot;. &bull; Tasks cases accurately to the correct queue. &bull; Conducts outbound scripted calls to providers to request clinical information as directed by clinician. &bull; Conducts outbound scripted calls to providers to complete approval notification process as directed by clinician. &bull; Performs Daily Task list maintenance activities under the direction of the Team Lead/Operations Manager and as per customer workflow. &bull; Provide administrative support to [Nurse Reviewer via case preparation, phone number verification, medical record requests and verbal call out approval notifications, &bull; Provide administrative support of post service claims utilizing the member s benefit contract and health plan guidelines. &bull; Performs administrative tasks and work as directed by clinician or Team Lead/Operations. Consults clinician and Team Lead/Operations Manager timely and appropriately. &bull; Reports inventory numbers and assigns task lists under the direction of the Team Lead/Operations and as requested by the customer. &bull; Prioritize follow-up and actions based on case request receipt dates, customer workflow, service level agreements and regulatory timeframes. &bull; Responsibilities exclude collection of non-scripted information, evaluation, or interpretation of clinical information, and providing medical advice/opinion on treatment or services. &bull; Please note that this role may require you to work in rotational shifts
 
Any Graduation

Health Admin Services Analyst

Msq Developers

Job Title: Business Analyst &ndash; HealthcareLocation: DHA Phase 8Timings: 6pm-3amExperience Required: 2&ndash;4 yearsDomain: Healthcare ITAbout the RoleWe are seeking a motivated Business Analyst with strong healthcare domain knowledge to bridge the gap between business needs and technical solutions. The ideal candidate should have hands-on experience in EDI integrations, NCCI rules, healthcare documentation, and compliance requirements, along with the ability to translate complex processes into actionable requirements for development teams.Key Responsibilities<ul><li>Gather, analyze, and document business requirements from stakeholders, providers, and healthcare IT teams.</li><li>Work closely with developers, QA, and product managers to ensure solutions align with business and compliance needs.</li><li>Support EDI transactions (837, 835, 270/271, 276/277, etc.) and ensure smooth integration with clearinghouses, payers, and providers.</li><li>Understand and apply NCCI (National Correct Coding Initiative) rules to claims processing and billing workflows.</li><li>Develop and maintain business requirement documents (BRDs), functional specifications, and user stories.</li><li>Perform gap analysis, workflow documentation, and process improvement in healthcare systems.</li><li>Ensure adherence to HIPAA, CMS, and other healthcare compliance standards.</li><li>Collaborate with QA teams to design test cases and validate system functionality against business needs.</li><li>Provide ongoing support for system enhancements, defect resolution, and stakeholder queries.</li></ul>Required Skills &amp; Qualifications<ul><li>Bachelor&rsquo;s degree in Computer Science, Healthcare Informatics, Business Administration, or a related field.</li><li>3&ndash;4 years of professional experience as a Business Analyst in the Healthcare domain.</li><li>Strong understanding of Healthcare EDI standards (X12, HL7) and claim life cycles.</li><li>Knowledge of NCCI rules, healthcare billing, coding, and documentation standards.</li><li>Experience writing clear and concise requirement documents, workflows, and user stories.</li><li>Familiarity with healthcare compliance standards (HIPAA, CMS).</li><li>Excellent analytical, problem-solving, and communication skills.</li></ul>Preferred Skills<ul><li>Experience with EHR/EMR systems and healthcare practice management workflows.</li><li>Familiarity with Agile/Scrum methodology.</li><li>Exposure to payer-provider integration projects.</li></ul>What We Offer<ul><li>Competitive salary and benefits.</li><li>Opportunity to work on innovative healthcare IT projects.</li><li>A collaborative environment that values growth and continuous learning.</li></ul>Job Type: Full-timeWork Location: In person

Business Analyst-- Healthcare

Technology Next

Urgently hiring for Business Analyst &ndash; Healthcare DomainExperience: 6&ndash;8 Years Work Mode: Hybrid Location: Noida , Pune , Bangalore , Chennai , Hyderabad Work Hours: 11:00 AM &ndash; 9:00 PM ISTJob Summary:We are seeking an experienced Business Analyst (Healthcare Domain) to bridge the gap between business needs and technical solutions. The ideal candidate will have strong expertise in clinical workflows, healthcare data analysis, and reporting systems, with hands-on experience in SQL and database management. You will work closely with stakeholders, data teams, and developers to analyze, document, and translate healthcare business requirements into functional specifications and actionable insights.Key Responsibilities:<ul><li>Collaborate with business and technical stakeholders to gather and document healthcare domain requirements.</li><li>Analyze clinical, operational, and claims data to support reporting, dashboards, and business intelligence initiatives.</li><li>Develop detailed business requirement documents (BRDs), functional specifications, and data mapping documents.</li><li>Work with cross-functional teams to define KPIs, build reports, and ensure accurate data representation.</li><li>Perform data validation and ensure data integrity across multiple systems and sources.</li><li>Support user acceptance testing (UAT) and change management processes.</li><li>Act as a liaison between business users and technical teams to ensure alignment on project goals and deliverables.</li><li>Identify process improvement opportunities within healthcare workflows and systems.</li></ul>Required Skills &amp; Qualifications:<ul><li>6&ndash;8 years of experience as a Business Analyst, preferably in the Healthcare or Clinical domain.</li><li>Strong understanding of healthcare data standards (e.g., HL7, ICD, CPT, EHR, EMR).</li><li>Hands-on experience with SQL for data querying, profiling, and validation.</li><li>Proficiency with data analysis and reporting tools (e.g., Power BI, Tableau, Excel, or similar).</li><li>Solid understanding of database management concepts and data modeling principles.</li><li>Strong analytical, problem-solving, and communication skills.</li><li>Ability to manage multiple projects in a fast-paced environment.</li></ul>Preferred Qualifications:<ul><li>Experience with HIPAA-compliant systems and clinical data management.</li><li>Knowledge of data warehousing or ETL concepts.</li><li>Familiarity with Agile or Scrum methodologies.</li></ul>Job Type: Contractual / Temporary Contract length: 6-12 monthsPay: &#8377;60,000.00 - &#8377;80,000.00 per monthWork Location: In person

Business Analyst – Healthcare Domain

CVS Health

<div>At CVS Health, we&rsquo;re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation&rsquo;s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues &ndash; caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
This position will be working from home anywhere in the continental US.
Standard business hours Monday-Friday.<ul><li>
Accountable for conducting oversight of entities that are contracted to perform clinical functions on Aetna's behalf.</li><li>
Monitor and track delegated entities compliance with regulatory and NCQA requirements.</li><li>
Communicate to delegated entities about industry standards, Aetna policies, and best practices.</li><li>
Accountable for preparing delegation oversight resources for NCQA and regulatory reviews</li><li>
This position supports NCQA, CMS, and other regulatory compliance initiatives.</li></ul> 
Required Qualifications<ul><li>
3&ndash;5 years of experience in Quality Management within the healthcare industry</li><li>
Demonstrated ability to consistently meet deadlines in a fast-paced environment</li><li>
Strong communication and interpersonal skills, with a proven ability to collaborate effectively across teams</li></ul> 
Preferred Qualifications<ul><li>
2 to 3 years prior experience working in Commercial/Medicare or Medicaid lines of business</li><li>
Medical Terminology and Claims Experience</li><li>
QuickBase Experience</li><li>
Experience with flexing and shifting priorities</li><li>
Experience working independently and collaboratively to solve problems, make decisions, and complete work/projects</li><li>
Growth mindset (developing yourself and others) skills</li></ul> 
Education<ul><li>
Bachelors Degree Preferred</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$43,888.00 - $102,081.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 11/21/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Analyst, Health Care Quality Management - Work at Home

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Health Care Data Analyst

MEDICAL/HEALTH CARE PROGRAM ANALYST

Health Admin Services Analyst

Business Analyst-- Healthcare

Business Analyst – Healthcare Domain

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home