Medical Claim Analyst Jobs

Location : The territory for this position includes parts of Detroit West out towards Lansing, then north all the way up to the lower part of the MI peninsula. Cities include: Rochester Detroit, Rochester Hills, Lansing, Gaylord and Alpena. We are currently looking for a Clinical Field Specialist (CFS) to join our Women's Health sales team! The CFS will drive revenue growth and market expansion through direct engagement with individual MFMs and OB/GYNs. This role focuses on building and maintaining strong relationships, while developing and executing strategic business plans that accelerate revenue growth. The CFS will support both established and newly launched products, providing clinical expertise, educational support, and hands-on training in technical product applications. PRIMARY RESPONSIBILITIES Increasing revenue and driving market development through direct sales to individual MFMs, Ob/Gyns and Genetic Counselors. Sales efforts include effective prospecting, cultivating and maintaining key relationships. Creating and implementing a strategic business plan to grow revenue quickly in your geography. Sales efforts will focus on currently marketed products and new product launches. Will play a critical role in the success of the organization. This role works with PHI on a regular basis both in paper and electronic form and have an access to various technologies to access PHI (paper and electronic) in order to perform the job Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire. Must maintain a current status on Natera training requirements. QUALIFICATIONS Bachelor’s degree required; preferred fields include Science, Nursing, or a related healthcare discipline Minimum of three years of physician sales experience in the diagnostic laboratory industry, ideally within genetics Strong background in medical o

At Lyft, our purpose is to serve and connect. We aim to achieve this by cultivating a work environment where all team members belong and have the opportunity to thrive. The Growth Products team drives rider and driver acquisition to scale the business and balance the marketplace. We specialize in incentive and messaging targeting, budget optimization, and paid media measurement, and move rapidly to test new ideas and products. As a Data Scientist expert in causal inference and marketing mix models (MMM), you will lead our efforts to measure and optimize investments across marketing channels. Responsibilities: Deliver results across the entire lifecycle of data science solutions for Growth: from defining the problem with cross-functional stakeholders to deploying production models that address key business problems. Own complex domains and develop long-term roadmaps to maximize business impact. Build statistical pipelines, write production code, and design/analyze experiments. Participate in the science on-call rotation to ensure automated campaigns operate successfully. Experience: Advanced degree in statistics, economics, mathematics, or equivalent industry experience. 4+ years of industry experience in causal inference or data science. Proven ability to apply statistics to unstructured problems and deliver measurable results. Deep technical expertise in causal inference and tackling challenging measurement problems. Expertise in marketing mix modeling is highly preferred. Expertise in SQL and experience with large-scale data platforms. Proficiency in Python and working within production coding environments. Benefits: Great medical, dental, and vision insurance options with additional programs available when enrolled Mental health benefits Family building benefits Child care and pet benefits 401(k) plan with company match to help save for your future In addition to 12 observed holidays, salaried team members have discretionary paid time off, hourly team membe

SUPERVISOR DE PROMOCION MEDICA — Peru - Lima. Apply via Workday.

SUPERVISOR DE PROMOCION MEDICA — Peru - Lima. Apply via Workday.

Administrar sistemas e ferramentas de suporte à gestão de processos, padronização e tratamento de anomalias, promovendo a gestão do conhecimento e treinamentos, monitorando e controlando os Registros de Tratamento de Anomalias (RTAs) com áreas operacionais e responsáveis pelos processos de SMS, Perdas de Produção, Medição e Conformidade. •Analisar, estruturar e manter as EAPs dos projetos e operações da Gerência Executiva, garantindo bom gerenciamento da interface com áreas de projetos, operação e disciplinas técnicas. •Apoiar atividades de planejamento, controle e gestão da gerência. Desenvolver e atualizar processos, ferramentas de report, elaborar material e realizar apresentações. Realizar a construção do Plano de Negócio e Plano Anual de Negócio, monitorar e controlar a carteira de projetos, operações e gastos administrativos da Gerência Executiva. •Atuar como suporte nos processos de contratação, gestão contratual e de processos internos do consórcio. Apoiar na coleta e processamento de dados para aprendizado constante e geração de valor (foco nos sistemas offshore) utilizando técnicas de Machine Learning. •Apoio na execução de rotinas transacionais e programações no sistema SAP, módulos PM, MM e OS, além de auxiliar e gerir acesso, avaliação e melhorias na coleta, consolidação e armazenamento de dados. •Consolidar a previsibilidade de chamada de caixa enviada por gestores e fiscais de contrato, verificando a coerência com o Plano de Trabalho e Orçamento (PTO) vigente. Pesquisar, estruturar e consolidar informações para documentos, relatórios e pareceres sobre a gestão de rotinas e processos, promovendo a revisão e disponibilização para avaliação e validação final dos profissionais envolvidos em demandas complexas, além de gestores e especialistas do cliente. •Realizar tarefas operacionais de média complexidade, suportando e executando a análise estruturada de dados e informações, consolidando levantamentos e orientando atividades relacionadas ao desenvolvimen

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Serves as the central execution and coordination lead for complex, cross-functional initiatives within the Medicare Part D product and strategy organization. Establishes clear visibility into what initiatives exist, who owns them, how they are progressing, and what dependencies must be managed to deliver results on time. Translates strategic priorities into structured plans, timelines, progress tracking, and executive-ready summaries that help leadership assess status, risks, and next steps. Required Qualifications 7–10 years of relevant experience, including project, program, or initiative management in healthcare, insurance, or a related field. Strong working knowledge of Medicare Part D, including regulatory, operational, and product considerations. Demonstrated ability to manage multiple complex initiatives simultaneously and translate strategic priorities into operational plans with measurable outcomes. Exceptional organizational skills with strong attention to detail and the ability to manage dependencies, sequencing, and critical paths. Proven experience creating clear summaries, dashboards, timelines, roadmaps, and visuals for senior leadership. Strong written and verbal communication skills, including the ability to frame communications for executive and cross-functional audiences. Experience supporting Medica

SOBRE A CAPCO A CAPCO é uma consultoria global de tecnologia e negócios, focada no setor de serviços financeiros e energia, somos apaixonados por ajudar nossos clientes, temos 33 escritórios nas Américas, Europa e Ásia-Pacífico! Vamos te apoiar e ajudar a acelerar sua carreira! EXPERIÊNCIA informática (Excel, PowerPoint, Word, Acrobat, MS Power BI, MS Project, Primavera), Solida experiência comprovada na carteira de trabalho em empresa de Engenharia ou óleo e gás SAP (módulo PS), Inglês Intermediário Gerenciamento de Projetos. ESCOLARIDADE Nível Superior em Engenharia com Pós-Graduação em Gerenciamento de Projetos. ATRIBUIÇÕES Elaboração de minuta e análise das diretrizes contratuais de planejamento e controle de Projetos; Elaboração e análise de minuta da Estrutura Analítica de Projeto (EAP) e critérios de medição de contratos; Elaboração e análise de minutas de cronogramas físico e financeiro; Elaboração de minuta de relatórios de acompanhamento dos Projetos e apresentações relacionadas; Monitoramento de prazo e custo de projetos no SAP; Estruturação da EAP de projetos no módulo PS do SAP; Alocação dos custos operacionais da gerência (centro de custo) nos projetos de atuação (repasse de custos); Elaboração de minutas de procedimentos, manuais, padrões, acordos e especificações referentes às atividades da área; Monitoramento e análise de indicadores do Empreendimento; Cadastro de dados de projetos nos sistemas corporativos; Preparação e verificação de requisitos de auditoria; Implantação e suporte à utilização de ferramentas (SAP, EPM – Enterprise Project Management, etc) de apoio ao gerenciamento de projetos; Mapeamento de processos inerentes ao gerenciamento de projetos; Dentre outros serviços relacionados a análise de custos e desempenho dos projetos de sistemas submarinos. Sobre a CAPCO: Na Capco promovemos uma cultura inclusiva. Valorizamos a diversidade em todas as suas expressões. Pensamos, em conjunto , sempre em a