The job profile for this position is Program Management Lead Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Role Summary: Data Analyst for our Pre/PostPay Edit editing program. This position will provide the technical component of our Pre/PostPay Edit editing program in development, implementation, production monitoring and maintenance of our internal PrePay edits. Individual will work with our matrix partners to evaluate edit ideas and use business requirements to develop the technical processes to obtain desired results and support strategic initiatives aimed at improving claim accuracy and operational efficiency. Strong technical coding experience will be needed to be successful in this role. Key Responsibilities: - Act as technical analyst for Proactive Claim Intervention projects and daily tasks for all aspects of our Pre/PostPay Edit editing program. - Data Analyst for the development, installation, execution and maintenance of our Pre/PostPay Edit editing program. - Develop and maintain editing on regular and ad-hoc basis, primarily using SAS, Microsoft SQL Server and internally developed ARM rule-based claim editing platform - Responsible for data mining activities and technology integration of Pre/PostPay Correction Program to support our Pre/PostPay Edit editing program. - Evaluates and appropriately utilizes various approaches to data mining to narrow in on trends and drivers that directly impact outcomes. - Makes well-thought-out decisions on complex or ambiguous IT architecture issues. - Participate in all phases of Pre/PostPay Edit program IT architecture process testing and implementation. - Ensures that system improvements are successfully implemented and monitored to increase efficiency. - Works closely with matrix business partners to define data needs, opportunities for improvement and effectively communicates results of analysis and solutions. - Acts as a resource for mentorship, training and guidance for junior staff. Required Qualifications: - Bachelor’s degree or higher strongly preferred in Business Analytics, Data Science, Information Systems, or a related field, or equivalent work experience required. - 5+ years of experience in healthcare data analytics required. - 5+ years coding experience required, with proficient skills using SAS and Microsoft SQL Server highly preferred. - Experience with rule-based editing platforms desired. - 5+ years of experience in healthcare data with proficient skills in medical analysis and project management. - Strong data investigation skills to mine healthcare data required. - Experience with Word, Outlook, PowerPoint, Teams, Webex, Excel (pivot tables/VLOOKUP preferred). - Strong data analysis skills with the ability to analyze large amounts of healthcare data to translate complex data into meaningful, actionable insights - Strong project management skills and comfort in ability to create and achieve success in highly matrixed environment. - Exceptional verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence and partner across the organization to a drive toward resolution for the client, provider and organization. - Strong presentation skills. Able to prepare, deliver, and ensure understanding of information regarding any customer-related or process improvement topic across audiences. - Demonstrated ability to work independently and drive to objectives. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers’ toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: Manager – Reporting and Analytics(Solventum) 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You’ll Make in this Role The Manager – Reporting & Analytics will lead the development and execution of the company’s reporting and analytics within the Finance organization. This role is responsible for overseeing report generation, driving predictive analytics initiatives, and making decisions on report design, consolidation, and automation. The ideal candidate will combine strong technical expertise with business acumen to deliver actionable insights that support data-driven decision-making across the enterprise. As a Manager – Reporting and Analytics you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by: - Leadership & Strategy - Implement the vision for reporting and analytics within Finance, aligning with organizational goals. - Lead a team of analysts and developers to deliver high-quality reporting solutions and advanced analytics. - Establish governance and standards for report design, consolidation, and automation. - Reporting & Consolidation - Drive the creation, maintenance, and optimization of financial and operational reports. - Implement initiatives to consolidate and streamline reporting processes across segments. - Ensure data integrity, accuracy, and compliance with internal and external requirements. - Predictive Analytics & Insights - Develop and implement predictive models to forecast financial performance and identify trends. - Partner with stakeholders to translate business needs into advanced analytics solutions including Predictive Analytics and AI. - Promote the use of data visualization and storytelling to communicate insights effectively. - Process Improvement and Automation - Work closely with Finance leadership and cross-functional teams to ensure alignment and adoption of analytics solutions. - Champion automation and self-service analytics to improve efficiency and scalability. Your Skills and Expertise To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications: Bachelor’s Degree or higher in Finance, Data Analytics, Business, or related field and (7) seven years of experience in reporting, analytics, or financial planning in a private, public, government or military environment In addition to the above requirements, the following are also required: - Strong knowledge of financial reporting, data visualization tools (e.g., Power BI, Tableau), and predictive analytics techniques. - Experience with ERP systems and data warehouses (e.g., SAP, Oracle, Snowflake). - Excellent communication, leadership, and stakeholder management skills. - (3) three years of management experience Additional qualifications that could help you succeed even further in this role include: - Skills include ability to multi-task and prioritize multiple high priority projects - Ability to communicate effectively to leadership on progress and recommendations on removing barriers - Ability to manage a small team of professionals successfully Work location: Remote-United States Travel: May include up to 10% travel Relocation Assistance: May be authorized Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status). Supporting Your Well-being Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Applicable to US Applicants Only:The expected compensation range for this position is $163,200 - $224,400, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-Rewards Responsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County. Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here. Before submitting your application you will be asked to confirm your agreement with the terms.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes. - Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data - Support execution of large-scale projects with limited direction from leadership - Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers - Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines - Support the design, testing, and implementation of process enhancements and identify opportunities for automation - Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products - Support multiple functions and levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners - Independently engage with customers and business partners to gather requirements and validate results - Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. 2+ years of experience working with large databases, data verification, and data management, or 1+ years IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/query languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified. Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Our Company Start your next chapter at Revecore! For over 25 years, Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We're powered by people, driven by technology, and dedicated to our clients and employees. If you're looking for a collaborative and diverse culture with a great work/life balance, look no further. As part of our team, you’ll be rewarded with:  - Competitive compensation with eligibility for a quarterly bonus - Comprehensive medical, dental, vision, and life insurance benefits from day 1 - 12 paid holidays and flexible paid time off     - 401(k) with company match    - Employee Resource Groups that build community   - Career growth opportunities    - An excellent work/life balance  Location: Remote-US    As an Underpayment Analyst within our Revenue Integrity team, you hold a pivotal position in ensuring hospitals receive accurate compensation for the services they provide.  Your role involves examining hospital claims to verify proper reimbursement and work with stakeholders to resolve issues and optimize reimbursement processes while adhering to regulatory guidelines and organizational policies.  Strong analytical skills, attention to detail, and problem-solving skills are essential in this role.   Training: Our comprehensive training begins on your first day and lasts 90 business days. It is led by instructors and incorporates interactive discussions and hands-on activities to accommodate diverse learning preferences.   Responsibilities: - Utilize company best practices along with technology enabled worklist and other internal tools to identify discrepancies between expected reimbursement and actual reimbursement amounts from insurance carriers - Investigate reasons for discrepancies, such as payment variances, coding errors, billing discrepancies, or incorrect application of payer policies - Contact insurance companies to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client - Prepare and submit correspondence such as letters, emails, faxes, online inquiries, appeals, adjustments, reports and payment posting - Maintain thorough documentation, including root cause of underpayment issues, trends, outcomes, and lessons learned to support ongoing improvement efforts and knowledge sharing within the organization - Actively participate in discussions, meetings, and brainstorming sessions where team members contribute insights and suggestions for improving processes - Demonstrate a commitment to upholding ethical standards and compliance with relevant regulations and guidelines in all reimbursement optimization activities - Other duties as assigned   This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.   Education/Licensing/Certifications: - High school diploma or equivalent required Work Experience & Skills: - Investigative and problem-solving skills to identify underpayments and discrepancies - Knowledge of healthcare billing, coding, and reimbursement methodologies - Strong analytical abilities to dissect complex guidelines and understand their implications on claims reimbursement - Ability to navigate and interpret various payer policies, including Medicare, Medicaid, and Commercial insurance guidelines - Detail-oriented approach to ensure accuracy in applying guidelines and documenting findings for audit and compliance purposes - Effective communication skills to collaborate with internal teams, payers, and external stakeholders - Experience with healthcare billing software and databases (EPIC, Cerner, Meditech) - Familiarity with legal and regulatory frameworks governing healthcare reimbursement, such as HIPAA, CMS regulations, and state-specific requirements. - Moderate computer proficiency including MS Excel, Word, and Outlook - Possess technical proficiency to work on multiple computer screens and software applications simultaneously - Previous experience working in a remote environment Physical Demands & Work Environment: The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.   Physical Demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to handle or feel objects, tools or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.   Work at Home Requirements:   - A quiet, distraction-free environment to work from in your home.    - A secure home internet connection with speeds >20 Mbps for downloads and >10 Mbps for uploads is required.  - The workspace area accommodates all workstation equipment and related materials and provides adequate surface area to be productive.    Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check.    Revecore is an affirmative action-equal opportunity employer that does not discriminate based on race, color, religion, sex or gender, gender identity or expression, sexual orientation, national origin, age, disability status, veteran status, genetic information, or any other legally protected status. We believe that a diverse workforce fosters innovation and creativity, enriches our culture, and enables us to better serve the needs of our clients and communities. We welcome and encourage individuals of all backgrounds, perspectives, and abilities to apply. Must reside in the United States within one of the states listed below: Alabama, Arkansas, Connecticut, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia and Wisconsin