Jobs
>
St. Louis

    Quality Review and Audit Lead Analyst - St Louis, United States - Hire Talent

    Hire Talent
    Hire Talent St Louis, United States

    3 weeks ago

    Default job background
    Description

    Service Reliability:
    Quality Review and Audit Lead Analyst - PBM (High Band 3)


    POSITION SUMMARY


    The Quality Review and Audit Lead Analyst is responsible for facilitating the analysis, research, and risk assessment of claims/system processing issues.

    The lead analyst will use an in depth understanding of technical principles, theories, and concepts in the field of quality to perform a thorough root cause and corrective action analysis.

    In addition to supporting tickets for root cause analysis, the lead analyst will be engaged in strategic initiatives to drive continuous improvement in the process to support our enterprise business.

    Required Qualifications

    3-5 years experience in Root Cause and Corrective/Preventive Action

    Excellent verbal and written business communication skills

    Knowledge including Microsoft Office; Outlook, Word, Excel, PowerPoint and SharePoint

    Knowledge of Client platforms preferred: Service Now, RSAM, Polaris

    Adapt to a dynamic work environment, learn quickly, solve problems and make decisions with minimal oversight

    Demonstrate initiative, commitment, and ability to work under pressure and meet tight deadlines

    Demonstrated ability to work collaboratively with other departments to resolve complex issues with strategic & innovative solutions

    Preferred Qualifications

    BA/BS degree

    Healthcare acumen

    Corrective Action/Preventive Action Management

    Responsibilities

    Review, analyze, and appropriately disposition tickets for RC/CA Analysis

    Collaborate with Business Partners to ensure correct root cause is established and a solid corrective action/preventive action is in place

    Utilize system platform to manage tickets and accurately capture/categorize all necessary trend information

    Review submitted data for quality and accuracy

    Support projects and initiatives which drive department strategy

    Assist in training, documentation, and other duties required to sustain and improve process performance

    Partner with Service Operations & PBM Customer Services to execute on action plan deliverables

    Share and communicate pertinent information with internal partners
  • Cigna Health and Life Insurance Company

    Lead Analyst

    3 weeks ago

    Cigna Health and Life Insurance Company St. Louis, United States

    Lead Analyst - Regulated Markets Issue Management - Express Scripts - Hybrid page is loaded · Lead Analyst - Regulated Markets Issue Management - Express Scripts - Hybrid · Apply · remote type · Hybrid · locations · MO, St. Louis, One Express Way · TN, Franklin, 730 Cool S ...

  • The Cigna Group

    Lead Analyst

    1 week ago

    The Cigna Group St Louis, United States

    Summary · Partners with the Senior Manager to establish strategies to manage issue management pipeline impacting Regulated Markets. Interfaces with multiple departments (e.g., Product, Account Team, Compliance, etc.) to develop relationships to resolve issues involving regulator ...

  • Iterum

    Lead Business Analyst

    12 hours ago

    Iterum St. Louis, United States Full time

    Responsibilities: · Drive company-wide excellence by working with business stakeholders to analyze operations and recommend solutions that align business functions with organizational goals · Improve existing operations by recommending solutions for general business processes and ...

  • Chameleon Integrated Services

    Lead Programmer Analyst

    1 week ago

    Chameleon Integrated Services Saint Louis, United States

    Job Description · Job Description We are a growing information technology company that offers its employees a culture of success, diversity in the workplace and the ability to work with leading edge technology that is revolutionizing federal IT infrastructure. We are seeking for ...

  • Saint Louis Public Schools

    Lead Finance Analyst, 2023

    3 weeks ago

    Saint Louis Public Schools St. Louis, United States Full time

    Job Description · Position Title: Lead Finance Analyst · Payroll/Personnel Type: 12 Month · Job #: 8987 · Reports to : Manager, Budget and Grants · Shift Length: 8 Hour Day · Union Eligibility: Not Eligible · Position Summary: · The Lead Financial Analyst performs assigne ...

  • Cigna

    Lead Analyst

    2 weeks ago

    Cigna Saint Louis, United States

    Job Description · Summary · Partners with the Senior Manager to establish strategies to manage issue management pipeline impacting Regulated Markets. Interfaces with multiple departments (e.g., Product, Account Team, Compliance, etc.) to develop relationships to resolve issues in ...

  • The Cigna Group

    Proposal Support Lead Analyst

    4 weeks ago

    The Cigna Group St Louis, United States

    Job Summary · The Proposal Support Lead Analyst is responsible for managing the proposal development process for less complex, custom bids, from receipt of the RFP through proposal submission. This individual will have specialized knowledge of their primary business segment, with ...

  • The Cigna Group

    Lead Analyst

    3 weeks ago

    The Cigna Group St. Louis, United States OTHER

    The job profile for this position is Product 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 recru ...

  • Core and Main

    Lead Incentive Compensation Analyst

    3 weeks ago

    Core and Main St Louis, United States

    Company Overview: · About Core & Main · Based in St. Louis, Core & Main is a leading distributor of water, sewer, storm drain and fire protection products in the United States. Operating approximately 320 branches nationwide, the company combines local expertise with a national ...

  • Husch Blackwell

    Lead Conflicts Analyst

    1 week ago

    Husch Blackwell St Louis, United States

    Husch Blackwell LLPis a full-service litigation and business law firm with multiple locations across the United States, serving clients with domestic and international operations. · At Husch Blackwell we believe that diverse, equitable and inclusive teams lead to better outcomes ...

  • Hire Talent

    Operations Lead Analyst

    3 weeks ago

    Hire Talent St Louis, United States

    Provides advanced professional input to complex Operations Management / Finance Operations assignments/projects. Supports and provides direction to more junior professionals. Works autonomously, only requiring expert level technical support from others. Exercises judgment in the ...

  • Cigna

    Product Management Lead Analyst

    2 weeks ago

    Cigna Saint Louis, United States

    Job Description · Product Management Lead Analyst – Centene Operations Management · This is a hybrid role and will require the ability to work in person. · The job profile for this position is Product Management Lead Analyst, which is a Band 3 Senior Contributor Career Track Role ...

  • The Cigna Group

    Pharma Rebate Analytics Lead Analyst- Express Scripts

    1 week ago

    The Cigna Group Saint Louis, United States OTHER

    **Pharma Rebate Analytics Lead Analyst supporting the BDRO-Benefit Driven Rebate Optimization team** · **OVERVIEW** · This position may be responsible for review and interpretation of current clinical rules impacting rebate eligible drugs. Review and interpret client benefit stru ...

  • The Ladders

    Lead Incentive Compensation Analyst

    1 week ago

    The Ladders St Louis, United States

    Job Summary · Responsible for the accounting and administration of company incentive compensation programs, which involves gathering disparate data from various data sources, analyzing and normalizing to ensure data integrity for analysis. Provide consistent, relevant, and accur ...

  • Ascension

    Lead Health Equity Analyst

    3 weeks ago

    Ascension St Louis, United States

    Details · Department: Ascension Data Science Institute · Schedule: Full-time, 8 hour day shift, Monday - Friday · Location: Remote · Benefits · Paid time off (PTO) · Various health insurance options & wellness plans · Retirement benefits including employer match plans · L ...

  • Core & Main

    Lead Incentive Compensation Analyst

    3 weeks ago

    Core & Main St Louis, United States

    Job Description · Job Summary · Responsible for the accounting and administration of company incentive compensation programs, which involves gathering disparate data from various data sources, analyzing and normalizing to ensure data integrity for analysis. Provide consistent, r ...

  • Elemental Enzymes Inc

    Quality Control Analyst Team Lead

    3 weeks ago

    Elemental Enzymes Inc St Louis, United States

    Job Description · Job Description Salary: · Quality Control Analyst Team Lead · Responsibilities: · Lead QC team in the laboratory for routine questions and direction with support and direction of QC Manager · Oversee and schedule analytical tests, enzyme quantification assays, ...

  • The Cigna Group

    Identity Governance Management Lead Analyst

    1 month ago

    The Cigna Group St. Louis, United States OTHER

    The job profile for this position is Information Protection 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 r ...

  • The Cigna Group

    Evernorth Sales Strategy Lead Analyst

    1 month ago

    The Cigna Group St. Louis, United States OTHER

    The job profile for this position is Sales Effectiveness 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 recr ...

  • The Cigna Group

    Financial Analysis Lead Analyst-Express Scripts-Hybrid

    3 weeks ago

    The Cigna Group St Louis, United States

    POSITION SUMMARY · Responsible for managing all aspects of pharmacy contractual guarantees. Analyst will conduct routine analysis on guarantee performance and make pharmacy pricing recommendations to management in order to meet the guarantees. · Responsible for coordinating, co ...