A US Healthcare Claims SME also acting as a Business Analyst, requiring deep expertise in US Healthcare claims adjudication and end-to-end process understanding.
Responsibilities
Understand and challenge complex Claims business requirements
Translate requirements into strong User Stories & Acceptance Criteria
Identify business-rule gaps, dependencies and exception scenarios
Guide Development & Testing teams throughout the sprint
Understand end-to-end adjudication including Benefits, Pricing, Provider, COB, Member liability, Denials/Pends, Adjustments and Reprocessing
Technical Specialist- Expert providing configuration management / release management support and guidance for Endevor software, focusing on SQL and DB2.
Responsibilities
Providing configuration management / release management support and guidance for Endevor software
Evaluate complex SQL queries
Recommend suggestions for better software performance and cost savings
Lead data operations activities post input receipt, acting as bridge between Supplier Engagement and Ops pillars, managing data quality, tickets, and reporting.
Responsibilities
Secure BAU operations
Analyze, classify, and manage data
Collaborate on retailer onboarding
Ensure data compliance
Track and resolve MSD tickets
Requirements
Master's Degree in statistics or data analytics or equivalent
Act as the primary technical subject matter expert for FloQast’s SAP integration strategy, effectively navigating and explaining the nuances of SAP S/4HANA (Public/Private Cloud) and legacy ECC environments to prospective clients.
Compensation
The base pay range for this position is $115,000- $150,000. This position is eligible for a commission plan in addition to base pay.
Responsibilities
Serve as subject matter expert for FloQast’s integration ecosystem
Join late-stage Sales opportunities to demonstrate integration requirements
Strategize with the Sales team on best next steps
Collaborate with the Product/Engineering team on developments
Design and validate integration workflows
Requirements
Degree in IT, Business Systems, Accounting Information Systems, or a related field
Supports research administration data and systems across the University, ensuring secure, accurate data collection and reporting for internal and external compliance.
Compensation
The base salary will be HEW Level 8 in the range $117,579 - $132,273 per annum, plus 17% superannuation. The total package will be in the range $137,567 - $154,759 per annum.
Responsibilities
Implement routine and complex reports and reporting tools for grants management, research development, ethics management
Support users and systems to enhance existing systems, interfaces, and user support processes
Prepare and benchmark internal reporting and government evaluations
Collaborate with Digital Solutions, Library, Planning & Analytics, and system vendors
Advise on technical compliance issues and ensure systems meet national and global standards
Requirements
Postgraduate qualification
Nice to have: high-level knowledge of API programming
Lead ongoing reviews of business processes and proposal/development of optimization strategies for the Program Services Team.
Locations (2)
Hamilton Square, New Jersey, United States
Hamilton, New Jersey, United States
Compensation
Base Salary Range: $95,000 - $120,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
Responsibilities
Lead ongoing reviews of business processes and proposal/development of optimization strategies
Gather and document data management risks and needs of the business to investigate and propose solutions with business case rationale
Construct workflow charts and diagrams; studying business process and system capabilities
Gather job specifications and business rules, and technical deliverables by directly interfacing with the business stakeholders upfront, then regroup to recommend solutions, and assist in the implementation and user training for roll-out of any solutions
Translate stakeholder business requirements to technical documentation for implementation
Requirements
Bachelor’s Degree in IT or Business field required (programming or computer science fields preferred)
Nice to have: Workflow platforms such as Power Apps, Appian, and Power Automate
Nice to have: Solid understanding of database, SQL and XML SQL or Business Intelligence (BI) platforms, such as Power BI
Nice to have: CRM experience preferred (Salesforce)
