Authorization and Claims Analytics Data Analyst III Job at L.A. Care Health Plan (Los Angeles)

Authorization and Claims Analytics Data Analyst III

The Authorization and Claims Analytics Data Analyst III serves as a Subject Matt...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree (or equivalent education/experience)
At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health
Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights
Experience analyzing multiple data sources and translating findings into actionable recommendations
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
Expert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes
Advanced proficiency in Tableau (or equivalent BI tools)
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts
Knowledge of version control (Git, GitHub) and collaborative development workflows
Ability to develop and maintain reusable analytic frameworks, templates, and processes

Job Responsibility

Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights
Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance
Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows
Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases
Maintains awareness of data lineage and governance compliance throughout all analytic work
Manages project planning, tracking, and post-implementation assessment for assigned deliverables
Mentors and models adherence to analytic development best practices
Applies subject matter expertise in evaluating business operations and processes
Consults across business operations, providing mentorship, and contributing specialized knowledge

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Authorization and Claims Analytics Data Analyst III

The Authorization and Claims Analytics Data Analyst III serves as a Subject Matt...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree (or equivalent education/experience)
At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health
Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights
Experience analyzing multiple data sources and translating findings into actionable recommendations
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
Expert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes
Advanced proficiency in Tableau (or equivalent BI tools)
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts
Knowledge of version control (Git, GitHub) and collaborative development workflows
Ability to develop and maintain reusable analytic frameworks, templates, and processes

Job Responsibility

Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights
Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance
Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows
Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases
Maintains awareness of data lineage and governance compliance throughout all analytic work
Manages project planning, tracking, and post-implementation assessment for assigned deliverables
Mentors and models adherence to analytic development best practices
Applies subject matter expertise in evaluating business operations and processes
Consults across business operations, providing mentorship, and contributing specialized knowledge

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Authorization and Claims Analytics Data Analyst III

The Authorization and Claims Analytics Data Analyst III serves as a Subject Matt...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree (or equivalent education/experience)
At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health
Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights
Experience analyzing multiple data sources and translating findings into actionable recommendations
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
Expert in SQL for complex exploratory analysis, data modeling, and ETL processes
Advanced proficiency in Tableau (or equivalent BI tools)
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts
Knowledge of version control (Git, GitHub) and collaborative development workflows
Ability to develop and maintain reusable analytic frameworks, templates, and processes

Job Responsibility

Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights
Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance
Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows
Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases
Maintains awareness of data lineage and governance compliance throughout all analytic work
Manages project planning, tracking, and post-implementation assessment for assigned deliverables
Mentors and models adherence to analytic development best practices
Applies subject matter expertise in evaluating business operations and processes
Identifies areas where technical solutions would improve business performance

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Authorization and Claims Analytics Data Analyst III

The Authorization and Claims Analytics Data Analyst III serves as a Subject Matt...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree (or equivalent education/experience)
At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health
Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights
Experience analyzing multiple data sources and translating findings into actionable recommendations
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
Expert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes
Advanced proficiency in Tableau (or equivalent BI tools)
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts
Knowledge of version control (Git, GitHub) and collaborative development workflows
Ability to develop and maintain reusable analytic frameworks, templates, and processes

Job Responsibility

Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights
Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance
Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows
Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases
Maintains awareness of data lineage and governance compliance throughout all analytic work
Manages project planning, tracking, and post-implementation assessment for assigned deliverables
Mentors and models adherence to analytic development best practices
Applies subject matter expertise in evaluating business operations and processes
Consults across business operations, providing mentorship, and contributing specialized knowledge

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Authorization and Claims Analytics Data Analyst III

The Authorization and Claims Analytics Data Analyst III serves as a Subject Matt...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree (or equivalent education/experience)
At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health
Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights
Experience analyzing multiple data sources and translating findings into actionable recommendations
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
Expert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes
Advanced proficiency in Tableau (or equivalent BI tools)
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts
Knowledge of version control (Git, GitHub) and collaborative development workflows
Ability to develop and maintain reusable analytic frameworks, templates, and processes

Job Responsibility

Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights
Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance
Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows
Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases
Maintains awareness of data lineage and governance compliance throughout all analytic work
Manages project planning, tracking, and post-implementation assessment for assigned deliverables
Mentors and models adherence to analytic development best practices
Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed
Perform other duties as assigned

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Benefit & Coding Analyst III

Our Client is seeking a Benefit & Coding Analyst III to analyze, develop, and ma...

Location

United States , Dayton

Salary:

70.00 USD / Hour

Medasource

Expiration Date

Until further notice

Requirements

Bachelor’s degree in a related field or equivalent experience required
Minimum five (5) years of experience in medical coding, benefit plan design, benefit configuration, or claims processing
Subject matter expertise in CPT, HCPCS, and ICD-CM coding
Experience with benefit configuration systems (Facets or equivalent preferred)
Strong analytical, problem-solving, and critical thinking skills
Understanding of claims-related reference data (revenue codes, bill types, POS, etc.)
Knowledge of Medicare, Medicaid, and Marketplace benefit structures highly preferred
Managed Care experience strongly preferred
Proficient with Microsoft Office Suite
database knowledge preferred

Job Responsibility

Analyze and translate complex medical benefit requirements into system configurations and coding specifications across multiple states and product lines
Develop, maintain, and validate code-level benefit definitions using correct coding methodologies, coding guidelines, and regulatory requirements
Create and review configuration templates and benefit grids to ensure alignment between benefit intent, coding logic, and system design
Research and interpret federal, state, and CMS regulations, including prior authorizations, EHB requirements, OPPS rules, MHPAEA compliance, and provider contract alignment
Participate in and support annual benefit change and quarterly coding update processes, ensuring timely implementation and compliance
Utilize reporting tools to analyze data, conduct impact assessments, resolve issues, and perform root cause analysis
Support cross-functional teams through effective communication, documentation, process improvement, and troubleshooting
Provide mentorship, peer reviews, and training to colleagues to ensure consistency and quality of work
Create and maintain SOPs, process flows, and operational documentation
Serve as backup or lead on assigned projects, internal/external meetings, and operational priorities as needed

What we offer

competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage with plans that can fit each employee’s needs
401k plan that includes a company match and is fully vested after you become eligible
paid time off
sick time
paid company holidays
Employee Assistance Program (EAP) that provides services like virtual counseling, financial services, legal services, life coaching

Fulltime

New

Store Associate

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Chicago

Salary:

16.60 - 23.60 USD / Hour

CVS Health

Expiration Date

June 19, 2026

Requirements

At least 16 years of age
Remaining upright on the feet, particularly for sustained periods of time
Lifting and exerting up to 35 lbs of force occasionally, up to 10 lbs of force frequently, and a negligible amount of force regularly to move objects to and from, including overhead lifting
Visual Acuity - Having close visual acuity to perform activities such as: viewing a computer terminal, reading, visual inspection involving small parts/details

Job Responsibility

Providing differentiated customer service by anticipating customer needs, demonstrating compassion and care in all interactions, and actively identifying and resolving potential service issues
Focusing on the customer by giving a warm and friendly greeting, maintaining eye contact and offering help locating additional items, when needed
Accurately perform cashier duties - handling cash, checks and credit card transactions with precision while following company policies and procedures
Maintaining the sales floor by restocking shelves, checking in vendors, updating pricing information and completing inventory management tasks as directed by store manager
Supporting opening and closing store activities, when needed
Providing customer support to all departments, including photo and beauty, ensuring departments are fully stocked and operational while remaining current with all updated services and tools
Assisting pharmacy personnel when needed, including working regular shifts in the pharmacy as part of opportunities for growth and career development
Embracing and advocating for new CVS services and loyalty programs that support our purpose of helping people on their path to better health

What we offer

Dental
Vision
Wellness resources
Employee discounts
Access to certain voluntary benefits
Other programs

Parttime

New

Front Desk Receptionist

As a Front Desk Receptionist, you will be the first and last point of contact fo...

Location

United Kingdom , London

Salary:

37800.00 GBP / Year

Four Seasons

Expiration Date

Until further notice

Requirements

Previous Front Desk or guest facing experience in a hotel environment
Strong communication skills and confident guest interaction
Excellent attention to detail and organisational ability
Ability to multitask and remain calm under pressure
Experience using Opera PMS or similar systems is preferred
Positive attitude and genuine passion for hospitality
Flexibility to work a range of shifts including evenings, weekends, and public holidays
Right to Work in the UK

Job Responsibility

Welcome guests warmly and manage all aspects of arrival and departure
Handle check in and check out procedures accurately using Opera PMS
Respond to guest enquiries and requests promptly and professionally
Coordinate with Housekeeping, Concierge, and Food and Beverage teams to deliver a seamless guest experience
Manage billing and payments accurately and securely
Provide local knowledge and personalised recommendations
Identify opportunities to enhance the guest experience, including upselling where appropriate
Maintain high standards of presentation, professionalism, and service at all times

What we offer

£37,800 annual package inclusive of base salary and service charge
Structured 40 hour working week
Excellent training and clearly defined career development pathways
Strong internal progression opportunities across London and the global Four Seasons portfolio
Holiday entitlement increasing with service up to 33 days
Up to two paid Wellness Days per year
Company Sick Pay, increasing with service
Life insurance while on duty
Up to 20 complimentary nights at Four Seasons Hotels and Resorts worldwide, increasing with service, as well as heavily discounted rates at all properties
50% discount across UK Four Seasons food and beverage outlets from day one for up to four guests

Fulltime

Authorization and Claims Analytics Data Analyst III

L.A. Care Health Plan

Location:
United States , Los Angeles

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 22, 2026

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