Healthcare data analyst jobs in Wayne, New JerseyCreate job alerts

Core Essential Skill sets: • Pharmaceutical experience is a must! Candidate has to quickly join in and start., • Medicaid rebate experience in pharm environment., • Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience, • Minimum 2+ years pharmaceutical/product focused healthcare experience; Medicaid Claim processing function; manipulation of large datasets, negotiation/conflict resolution. System Implementation and report writing., • Revitas/Flex Medicaid and advance Microsoft Excel skills., • Strong ability to organize and manipulate large volume of data in various formats. Attention to detail and high degree of accuracy in data processing and reviews. Position Summary: • The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing when necessary, and remitting payment for assigned state Medicaid agencies, SPAPs and Supplemental Rebates., • Analyst is accountable for submitting payments within deadlines and in compliance with CMS guidelines and Client rebate contract terms., • This position also provides assistance in resolving dispute resolution, weekly pay run activities, SOX audits, system upgrade/implementation and ad hoc analysis. Essential Duties & Responsibilities • Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and review to ensure completeness of information received. Upload data into Medicaid systems and authorize transactions. Document errors and perform research., • Conduct initial quality check on summary data on all claim submissions to ensure rebate eligibility and data consistency. 20%, • Perform Claim Level Detail validation. Review suspect claim records and determines if record should be disputed for payment.20%, • Resolve disputes and propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid claims. Must have ability to work independently and make recommendation on state disputes, apply proper amounts to be paid & ensure CMS codes are applied correctly; notify states of results/findings. 20%, • Complete Medicaid analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs.10%, • Provide backup for Medicaid team members in any necessary functions and work with team to establish best practices within Client Medicaid work environment.5%, • Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and review to ensure completeness of information received. Upload data into Model N / Medicaid systems and authorize transactions. Document errors and perform research 5%, • Conduct initial quality check on summary data on all claim submissions to ensure rebate eligibility and data consistency 5%, • Perform Claim Level Detail validation. Review suspect claim records and determines if record should be disputed for payment. 5%, • Resolve disputes and propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid claims. Must have ability to work independently and make recommendation on state disputes, apply proper amounts to be paid & ensure CMS codes are applied correctly; notify states of results/findings. 5%, • Complete Medicaid analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs. 5% Education Required: • Bachelor's degree/ High school Diploma or equivalent combination of experience, training and/or direct work related experience., • Experience Required: Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience, • Experience Preferred: Minimum 2+ years pharmaceutical/product focused healthcare experience; Medicaid Claim processing function; manipulation of large datasets, negotiation/conflict resolution. System Implementation and report writing., • Specialized or Technical Knowledge, License, Certifications needed: Knowledge of the Model N or Revitas/Flex Medicaid and/or Flex Validata system (or other comparable system) and advance Microsoft Excel skills., • Familiar with CMS Medicaid rules and state specific issues. Up to date knowledge on Medicaid Validation rules and issues with 340B covered entities., • Strong ability to organize and manipulate large volume of data in various formats. Attention to detail and high degree of accuracy in data processing and reviews., • Company/Industry Related Knowledge: Medicaid, Government Pricing and Rebate Pharmaceutical industry experience/knowledge prefer. Core competencies • Uses good analytical and data interpretation skills to analyze and resolve complex problems, • Analyzes processes and systems to improve efficiency and effectiveness through standardization, simplification and automation.

Job DescriptionAbout Agadia We specialize in healthcare management technology and offer our clients a suite of utilization management software solutions. Our mission is dedicated to improving the quality of care and expediting the delivery of healthcare services by advancing and automating utilization management processes. We are based in Parsippany, NJ, with clients across the United States. Job Overview As we grow, we seek a detail-oriented, self-motivated, independent Business Analyst with strong domain expertise in FHIR (Fast Healthcare Interoperability Resources), Electronic Medical Records (EMR), and Healthcare Interoperability. Job Responsibilities Key Experience Areas: • FHIR Standards & API Integration:, • Proven experience working with HL7 FHIR specifications, including resource modeling, API design, and implementation for clinical data exchange., • Lead requirements gathering and gap analysis for FHIR-based APIs to support patient data exchange across systems., • Collaborated with development teams to define resource mappings and ensure compliance with HL7 standards., • Participated in testing and validating FHIR endpoints for clinical and administrative data., • EMR Systems:, • Hands-on experience with leading EMR platforms like Epic, Cerner, or Allscripts. Ability to analyze workflows, extract structured/unstructured data, and support integration efforts., • Worked with multiple EMR platforms (e.g., Epic, Cerner, Allscripts) to extract and normalize patient data for downstream processing., • Defined workflows for integrating EMR data into analytics platforms and care coordination tools., • Partnered with clinical stakeholders to ensure EMR configurations aligned with operational needs and regulatory requirements., • Healthcare Interoperability:, • Deep understanding of interoperability frameworks, including CMS and ONC mandates, 21st Century Cures Act compliance, and payer-provider data exchange. Experience facilitating seamless data flow across systems using secure protocols and standardized formats., • Supported initiatives aligned with CMS and ONC interoperability mandates, including 21st Century Cures Act compliance., • Facilitated data exchange between payers, providers, and third-party applications using APIs and secure transport protocols., • Conducted impact assessments and documentation for interoperability enhancements, including patient access and provider directory services., • Business Analysis Skills:, • Strong capabilities in requirements gathering, stakeholder engagement, process mapping, and documentation. Experience working in Agile environments and collaborating with cross-functional teams including developers, QA, and product owners. Desired Skills • Strong verbal and written communication skills, • Familiarity with utilization management processes, preferably prior authorization within all lines of business, • Experience working with health plans, PBM, and specialty pharmacies is a plus., • Problem-solving and business analysis skills with strong attention to detail, • Strong execution skills, • Highly organized and flexible, • Team Player Qualifications, • Three plus years working as a Business Analyst, • Bachelor's Degree required., • Experience working with MS Office products. Key Competencies Communicates effectively – Attentively listens to others, provides timely and helpful information, and is effective in various professional settings. Demonstrates excellent oral and written communication skills. Able to communicate effectively with all levels of the organization, from staff to senior leadership. Being resilient - Demonstrates grace under pressure; maintains a positive attitude in adversity and rebounds from setbacks. Manages complexity - Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems. Has strong organizational skills and can manage multiple projects at once. Ensures Accountability - Follows through on commitments and ensures others do the same. Able to work independently and as part of a team

Job Description ELLKAY started out providing connectivity solutions to laboratories and, within a few years, grew to also provide data management solutions to ambulatory organizations. ELLKAY is now a trusted data management partner in five healthcare segments. ELLKAY’s solutions continue to serve laboratories and ambulatory practices and have expanded to empower hospitals and health systems, healthcare IT vendors, ambulatory practices, health plans, and other healthcare organizations with cutting-edge technologies and solutions that drive their growth and interoperability strategies. Today, ELLKAY remains true to our core values, building strong partner relationships and offering unparalleled service and support while providing innovative, scalable solutions to the challenges our customers face in today’s data-rich world. ELLKAY's experience, customer-focused approach, and reputation for innovation, speed, and accuracy differentiate ELLKAY as a premier partner for your interoperability needs and data management strategy. Job Description: The Sr. Analyst, Interface will be responsible for the successful implementation of HL7 interfaces between Electronic Medical Record (EMR) systems and Lab Information Systems (LIS). Successful implementation includes establishing connectivity, coordinating development, testing, troubleshooting, as well as managing relationships with EMR resources and LIS resources Essential Duties & Responsibilities: • Install and configure proprietary software solutions remotely, • Plan and schedule project timelines, • Serve as primary point of contact for all project communication, both oral and written, • Communicate to all key stakeholders on progress in a timely manner throughout the entire project life cycle, • Set and manage appropriate expectations, • Create and maintain accurate documentation for each project, • Experience with interfacing between different systems, • Experience working with different data formats (e.g., HL7, XML, CSV, JSON, etc.), • Experience working with different EMR vendors and/or Labs on connectivity projects, • Knowledge of basic networking and different connectivity solutions (e.g., VPN, SFTP, TCP-IP, etc.), • Demonstrated strong organization and planning abilities, • Strong critical thinking and problem-solving skills, • Strong oral and written communication skills, • Ability to communicate professionally with people at all levels of the organization, • Demonstrated ability to manage multiple high-priority projects at the same time, • Ability to exercise effective decision-making in a fast-paced environment ELLKAY offers a comprehensive and competitive benefit package that starts day one! Including: • Medical, Dental, and Vision benefits, • Employer-paid Life and LTD, • 401k w/ matching – once eligibility is met, • Work/life balance, • Paid Volunteer Program, • Flexible working hours, • Generous FTO, • Remote work options, • Employee Discounts, • Working with talented, collaborative, and friendly people who love what they do, • Professional growth within, • Innovation environment At ELLKAY, we are committed to operating as a hybrid workplace, offering employees flexibility in how they structure their time between in-office and remote work. We recognize the significance of fostering connections, collaboration, and creativity within our office culture and its positive impact on our business. Our philosophy of operating as a hybrid workplace underscores our dedication to enabling employees to tailor work-life balance to their individual preferences. For those who do not live within 40 miles of one of our offices, we are open to considering remote work for candidates whose skills and experience strongly align with the role. While we prioritize a hybrid work environment for most roles, we understand the importance of flexibility and are open to remote work for specific positions and specialized skill sets. For more information on our company, visit . ELLKAY LLC is a Smoke-Free Workplace. ELLKAY, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job DescriptionCompany Description Leap Consulting Group supports clinical diagnostics and clinical research organizations through a full range of services supporting the end-to-end digital and technology needs of the lab, from the digital front door to the pre-analytical lab bench process (LIMS, instrumentation, automation, etc.), and all of the complex processes for report writing, revenue cycle, and patient engagement before and after testing. Leap provides turnkey services starting with strategic planning through full implementation and everything in between for CLIA, CAP, NYS CLEP, and FDA-compliant laboratories. Leap’s lab practice is led and staffed by veteran laboratory leaders from high-volume, high-complexity laboratories across the United States. In addition to lab-centric capabilities, Leap offers full capabilities across digital, cloud, and the rest of the IT ecosystems. Job Description We’re looking for experienced laboratory professionals — former bench technologists, R&D scientists, or lab operations specialists — who are excited to apply their laboratory expertise to be client-facing and working directly on client lab projects building the latest and greatest in clinical laboratory workflows and laboratory software system implementations. This is a hands-on, problem-solving role — you’ll work alongside scientists, engineers, and clinicians to make lab systems work better, not sell software or convince people why they need to do better - everyone is working together to make it better. This role is not a generic IT business analyst position — it’s designed for individuals with deep understanding of how labs actually function, from sample accessioning to reporting. If you have great IT analyst skills we need those too, but we are currently not hiring for those. Please do not apply here if you are not deeply experienced in clinical laboratory and/or LIMS. This is a role reporting into our Healthcare Practice Lead focused on supporting several laboratory initiatives including digital-front-doors, preanalytical systems, LIMS, lab automation, bioinformatics, revenue cycle, and other related needs. The role requires Laboratory Operations and/or Laboratory IT awareness, a background in digital transformation or information systems, and ideally exposure to clinical laboratory revenue cycle. The person in this role would be a smart, inquisitive, experienced clinical laboratory or health system technology business analyst or functional technical analyst. From Buy vs. Build Analysis, to System Sourcing projects, to big picture planning, and down to the real roll-up-your-sleeves implementation requirements gathering, technical design, and partnering with your software engineering peers to deliver solutions. In this position, you will work closely with Leap client’s business, clinical, and technology leaders to understand their needs, design and develop innovative solutions, and tackle complex challenges. The people in this role will help clients articulate their requirements, prioritize their needs, develop detailed specifications, and at times will lead implementations in Agile methodologies often supporting a mixed team of both Leap provided and client employee engineering resources. The ideal candidate will be well spoken, extremely organized, and able to succinctly capture every detail. You should also be able to ask questions to clients to ensure there are no gaps in the analysis conducted and be an effective communicator when there have been changes in the requirements. As is the nature of digital transformation consulting, the right people for this role find themselves adaptable and flexible in an environment where change is the only constant. The ideal candidate finds clarity in ambiguity and shifts priorities quickly as new client considerations, challenges, and opportunities arise. You should excel in managing projects, driving product development, and analyzing business needs, all while thriving in a fast-paced and collaborative environment. This role is a hybrid position based in our Bergen County NJ offices. Hybrid expectations include 4 days a week in office, 1 day remote, exclusive of client-related-travel which would be as required. Key Responsibilities: * Portfolio and Program Management: * Partner with clients to define a product or program vision, strategy, and roadmap in alignment with business goals and stakeholder needs * Business Analysis: * Able to understand complex lab workflows and communicating future state changes to developers * Perform gap analysis to identify discrepancies between current processes and desired outcomes * Translate bench-side workflows into system requirements * Document process maps that mirror the flow of specimens through the lab * Collaborate with engineers to digitize and automate R&D and QC processes * Be able to handle changes in workflow and how to address them when those blockers occur * Facilitate meetings to gather requirements, develop solution plans, and drive alignment with business stakeholders * Participate in detailed design sessions with the technical teams to define the implementation approach based on requirements gathered * Project Management: * Handle project ambiguity, complexity, and interdependencies with an organized and structured approach * Assess and prioritize new information and requirements, integrating them seamlessly into project deliverables * Identify and manage project risks and issues * Maintain project documentation, ensuring all project deliverables are documented, updated, and communicated effectively * Facilitation & Communication: * Maintain situational awareness and resolve conflicts efficiently to keep projects on track * Ensure clear and effective communication across all levels of the organization * Adaptability & Creative Problem Solving: * Demonstrate a proactive approach to identifying and addressing challenges * Embrace and manage chaos with a continuous learning mindset, adapting to evolving requirements and challenges * Detail Orientation & Strategic Vision: * Dive into the details to ensure precision and accuracy while maintaining a strategic, high-level perspective * Communicate complex technical concepts in a way that is accessible to non-technical stakeholders, effectively bridging the gap between technical and business perspectives * Stay strategic without losing the detail - it is an art more than a science * Execution & Results: * Demonstrate dependability and reliability with a focus on clear thinking and meticulous attention to detail * Produce detailed stories to drive development and be reliable for QA testing If you are an energetic and multifaceted professional who can embrace uncertainty, think on their feet, and effectively manage shifting priorities to drive projects forward, with the ability to navigate both technical details and strategic business goals, we encourage you to apply and help us drive impactful solutions for our clients! Keywords: LIMS, LIS, ELN, middleware, automation, genomics, pathology, molecular diagnostics, assay development, quality control, sample tracking, data integrity, CLIA, CAP, HL7, FHIR, lab workflow optimization Qualifications Minimum Qualifications: * Education: BA/BS Required * Experience: Minimum of 3-5 years working at the bench and/or as a Business Analyst or Functional Technical Analyst, preferably in a clinical laboratory * Be comfortable communicating in-person, by phone, over video, as well as collaboration chat tools such as Slack and Teams * Be a self-starting independent team player who is both professional and kind to colleagues and customers * Be tech savvy and ideally consider yourself 'fairly technical' * Proven experience in project management, product management, and business analysis * Strong facilitation, communication, and conflict resolution skills * Ability to manage multiple projects simultaneously and prioritize tasks effectively * Ability to manage complexity and ambiguity in a structured and organized manner * Demonstrated ability to drive results and deliver innovative solutions * Proficiency in discussing technical details and translating them into business value * Experience in performing gap analysis and creating business process flows Preferred Qualifications: Knowledge, experience, or proficiency in most or all of the following: * Acting as a liaison between technical operations and solutions providers * Documenting, analyzing, and recommending solutions to complex problems * Information Technology and Software Development business cycles * Healthcare Digital Physician and/or Patient Portals * Revenue Cycle Management * Laboratory Operations * Bioinformatics Additional Information • Be comfortable communicating in-person, by phone, over video, as well as collaboration chat tools such as Slack, • Be a self-starting independent team player who is both professional and kind to colleagues and customers

Job DescriptionDocument Processor / Compliance Analyst (Full-Time - NJ) Business Credentialing Services, Inc. (BCS) is a fast-growing technology company in the insurance and risk management industries. We are growing our Operations department and are looking to hire a Document Processor to assist with data entry and customer support. Today, we have more than 70 employees and two office locations in Parsippany, NJ and Provo, UT. Our compliance and risk management platform helps companies reduce their risk exposure by systematically verifying Vendors/Suppliers they do business with. Blending professional services with web-based applications, BCS continues to maintain its foothold as one of the industry leaders. Job Type: Full-time Employee Pay: $19.50 per hour Responsibilities: • Perform data entry tasks, including inputting and updating information in databases., • Review incoming documentation to verify pertinent information for our clients., • Send emails and make phone calls to provide feedback on the documents received., • Assist with administrative tasks as needed., • Attend team meetings/phone calls. Requirements: • Strong data entry skills with a high level of accuracy and attention to detail., • Strong written and verbal communication skills., • Excellent organizational and time management skills., • Ability to perform data entry tasks within our software platform quickly and accurately., • Intermediate computer literacy is required., • Bachelor's Degree required in any field. Employee Benefits and Additional Information: • Starting Pay Rate: $19.50 per hour., • Required to report to the office in Parsippany, NJ Monday - Friday. When an employee reaches six months of employment, they can work remotely one day per week. When an employee reaches three years of service, they can work remotely two days per week., • Semi-Annual Pay Increases - Employee can earn up to a 2.5% pay rate increase every six months based on performance., • Healthcare Benefits (Medical, Vision, Dental) are available for employees on their first day of employment., • 401(k) / Retirement Benefits - An employee is eligible to participate in the BCS 401(k) program with company matching on their three-month anniversary., • Paid Federal Holidays and Paid Time Off.

Job Description Behavior Technician/Registered Behavior Technician (BT/RBT) – ABA Centers of New Jersey Part-Time West Orange, NJ Starting rate of $24.15/hour. Final compensation will be determined by a candidate’s experience, training, and educational credentials* Growth Opportunity in Healthcare—Will Train! Do you love working with kids? Looking for a new career in healthcare with a stable, growing company that supports and values its team members? Come be a Registered Behavior Technician (RBT) with us! We offer paid training and thorough preparation for the RBT exam through our ABA Academy of Excellence! Plus, you'll benefit from ongoing career support and advancement opportunities. Interested in Furthering Your Career in ABA? We Can Help! For career-minded RBTs who wish to pursue advancement, we offer opportunities to: • Advance your RBT career to positions like Lead RBT, RBT Supervisor, BCBA, and other corporate or clinic positions, • Apply for our full scholarship at Temple University for Master’s in ABA, • Join our BCBA Apprentice Program (after 90 days of full-time work) What You’ll Do • Support individuals with autism in the home, in the community, or in one of our new centers, • Teach daily living skills and social skills using effective behavior and evidence-based treatments, • Collect, organize, and summarize unbiased data during sessions, • Collaborate and participate in clinical team meetings and ongoing training, • Implement training and therapy sessions designed by a Board Certified Behavior Analyst (BCBA), • Proactively communicate and collaborate effectively with fellow RBTs, BCBAs, families, Executive Directors, and additional team members to support the client's needs, • Performs other clerical and administrative duties as assigned to support operations Requirements Education/Experience and Other Requirements • High-school diploma or equivalent, • Availability during after-school hours, weekends, and holidays, • Consistent, reliable transportation, a driver’s license, and car insurance to provide in-home services for clients, • Must maintain clean background/drug screenings and driving record, • BT: Ability to attend our 40-hour RBT training course and be eligible to pass the RBT exam within 45 days of hire, • 401(k) program, • Mentoring for team members who wish to become BCBAs, • Paid Registered Behavior Technician training, • CEU reimbursement, • Tuition reimbursement, • Eligible to receive either a $200 monthly gas stipend (pre-tax), with 50% paid bi-weekly, or mileage reimbursement at the current IRS standard rate., • Opportunity for full-tuition scholarship to Temple University's Master's in ABA program (transition to Full time required), • Performance bonus potential **$5,000 bonus for referring BCBAs to work with us. **$500 bonus for referring RBTs to work with us. About ABA Centers of New Jersey ABA Centers of New Jersey is a great place to work! Don't take our word for it, though. We're listed in Inc. magazine’s Best in Business list for “Health Services,” honoring companies that have made an extraordinary impact in their fields and on society.

Job Description Behavior Technician/Registered Behavior Technician (BT/RBT) – ABA Centers of New Jersey Full-Time West Orange, NJ Hourly: $24.15 Growth Opportunity in Healthcare—Will Train! Do you love working with kids? Looking for a new career in healthcare with a stable, growing company that supports and values its team members? Come be a Registered Behavior Technician (RBT) with us! We offer paid training and thorough preparation for the RBT exam through our ABA Academy of Excellence! Plus, you'll benefit from ongoing career support and advancement opportunities. Interested in Furthering Your Career in ABA? We Can Help! For career-minded RBTs who wish to pursue advancement, we offer opportunities to: • Advance your RBT career to positions like Lead RBT, RBT Supervisor, BCBA, and other corporate or clinic positions, • Apply for our full scholarship at Temple University for Master’s in ABA, • Join our BCBA Apprentice Program (after 90 days of full-time work) What You’ll Do • Support individuals with autism in the home, in the community, or in one of our new centers, • Teach daily living skills and social skills using effective behavior and evidence-based treatments, • Collect, organize, and summarize unbiased data during sessions, • Collaborate and participate in clinical team meetings and ongoing training, • Implement training and therapy sessions designed by a Board Certified Behavior Analyst (BCBA), • Proactively communicate and collaborate effectively with fellow RBTs, BCBAs, families, Executive Directors, and additional team members to support the client's needs Requirements Education/Experience and Other Requirements • High-school diploma or equivalent, • Availability during after-school hours, weekends, and holidays, • Consistent, reliable transportation, a driver’s license, and car insurance to provide in-home services for clients, • Must maintain clean background/drug screenings and driving record, • BT: Ability to attend our 40-hour RBT training course and be eligible to pass the RBT exam within 45 days of hire, • 21 paid days off (15 days of PTO, which increases with tenure, plus 6 holidays), • Medical, dental, vision, long-term disability, and life insurance, • Generous 401(k) with up to 6% employer match, • Mentoring for team members who wish to become BCBAs, • Paid Registered Behavior Technician training, • CEU reimbursement, • Tuition reimbursement, • $400 monthly gas stipend, • Opportunity for full-tuition scholarship to Temple University's Master's in ABA program, • Performance bonus potential **$5,000 bonus for referring BCBAs to work with us. **$500 bonus for referring RBTs to work with us. About ABA Centers of New Jersey ABA Centers of New Jersey is a great place to work! Don't take our word for it, though. We're listed in Inc. magazine’s Best in Business list for “Health Services,” honoring companies that have made an extraordinary impact in their fields and on society.