- The Cigna Group (Nashville, TN)
- …In addition to identifying root causes of quality and accuracy issues, they will provide technical support and coaching for our data stewards. The data ... project. They will help to drive improvements in the provider data domain to ensure we meet...assisting with improved claims auto-adjudication. + Work within the Data Quality management process to champion incremental… more
- The Cigna Group (Franklin, TN)
- …within the Medicare Stars Analytics team, who's function is to provide operational and analytical support to internal and external partners to improve Cigna's ... data including healthcare claims, clinical outcomes and Stars quality measures to make recommendations based on relevant findings....to detail and accuracy + Work experience as a Data Analyst in Medicare Stars, specifically in… more
- The Cigna Group (Nashville, TN)
- …an individual contributor responsible for supporting the analytics strategy for Medicare Health Services, performing research and analysis within the Clinical ... team. This role will help us accomplish this through data -driven analytics, strategic insights, and collaboration with our internal...to meet our goal of reducing costs and increasing quality of care to our members. This individual will… more
- Humana (Nashville, TN)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... address gaps to targeted metrics. Leverages market level projections and experience data tools to research root cause and capture insights. Researches and… more
- The Cigna Group (Nashville, TN)
- … data related investigations, track lineage and quality issues, reviews data layout and structures + Provide support in Production issue/defect resolution ... Facilitate source business owner review sessions and plan/execute E2E, integration, and data quality validations + Collaborate with the business, compliance, and… more
- Humana (Nashville, TN)
- …your skills in a dynamic environment and make significant contributions to our data -centric projects. Join our Provider Development IT team, an essential ... and performance management product capabilities. This role focuses on data operations and analytics to enhance our connectivity with...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Nashville, TN)
- … assets, enterprise-wide governance processes and tools, sensitive data management, data literacy and data quality . This individual will collaborate ... data governance, data lineage and mapping, data enrichment, data quality , ...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Nashville, TN)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... services using technology and analytics. We are looking for a Senior Data Scientist who will utilize cutting-edge AI, NLP, GenAI techniques, build predictive… more
- Humana (Nashville, TN)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... caring community and help us put health first** The Data and Reporting Professional 2 generates ad hoc reports...age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our… more
- Elevance Health (Nashville, TN)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs._ The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for… more
- Humana (Nashville, TN)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical...to complex issues where the analysis of situations or data requires a case by case consideration of the… more
- Elevance Health (Nashville, TN)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs._ The **Audit and Reimbursement Lead** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for … more
- CenterWell (Nashville, TN)
- …Internal Medicine or Geriatric Medicine preferred + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of ... team-based care environment. We are a value based care provider focused on quality of care for...unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes… more
- CenterWell (Nashville, TN)
- …Internal Medicine or Geriatric Medicine preferred. . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of ... our team-based care environment. We are a value-based care provider focused on quality of care for...unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes… more
- CenterWell (Bellevue, TN)
- …screened for TB. **Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience ... our team-based care environment. We are a value-based care provider focused on quality of care for...unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes… more
- The Cigna Group (Nashville, TN)
- …members of health care team to ensure outstanding patient care is delivered + Provider must be able to interpret laboratory data and diagnostic testing when ... Our focus is comprehensive care at home to improve quality of life, increase understanding and management of serious...within the continuum of serious and complex illness; we provide the right level of care at the right… more
- Elevance Health (Nashville, TN)
- **JR130960 Business Change Director ( Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... / Quality Control Test Architect. This high-performing individual contributor will...status as defined in the test plan with supporting data . + Manages both onshore and offshore test execution… more
- Humana (Nashville, TN)
- …national level. + Develops policy and procedure, and defines/improves processes regarding quality measurement data collection and improvement methodology for all ... Excel. + Demonstrated ability to perform moderate to complex data analysis. + Strong relationship building skills. + Excellent...need it. These efforts are leading to a better quality of life for people with Medicare ,… more