- The Cigna Group (Nashville, TN)
- **Summary** The Provider Data Quality &..._###@cigna.com_ _for an update on your application or to provide your resume as you will not receive a ... data cleansing algorithms and processes. + Communicate data quality findings and recommendations to both...through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.… more
- The Cigna Group (Nashville, TN)
- …Audit, Controls & Compliance Advisor will support the Internal Monitoring function within the Provider Data Quality & Accuracy (PDQA) team. They will help ... execute monitoring programs to identify data accuracy issues which negatively impact our ability to...through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.… more
- The Cigna Group (Nashville, TN)
- …critical processes + Develop reporting in collaboration with analytics partners to monitor data quality + Work effectively and efficiently on multiple tasks and ... **Summary** The Medicare Risk Adjustment Advanced Analytics team is searching...while producing high quality results + Ensure quality and integrity of data and follow… more
- Elevance Health (Nashville, TN)
- …medical policy application as well as to ascertain adherence to the policies, Provider Outreach and Education, PSC Liaison activities, data mining & reporting, ... **Director I Medicare Operations** **Location:** This position will work a...for improvement and consistency of decisions. + Responsible for Quality Assurance, response to Internal Audit results, Workforce Management… more
- Elevance Health (Nashville, TN)
- **Audit & Reimbursement Senior -** ** Medicare Cost Report Audit** **Locations:** _This is a United States based, virtual position._ **National Government Services** ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...Standards (GAS) and CMS requirements. + Analyze and interpret data with recommendations based on judgment and experience. +… more
- Humana (Nashville, TN)
- …Health Medical Director will attend and participate in meetings involving care management, provider relations, quality of care, audit, grievance and appeal and ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- The Cigna Group (Nashville, TN)
- …experience in healthcare analytics; value-based care experience preferred + Experience with government medicare data highly desired + Data extraction and ... quality of care of our members by our provider groups. In addition, this person will be responsible...collaboratively with key technical and non-technical matrix partners to provide analytical reporting for use in evaluation of our… more
- HCA Healthcare (Nashville, TN)
- …and billing errors, utilizing proper customer service protocol + Update and maintain data inappropriate Provider Enrollment systems while ensuring accuracy and ... Plan and Provider Enumeration System (NPPES) and Council for Affordable Quality Healthcare (CAQH) preferred. + Must have the ability to acquire and maintain… more
- Humana (Nashville, TN)
- …& Benefits and Referrals, SharePoint knowledge + Experience working with healthcare related data (Insurance, Clinical, Provider , Managed care etc ) + Strong ... caring community and help us put health first** The Provider Connectivity Professional 2 provides analysis and support to...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Nashville, TN)
- … relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, ... community and help us put health first** The Supervisor, Provider Engagement develops and grows positive, long-term relationships with...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Nashville, TN)
- …with data analytics teams to use insights in enhancing provider visibility and member decision-making + Manage the product backlog, prioritize features ... us put health first** The Lead Product Manager - Provider Directory helps identify, validate, and implement improvements to...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Highmark Health (Nashville, TN)
- … data management solutions. + Provide business process, system support and data quality governance through data coordination and integration to ensure ... management solutions. Provides business process, system support and data quality governance through data ...analysis in the develop and support of HEDIS and Medicare Star data analysis. Determines how decision… 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)
- …of successful software development. Your expertise will drive the creation of high- quality test data , helping teams to innovate with confidence. Embrace ... software development. Your expertise will enable the creation of high- quality test data , empowering teams to innovate...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 ... caring community and help us put health first** The Data Manager 2 supports all aspects of configuration control,...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment… 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
- 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
- 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 ... first** The Associate Vice President (AVP) of Sales, Group Medicare and Specialty Marketing and Enablement plans and executes...We believe our role goes beyond that of a provider of insurance to that of a well-being partner… 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
- 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