- The Cigna Group (Nashville, TN)
- **Summary** The Directory Data Steward is an Advisor level role within the Provider Data Quality & Accuracy team, responsible for maintaining 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 (Nashville, TN)
- **Job Description** Medicare Technology Operations - Data Measurement and Reporting Senior Analyst **Overview** Guides the team to deliver tasks in the Data ... will play an important role in the development and support of key data -related deliverables within the Medicare Technology Operations team, including but not… 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)
- …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 ... leading the analytics strategy for Cigna Healthcare within the Medicare Stars program with a focus on Part D...The Business Analytics Senior Advisor will lead development of data analyses utilizing pharmacy claims, clinical outcomes, and Stars… 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 ... involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for… more
- The Cigna Group (Nashville, TN)
- …Engineering Senior Manager will oversee a team dedicated to creating and delivering high- quality cloud solutions for our Medicare plans. To ensure future success ... The Medicare Technology Operations organization is looking for experienced,...they are delivered on time, within budget, and meet quality standards. + Develop solutions using TDD methodology. +… 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
- Vanderbilt University Medical Center (Nashville, TN)
- …revenue cycle processing and reporting. Assists with the analysis and interpretation of data from internal/external sources to provide information to all levels ... analysis/trending impacts and system and operational improvement action plans. Incorporates data into formal presentations to provide guidance and supporting… 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)
- …+ Accountable for meeting Key Performance Indicators regarding Turnaround Time and Quality + Analyze business metrics and provide monthly review of ... leadership role within a highly complex operational environment + Provider Experience related to data , contracting, network,...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 Manager, Encounter Data Management develops business processes to ensure successful submission and reconciliation… more
- Humana (Nashville, TN)
- …The Quality Compliance Professional 2 participates in performance and quality improvement projects by implementing member and provider targeted interventions ... to improve health outcomes and member and provider experiences. The Quality Compliance Professional 2...gaps, audit records to identify improvement opportunities, and abstract data from records to close gaps + Quality… 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 ... community and help us put health first** The Senior Data Scientist uses mathematics, statistics, modeling, business analysis, and...Please be aware that applicants may be asked to provide their Social Security Number, if it is not… 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 ... community and help us put health first** The Senior Data and Reporting Professional generates ad hoc reports and...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
- 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 ... of CMS Interoperability, FHIR Implementation Guides and Standards, and data management specific to Medicare along with...business owner review sessions and plan/execute E2E, integration, and data quality validations + Collaborate with the… more
- CenterWell (Brentwood, 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