- Elevance Health (Nashville, TN)
- …Services to transform federal health programs. The **Director I Medicare Operations ** is responsible for directing multiple business function operations ... **Director I Medicare Operations ** **Location:** This position will...will make an impact:** + Responsible for directing multiple business function operations teams on Tier I… more
- The Cigna Group (Nashville, TN)
- **Summary** The Data Scientist Lead Analyst will contribute to the Medicare Clinical and Customer strategy, performing research and analysis within the Clinical, ... to improve clinical programs, customer value, growth, and retention for Cigna Medicare . This role will help us accomplish this through data science, strategic… more
- Humana (Nashville, TN)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Project Management Certification + Experience in business consulting ... community and help us put health first** The Senior Project Manager manages all aspects of a project...experience + 5 or more years of experience managing business projects + Highly self-motivated and proactive with a… more
- Elevance Health (Nashville, TN)
- …priorities; must be comfortable interfacing with senior leadership. + Partner with business operations to understand operational metrics and reporting; assist ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...quality and other operational issues. + Assists in managing project scope to ensure business needs are… more
- Evolent Health (Nashville, TN)
- …with Clinical Operations , Medical Leadership, IT, Provider Relations, and other business groups. **What You Will Be Doing:** + Support team responsibilities and ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...for the culture. **What You'll Be Doing:** As a Project Manager on the Medical Policy team, you will… more
- Elevance Health (Nashville, TN)
- …+ Ability to analyze and manipulate large and complex datasets. + Background in Medicare operations and/or financial reporting. + Exposure to provider or health ... + Requires a BA/BS and minimum of 10 years business analysis experience, which should include analysis, project...risk adjustment and/or health insurance industry. + Experience in Medicare Advantage and Medicaid in a provider based or… more
- The Cigna Group (Nashville, TN)
- …allows associates to work in a variety of cross-functional roles, such as operations , strategy, marketing, finance and project management to create a robust ... Project Management - Develop comprehensive project plans, track project performance, and drive deliverables for new business -critical initiatives + Data… more
- Humana (Nashville, TN)
- …products. + 5+ years of experience supporting Medicaid managed care health services operations and the Medicaid managed care business development lifecycle. + ... work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize,...and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated… more
- Public Consulting Group (Nashville, TN)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... . **Job-Specific Responsibilities** + Provide strong leadership on all Medicare /Medicaid cost settlement and supplemental payment projects, effectively supervising… more
- The Cigna Group (Nashville, TN)
- …This leadership role will bridge the gap between technology and our Pharmacy business and vendor partners ensuring we maintain a high level of technology ... collaboration and oversight with MAPD and PDP lines of business . The Director will be the leadership point of contact for all pharmacy related technical initiatives… more
- Humana (Nashville, TN)
- …Qualifications** + Master's Degree + Certification with Six Sigma and/or the Project Management Institute + Knowledge of Medicare Advantage **Scheduled Weekly ... Professional will work as liaison between vendors and Humana supporting internal business areas while helping ensure vendors meet contractual obligations as part of… more
- Humana (Nashville, TN)
- …from across the enterprise (clinical, quality, operations , analytics, and business ) and leading the end-to-end project of strategy development for ... and address business issues and opportunities related to the high-needs Medicare Advantage (MA) and Special Needs Plan (SNP) populations that benefit from payer… more
- Public Consulting Group (Nashville, TN)
- …+ Strategy, Architecture, Planning, and Procurement + Business Enablement + Business Solutions + Project Assurance The Medicaid marketplace is changing, and ... (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and...as well as experience working with the Centers for Medicare and Medicaid Services (CMS) and the new streamlined… more
- Humana (Nashville, TN)
- …years of project leadership and consulting experience. + Health Care Business Domains - Medicare , Medicaid, Group, Specialty etc. **Additional Information** ... help us put health first** Are you interested in leveraging technology and business strategy to deliver improved member experiences and health outcomes to Humana's… more
- Public Consulting Group (Nashville, TN)
- …federal and state law and regulation. + Reviews and is an expert in business operations for service and efficiency improvements. + Develops and executes new ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies… more
- Vanderbilt University Medical Center (Nashville, TN)
- …objectives are being met. * Define and achieve financial targets in support of business goals of the institution. * Project future budget based upon analysis ... Clinical trial budgeting experience * Oncology experience * Understanding of Medicare coverage analysis Department Summary: Vanderbilt-Ingram Cancer Center (VICC) is… more
- Humana (Nashville, TN)
- …with a focus on strategic planning + 6+ years of experience in operations /product owner development experience. ( project management) + 3+ years' experience in ... innovation opportunities, and translates ideas into actionable and profitable business . The Director, Innovation Portfolio Strategy requires an in-depth… more
- Humana (Nashville, TN)
- …Analytics Professional manages data to support and influence decisions on day-to-day operations , strategic planning and specific business performance issues. The ... on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude… more
- HCA Healthcare (Brentwood, TN)
- …+ Developing study designs and analytic solutions based on available data sources, business partner's needs, and timelines; + Managing multiple projects related to a ... wide variety of business settings and clinical needs; + Collaborating with key...and often requiring solutions not previously used by the project team or work group. + Develop and maintain… more