- 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)
- **Anticipated End Date:** 2024-09-17 **Position Title:** Audit & Reimbursement Senior- Medicare Cost Report Audit **Job Description:** **Audit & Reimbursement Senior ... -** ** Medicare Cost Report Audit** **Locations:** This is a virtual...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
- The Cigna Group (Nashville, TN)
- …tasks and deadlines, while producing high quality results + Ensure quality and integrity of data collected and analyses performed **Qualifications** + ... **Summary** The Medicare Risk Adjustment Analytical Consulting team is searching...business analytics advisor to identify key analytics needs and provide insights which address business questions and influence decision-making.… more
- The Cigna Group (Nashville, TN)
- …Cigna's Medicare PDP growth goals. **Responsibilities** + Partner to provide the strategic direction and management of digital acquisition marketing initiatives ... in driving marketing strategy and initiatives with a strong focus on data -driven decision-making and a deep understanding of digital marketing. Additionally, will be… more
- Prime Therapeutics (Nashville, TN)
- …mining and analyses to help investigate and answer challenging questions regarding actuarial data and concepts + Provide strategic pricing advice on structures ... decision we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- The Cigna Group (Nashville, TN)
- …evaluate the cost and quality of care of our members by our provider groups. In addition, this person will be responsible to identify opportunities for our ... collaboratively with key technical and non-technical matrix partners to provide analytical reporting for use in evaluation of our...quality of care opportunities for a variety of provider groups in a value-based care arrangement + Extract,… more
- Highmark Health (Nashville, TN)
- …and authority. + Develop, implement and execute, the Provider STARs quality strategy, support/develop technology and data strategies to support STARs ... Responsibilities include but are not limited to the overall field facing STARs Provider Strategy, supporting and developing technology and data strategies to… more
- The Cigna Group (Nashville, TN)
- …facility systems as well as develop a competitive intel process leveraging transparency data as well as Medicare and Medicaid pricing. + Collaborate with ... of strategic initiatives regarding Network Solutions and Innovative Contracting to enhance provider supply and demand as well as the evolution of our reimbursement… more
- Humana (Nashville, TN)
- …rotations through various DVACO departments including Care Coordination, Practice Transformation, Data Analytics, Post-Acute Care and Clinical Quality , and the ... Fellow can tailor their experience through various projects in quality oversight, data reporting, performance improvement, physician...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Mathematica (Nashville, TN)
- …machine learning architecture to make predictions with a large multiyear sample of Medicare beneficiaries with detailed claims data about millions of people. ... collaboration to reduce drug overdoses. Position Requirements: *Responsibilities:* * Provide technical leadership to multidisciplinary teams combining data … 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)
- …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 ... us put health first** Join our team as a Data Visualization Engineer 2 and revolutionize how we interact...the US without Humana sponsorship as Humana does not provide work visa sponsorship for this role._** **Location/Work Style:**… more
- CenterWell (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 ... play critical role in defining and executing Integrated Health data strategy and oversee the creation of trusted, cross-domain...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 ... our caring community and help us put health first** The Senior Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform… more
- Prime Therapeutics (Nashville, TN)
- …empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If ... drives every decision we make. **Job Posting Title** Health Data Analyst - Remote **Job Description** The Health ...new products + May be responsible for Centers for Medicaid/ Medicare Services reporting and analysis, including the management of… more
- Humana (Nashville, TN)
- …Communicate insights and analytical findings to a broad range of audiences * Ensure solutions provide the highest quality of data * Contribute to moving the ... team towards cloud-based analytical platforms Member and Provider Analytics, the department this role is a part...analytic solutions. The Stars program is the Centers for Medicare & Medicaid Services (CMS) five‐star 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 ... 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