- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Lincoln Financial Group (Frankfort, KY)
- …**The Role at a Glance** Lincoln National Corporation seeks multiple positions for Sr Analyst , Application Development in Radnor, PA. DUTIES: Design, build, and ... (using AWS, Informatica and Python to further these objectives). Lead other developers, business systems analysts and quality analysts on project led efforts to add… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... key business issues related to cost, utilization and revenue for...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… more
- Molina Healthcare (Lexington, KY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… more
- Molina Healthcare (Lexington, KY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in contracts and benefits configuration. + Strong background in claims is required. + Experience working on Networx, QNXT… more
- Molina Healthcare (Lexington, KY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (Lexington, KY)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- CVS Health (Frankfort, KY)
- …CVS Health is currently looking for a dynamic individual to join our team in an Sr . Analyst role. This is a client facing project management / auditor position ... initiated by CMS / States. In this position, the Sr . Analyst will work closely with multiple...requested audits with consistency and minimal disruption to the business . This position needs to be able to manage… more
- Evolent (Frankfort, KY)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a ... the impact of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams… more
- Humana (Frankfort, KY)
- …The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer ... as it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more
- UMB Bank (Frankfort, KY)
- …used for the creation of reports to be consumed by LOB (lines of business ) senior executives and analysis for managing fraud prevention strategies across all ... position will report directly to the Manager, Enterprise Fraud Strategy, supporting business reporting and analytical needs for multi channel payment systems. These… more
- Highmark Health (Frankfort, KY)
- …in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities. **ESSENTIAL ... strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought… more
- Highmark Health (Frankfort, KY)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... lower level HMIG Underwriters. **ESSENTIAL RESPONSIBILITIES** + Responsible for a book of business of renewing accounts and writing new business at profitable… more