- Prime Therapeutics (Nashville, TN)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Nashville, TN)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- HUB International (Brentwood, TN)
- …the organization. **Other Responsibilities:** + Attend and participate in various senior claims management meetings. + Coordinate monthly underwriting/ claims ... best practices and KPIs; as well as managing daily workflow and handling of all claims within the units. The Assistant Vice President/ Senior Manager must be able… more
- Deloitte (Nashville, TN)
- Senior Consultant, Operations & Technology Transformation, Insurance, Guidewire Integration & Configuration What we do Operations and Technology ... and technology solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems strategy, develop system… more
- Deloitte (Nashville, TN)
- Operations Technology Transformation Senior Consultant, Guidewire Configuration / Integration What we do Operations and Technology Transformation delivers ... and technology solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems strategy, develop system… more
- Deloitte (Nashville, TN)
- Senior Consultant, Operations and Technology Transformation, Guidewire Application Java Developer What we do Operations and Technology Transformation ... and technology enabled solutions focused on "heart of the business " issues in specific sectors including Health Care &...2025 Work you'll do As an OTT Insurance Transformation Senior Consultant, you will bring technical expertise to deliver… more
- HealthEdge Software Inc (Nashville, TN)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- The Cigna Group (Nashville, TN)
- …- Required + Teradata and Databricks - Preferred + Ability to understand business operations requirements and translate them into technical applications + ... **Summary** The Part D Stars Business Analytics Senior Advisor will be...Advisor will lead development of data analyses utilizing pharmacy claims , clinical outcomes, and Stars quality measures to make… more
- Sedgwick (Nashville, TN)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Senior Vice President Business Development **PRIMARY PURPOSE:** To expand and ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
- Zurich NA (Nashville, TN)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Nashville, TN)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- Prime Therapeutics (Nashville, TN)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- Fujifilm (Nashville, TN)
- …please visit_ _healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** ** Senior Compliance Specialist** **Job purpose** The accomplished Senior ... Compliance Specialist will support FUJIFILM's Corporate compliance program operations to ensure high ethical standards are observed and compliance program is… more
- Prime Therapeutics (Nashville, TN)
- …file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations . **Job Description** + Effectively ... and drives every decision we make. **Job Posting Title** Senior Enrollment Specialist **Job Description Summary** This position is...supports Magellan's SBU program operations ensuring that data is entered accurately and timely… more
- Cardinal Health (Nashville, TN)
- …colleagues as a coveted member of the Product Experience organization. As a Senior Product Experience Designer, you will define, lead, and implement the analytics ... their practices' financial performance. These products help monitor drug utilization, claims payment and denials, reimbursement trends, margins, and provide insights… more
- Cardinal Health (Nashville, TN)
- …of data to create innovative solutions that improve patient outcomes, streamline operations , and enhance the overall healthcare experience. We are seeking a highly ... Difference: Contribute to cutting-edge solutions that improve patient care, enhance healthcare operations , and drive positive change in the industry. + Work with a… more
- CVS Health (Nashville, TN)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Deloitte (Nashville, TN)
- Manager/Specialist Master, Operations & Technology Transformation, Insurance, Guidewire Integration & Configuration What we do Operations and Technology ... and deploy innovative and technology enabled solutions focused on "heart of the business " issues in specific sectors including Health Care & Life Sciences, Digital… more
- Elevance Health (Nashville, TN)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program ... and implement varied projects, programs and plans that support the achievement of business unit and enterprise goals. The work here will be Test Program Management… more
- HUB International (Brentwood, TN)
- …Billing, Finance, and Legal departments to align collections strategies with broader business goals, ensuring seamless operations . + **Regulatory Compliance** : ... Collection Center of Excellence (COE) organizational structure under the supervision of Operations leadership to better align with Billing and Operational teams and… more