- Ford Motor Company (Frankfort, KY)
- ** Claims Lead Analyst ** We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves and build a better world -- ... is a hybrid role.** **What you'll do ** Lead development efforts for claims /returns modernization, ensuring current and future business requirements are met with… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... organizations. + Maintains SharePoint Sites as needed. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… more
- Molina Healthcare (Louisville, 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
- Elevance Health (Louisville, KY)
- **Subrogation Analyst ** **Location:** This is a virtual position, however the ideal candidate will live within 50 miles of an Elevance Health PulsePoint in ... Louisville, KY or Waukesha, WI. The **Subrogation Analyst ** is responsible for handling complex Third Party Liability, Workers Compensation and other healthcare… more
- CVS Health (Frankfort, KY)
- …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 that is ... by CMS / States. In this position, the Sr. Analyst will work closely with multiple clients and various...requested audits with consistency and minimal disruption to the business . This position needs to be able to manage… more
- Evolent (Frankfort, KY)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides...team provides a unique opportunity to collaborate with key business , analytics, product, and operational leaders to deliver client-specific… more
- Elevance Health (Louisville, KY)
- …a strong, clinical-first lens to deliver member-centered, lasting pharmacy care. The **Test Analyst ( Business Analyst III)** will be responsible for serving ... **Test Analyst - Pharmacy Benefit Management (PBM)** **Location:** Alternate...as the liaison between the business and IT in translating complex business … more
- Molina Healthcare (Louisville, 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...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Humana (Frankfort, KY)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of… more
- Molina Healthcare (Louisville, 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 (Louisville, 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...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Molina Healthcare (Louisville, 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… more
- Lincoln Financial Group (Frankfort, KY)
- …at a Glance** Lincoln National Corporation seeks multiple positions for Sr Analyst , Application Development in Radnor, PA. DUTIES: Design, build, and maintain ETL ... (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 (Louisville, 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 (Louisville, 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
- Highmark Health (Frankfort, KY)
- …**If the candidate lives within 50 miles of the Highmark footprint, they will be required to work in the office as needed by the team.** This job creates data-driven ... in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities. **ESSENTIAL… more
- Highmark Health (Frankfort, KY)
- …patterns in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities. This position ... strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… more
- Molina Healthcare (Louisville, KY)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… 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