- Public Consulting Group (Nashville, TN)
- …Project and Grants Management + Assessments and Feasibility Studies Analyzes claims for accuracy, provides client support, documents inquiries, supervises staff, ... process improvements. **Duties and Responsibilities** + Analyzes and reviews claims for accuracy, completeness and eligibility. + Provides leadership, supervision… more
- Molina Healthcare (Bowling Green, KY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... completion dates with Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and configuration of all… more
- Prime Therapeutics (Nashville, TN)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic… more
- Molina Healthcare (Bowling Green, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify...Python, R, etc.) to answer a given problem + Lead monthly trend presentations to plan leadership and other… more
- Evolent (Nashville, TN)
- …positively contribute to Evolent's broader mission. **Collaboration Opportunities:** The Analyst , Performance Suite Analytics utilizes and develops analytic tools to ... and articulating our value.** **Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- Molina Healthcare (Bowling Green, KY)
- …and claims functionality. Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. + Complex ... and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive...and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex… more
- Elevance Health (Nashville, TN)
- **Business Information Analyst II** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of ... our Elevance Health PulsePoint locations. The **Business Information Analyst II** will be responsible for analyzing the business process, proposing solutions to… more
- Molina Healthcare (Bowling Green, KY)
- …Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
- Molina Healthcare (Bowling Green, KY)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,… more
- Vanderbilt University Medical Center (Nashville, TN)
- …project implementation. . KEY RESPONSIBILITIES * Monitors success of bundled payment claims and payments transactions, and the overall performance of the financial ... Acts as a "go-to" resource for colleagues with less experience; may lead small project teams. **Core Capabilities** **:** Supporting Colleagues: - Develops Self… more
- Lumen (Nashville, TN)
- …connect the world and shape the future. **The Role** We are seeking a Lead Product Marketing Manager to drive the creation and delivery of unique market positioning ... to identify and develop valuable messaging that will drive engaging content. The Lead Product Marketing Manager is expected to be a content marketing expert across… more