• Analyst , Business -( Claims

    Molina Healthcare (Louisville, KY)
    …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
    Molina Healthcare (12/20/24)
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  • Business Analyst ( Claims

    Molina Healthcare (Louisville, KY)
    **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
    Molina Healthcare (12/21/24)
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  • IT Business Systems Analyst Sr

    Prime Therapeutics (Frankfort, KY)
    …work efforts + Desire and ability to educate and advance the business systems analyst practice within the Claims IT team and across the organization + Strong ... It fuels our passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr **Job Description** The Business Systems … more
    Prime Therapeutics (12/19/24)
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  • Clinical Content Analyst

    Elevance Health (Louisville, KY)
    **Clinical Content Analyst ** **Location:** This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles ... MO, Wallingford, CT, Grand Prairie, TX or Louisville, KY. The **Clinical Content Analyst ** will be responsible for driving the development and execution of the… more
    Elevance Health (12/21/24)
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  • Business Systems Configuration…

    Intermountain Health (Frankfort, KY)
    **Job Description:** At SelectHealth, the Business Systems Configuration Analyst I is responsible to analyze, design, configure, test, implement and support ... Facets software configuration through an understanding of business requirements as well as technical knowledge of the systems. Using relational databases and SQL… more
    Intermountain Health (01/07/25)
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  • Analyst , Medicaid Rebates

    Sumitomo Pharma (Frankfort, KY)
    …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
    Sumitomo Pharma (11/07/24)
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  • Senior Pricing Analyst

    Prime Therapeutics (Frankfort, KY)
    …passion and drives every decision we make. **Job Posting Title** Senior Pricing Analyst **Job Description** The Senior Pricing Analyst participates in the ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
    Prime Therapeutics (12/19/24)
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  • Sr Analyst , Medical Economics (NY Medicaid…

    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 (eg authorization) to identify… more
    Molina Healthcare (12/29/24)
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  • IT Systems Analyst Specialist

    Sedgwick (Louisville, KY)
    …of LLMs + RESTFUL APIs + Knowledge of third party administration and claims management business and technology + Oral and written communication skills ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
    Sedgwick (12/07/24)
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  • Senior Analyst , Client Analytics - 2+…

    Evolent (Frankfort, KY)
    …creativity, accountability, and a growth mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics ... structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between institutional vs… more
    Evolent (12/05/24)
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  • Provider Contract Cost of Care Analyst

    Elevance Health (Louisville, KY)
    **Provider Contract Cost of Care Analyst Senior** **Location:** This position will work a hybrid model (remote and in office one day per week). Ideal candidates will ... one of our Pulse Point locations. The **Provider Contract Cost of Care Analyst Senior** provides analytical support to the Cost of Care and/or Provider Contracting… more
    Elevance Health (12/21/24)
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  • Sr. Applied Stars and Quality Analytics…

    Prime Therapeutics (Frankfort, KY)
    …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, ... as a champion of the consulting and analytic methodology for designated line of business ; may provide work direction, serve as a mentor or train junior level… more
    Prime Therapeutics (12/24/24)
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  • Senior Analyst Project Manager

    CVS Health (Frankfort, KY)
    …health care more personal, convenient and affordable. **Position Summary** The Sr Analyst Project Management position within the NextGen Train 6 Reporting and ... requirements and supporting existing reports/feeds. This position will be working with business customers to ensure requirements for new reports are defined. The… more
    CVS Health (01/05/25)
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  • Senior Analyst , Strategic Healthcare…

    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:** ... Analytics team offers candidates the opportunity to work with key business , analytics, product, and operational leaders to deliver client-specific analytical… more
    Evolent (11/27/24)
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  • Analyst , Data (Remote)

    Molina Healthcare (Louisville, KY)
    …used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables ... departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods… more
    Molina Healthcare (12/15/24)
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  • Appeals Analyst

    Highmark Health (Frankfort, KY)
    …+ Knowledge of multiple processing systems and workflows + Knowledge of claims processing methodologies + Ability to interpret all government regulations + Knowledge ... behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of...employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to… more
    Highmark Health (12/31/24)
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  • Renewal and Reporting Analyst

    CVS Health (Frankfort, KY)
    …setup essential for online viewing and processing related to Customer Service, Claims , Enrollment, Billing and Reporting in support of internal and external ... other related documents prepared internally or externally by clients. + Uses business knowledge and experience to make plan design and processing recommendations… more
    CVS Health (01/01/25)
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  • Senior Implementation Specialist

    Elevance Health (Louisville, KY)
    …Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and ... support, configuration, design, testing and implementation for ratings or claims systems. **How you will make an impact:** +...edits to drive cost saving results. + Works with business owners to identify and analyze requirements and processes… more
    Elevance Health (12/21/24)
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