- Humana (Nashville, TN)
- …to solve complex business problems, issues, and enable Market and National Medicaid Operations (NMO) leaders to make informed decisions based off current and ... put health first** Humana Healthy Horizons is seeking a Medicaid Compliance Business Intelligence Lead who describes...segment to manage compliance risk needed to support current Medicaid compliance operations as well as projected… more
- Humana (Nashville, TN)
- …will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new states. The business … more
- Highmark Health (Nashville, TN)
- …on cross-functional efforts, in this role the incumbent should also act as a business data subject matter expert hands on where possible, and guide, lead and educate ... to: involved in hiring and termination decisions, coaching and development , rewards and recognition, performance management and staff productivity.Plan, organize,… more
- HCA Healthcare (Nashville, TN)
- …Assists with developing and reviewing any reports necessary to support Parallon operations , including the development of tools to effectively measure ... a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Work from Home...+ Builds a strong understanding of Parallon revenue cycle operations , including business processes, tools, and technologies.… more
- HCA Healthcare (Nashville, TN)
- …of Credentialing with developing and maintaining reporting tools necessary to support operations , including the development of tools to effectively measure ... with IT&S to build bolt on systems and new business intelligence tools to improve operations . +...+ Integrates strong understanding of Credentialing Processing Center (CPC) operations and Cactus data into the development … more
- Humana (Nashville, TN)
- …value propositions, white papers and other advocacy materials which support state business development opportunities and operations . + Under direction ... to analyze public policy, develop positions, and draft deliverables supporting Humana business strategy. + Monitor and analyze state Medicaid trends. Contribute… more
- HCA Healthcare (Nashville, TN)
- …supported by development Assist in identification, documentation and evaluation of business needs and development efforts Work with other business ... job functions in order to determine potential workflow enhancements Assists in business case development for new ideas, understanding and including technology,… more
- Humana (Nashville, TN)
- …will be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy ... will be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy… more
- Prime Therapeutics (Nashville, TN)
- …overall administration of the programs. Activities address impact on customers, operations , program integrity, pricing, quality and satisfaction. Develops and tracks ... expertise with data management and overall healthcare trends specific to the Medicaid population. **Job Description** + Partners with appropriate staff in the… more
- Pearson (Nashville, TN)
- … outcomes. The OT Supervisor supports a variety of tasks to enable business operations across service lines. Projects and responsibilities are determined by ... And as a result, our category has seen explosive growth, and our business has experienced enormous increases in awareness and enrollments. This presents an… more
- HCA Healthcare (Brentwood, TN)
- …multiple government and commercial payer programs + Oversees collaborations and leads development processes with business partners to build operational tools ... and clinical informatics required + Expert level Excel skills and previous development experience with business intelligence and analytics tools (such as … more
- HCA Healthcare (Brentwood, TN)
- …, based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA ... The AVP of Reimbursement will be responsible for the direction of all operations activities of the Reimbursement staff's effort to comply with Medicare, Medicaid… more
- Humana (Nashville, TN)
- …+ Advanced certifications in software and/or process improvement + Experience with Medicaid + Experience in provider networks/provider operations + Advanced ... Adequacy tests the overall network in each county of operations to ensure the network is strong enough to...matching program + Network Resource Groups (NRGs) + Career development opportunities **Use your skills to make an impact**… more
- Vanderbilt University Medical Center (Nashville, TN)
- …fraud, waste and abuse laws and related regulations, Medicare and Medicaid (TennCare) regulations and conditions of participation, and clinical research compliance. ... counsel on all aspects of compliance. with state and federal health care operations and billing laws and regulations, including federal and state fraud, waste and… more
- Sevita (Nashville, TN)
- …assigned Operating Group's Management team during audits to discuss identified issues affecting the business and operations and to act as a resource for the ... Ethics and Compliance Officer(s) and respective Operating Group management team(s) in the development and review of new business activities and programs as the… more
- Elevance Health (Brentwood, TN)
- …Skills, Capabilities and Experiences:** + Experience working with all lines of business (Medicare, Medicaid , and Commercial) + Demonstrated experience in product ... and be a strong partner to the Solutions, Sales, Client Partnerships and Operations organizations within Carelon. **Team Scope:** The CMO leads a team of 10… more
- HCA Healthcare (Nashville, TN)
- …be a part of our team. **GENERAL SUMMARY OF DUTIES -** **The Consulting Product Business Analyst - Contact Center Virtual Agent and IVR is the driver of our ... improved efficiency and productivity. We're currently searching for an experienced product business analyst to help guide our organization to the future. From… more
- HCA Healthcare (Brentwood, TN)
- …, based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA ... part of our team. **Job Summary and Qualifications** Complete Medicare and Medicaid cost reports to obtain appropriate reimbursement from these programs and monitor… more
- Vanderbilt University Medical Center (Nashville, TN)
- …preeminent programs in patient care, education, and research. **Organization:** Finance- Operations Reporting **Job Summary:** JOB SUMMARY The Associate Director ... Services To provide financial support for Vanderbilt Health's growing laboratory operations to include revenue recognition, reference lab invoicing, analysis of… more
- HCA Healthcare (Nashville, TN)
- …and make timely decisions. This role will collaborate heavily with CDRA Operations , Information Technology (IT) Business Intelligence (BI) and HIM, Coding ... organizational levels for purposes of planning, problem solving, or strategy development . **Education** + Bachelor's degree in analytics, business analytics,… more