- The Cigna Group (Nashville, TN)
- …the analytics strategy for Cigna Healthcare, performing research and analysis within the Medicare Stars program. This position is located within the Medicare ... support to internal and external partners to improve Cigna's Medicare Star Ratings. Reporting to the Senior Manager of...clinical outcomes and Stars quality measures to make recommendations based on relevant findings. The Data Science Analyst will… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Value Based Programs Lead generates ad hoc reports and regular datasets and/or report ... + Design Return on Investment (ROI) Analyses for new Value Based Payments (VBP) using multiple data...into reports and dashboards + Experience in Medicaid and/or Medicare managed care + Experience working with big and… more
- Humana (Nashville, TN)
- …our caring community and help us put health first** The Associate Director, Value - Based Solutions will be responsible for leading the operational performance of ... Humana Healthy Horizon's specialty value - based payment (VBP) model portfolio. The Associate...Qualifications** + Masters Degree + Expertise in Medicaid and Medicare managed care + Expertise performing claims data analysis… more
- Humana (Nashville, TN)
- …be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy ... be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy… more
- Humana (Nashville, TN)
- …corporate strategy. The Financial Analytics Lead plays a pivotal role in our Value Office by collating, modeling, interpreting, and analyzing data to identify and ... calculate and analyze key financial metrics, including Net Present Value (NPV) and Internal Rate of Return (IRR), to...posting. The pay range may be higher or lower based on geographic location and individual pay will vary… more
- CenterWell (Nashville, TN)
- …in proximity to a Conviva/CenterWell market location(s) + Experience working in a value - based care, senior care, and/or Medicare managed care **Workstyle** ... quality, cost, and appropriate use based on evidence- based practices for a large, national primary...and align pharmacy services with improvement quality metrics and Medicare part D performance. + Collaborate with stakeholders to… more
- Humana (Nashville, TN)
- …high degree of integrity, professionalism, resourcefulness, and enjoy working in a team- based environment. Medical Directors support Humana value throughout all ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- HCA Healthcare (Brentwood, TN)
- …with the analysis and implementation of government and/or commercial payer value - based programs such as MACRA/MIPS, Centers for Medicare and Medicaid ... development, operationalization, management, and support of Physician Services' (PSG) provider- based government and commercial value - based payer… more
- Humana (Nashville, TN)
- …of Humana processes, as well as a focus on collaborative business relationships, value - based care, population health, or disease or care management. **Use your ... quality of care and financial goals. Provides information for pricing guidelines based on utilization patterns and client demographics. Makes decisions on moderately… more
- Humana (Nashville, TN)
- …of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. **Use ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- Vanderbilt University Medical Center (Nashville, TN)
- …compliance issues applicable to Accountable Care Organizations, Clinically Integrated Networks, Medicare Shared Savings Programs, value - based healthcare ... 10 **Job Summary:** Vanderbilt Health - Executive Search Team is conducting a national search for a Division Counsel - Compliance & Regulatory Attorney with a… more
- HCA Healthcare (Brentwood, TN)
- …financial wellbeing + 401(k) Plan with a 100% match on 3% to 9% of pay ( based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock ... offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)… more
- CenterWell (Nashville, TN)
- …or related field. * Experience working in a complex value - based health care organization. **Knowledge/Skills/Abilities/Competencies** **Required** * Strong ... a part of our caring community and help us put health first** ** National ** **Director of Transitional Care and High-Risk Patient Management** The Director of… more
- CenterWell (Clarksville, TN)
- …understanding of Best Practice in coordinated care environment in a value based relationship environment + Knowledge of Medicare guidelines and coverage + ... our team- based care environment. We are a value based care provider focused on quality...Medicine preferred + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- Philips (Nashville, TN)
- …present supporting clinical evidence; educate on patient selection and how to order based on Medicare and private insurance coverage criteria. + Present ... regard to race, color, ethnicity, religion, gender, pregnancy/childbirth, age, national origin, sexual orientation, gender identity or expression, disability or… more
- Humana (Nashville, TN)
- …Application modernization initiatives including rearchitecting legacy mainframe, stand-alone and web- based applications to value driven enterprise architecture ... that technology execution aligns with business strategy. + Help achieve value -driven outcomes by ensuring Humana's Technology Strategy is executed in alignment… more
- Deloitte (Nashville, TN)
- …and/or product strategy + 1 year + experience with reimbursement models a€" including value based care/ACO modeling + Ability to program using SQL The wage ... and human resource performance and establish a culture focused on adding business value ? That is what the new generation of human resource transformation is all… more
- Humana (Nashville, TN)
- …apprentice) + Minimum of 2 years Outpatient medical coding experience + Medicare and/or Medicaid experience + Prior healthcare experience + Microsoft Office ... organization focused on continuously improving consumer experiences. **Preferred Qualifications** + Medicare and Medicaid policy manuals and fee schedules + Provider… more
- Humana (Nashville, TN)
- …Intelligence will be responsible for leading the operational performance of Value - Based Specialist Programs within the Service Fund organization. Overseeing ... implement operational processes to support payments and reporting for external value - based partners. The Associate Director, Business Intelligence leverages the… more
- Humana (Nashville, TN)
- …solutions to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries through an evidence- based approach using data analytics, ... healthcare areas such as EMR, Episode grouper, utilization management, value - based care, low value care...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more