• Pharmacy Appeals Team

    Cognizant (Nashville, TN)
    ** Pharmacy Appeals Team Lead (remote)** This is a remote position that is open to any qualified candidate who lives in the United States. Our Cognizant ... is currently seeking an individual to perform as a Team Lead that will have the following...following duties and work as part of our established pharmacy appeals team . The full-time… more
    Cognizant (10/30/25)
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  • Gene and ACT Program Advisor - Evernorth Specialty…

    The Cigna Group (Franklin, TN)
    The Product Strategy & Management team for Gene and Advanced Cellular Therapy (ACT) enhances operational effectiveness through strategic planning, tactical ... The Program Advisor will act as a strategic enabler, operational lead , and digital transformation advocate across high-impact initiatives. **Program Advisor Role… more
    The Cigna Group (10/25/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Nashville, TN)
    …Johnson & Johnson Innovative Medicine's Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a ... Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs),… more
    J&J Family of Companies (10/04/25)
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  • Senior Director Of Revenue Cycle

    BrightSpring Health Services (Nashville, TN)
    …include identifying reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed, and resolving billing-related issues. This position ... Cash Control and Accounting. They should be able to lead strategic initiatives, utilize technologies, and create an environment...is performed to enhance the skill base of the team . + Adhere to all policies and procedures, within… more
    BrightSpring Health Services (10/29/25)
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  • Medical Director - Medicaid N. Central

    Humana (Nashville, TN)
    …to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy ), and reviews for DME, genetic testing, ... standards, and contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health… more
    Humana (10/25/25)
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  • Principal Analytics Consultant - Medical…

    Health Care Service Corporation (Nashville, TN)
    …communication and presentation skills. + Ability to work independently and as part of a team . + Ability to lead multiple analytic related projects in parallel. + ... Job Qualifications:** + Experience with Utilization Management data (eg authorizations, appeals , grievances) + Experience with DCMS healthcare data (eg MMR, Claims… more
    Health Care Service Corporation (10/16/25)
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