- Elevance Health (Nashville, TN)
- **Rating/ Claims Systems Analyst Senior ** **Hybrid 1:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and ... for employment, unless an accommodation is granted as required by law. The **Rating/ Claims Systems Analyst Senior ** is responsible for providing support,… more
- The Cigna Group (Nashville, TN)
- …a line of business within the Cigna Group is hiring a Claims System Senior Analyst . This highly technical systems role requires the review of our ... the system per the specifications of the provider. The Claims System Senior Analyst will... will have in depth knowledge of the eviCore claims systems and products. As the Subject… more
- Molina Healthcare (Bowling Green, KY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component + Assists with… more
- Molina Healthcare (Bowling Green, KY)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably. Performs research, financial… more
- Molina Healthcare (Bowling Green, KY)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably. Performs research, financial… more
- Molina Healthcare (Bowling Green, KY)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending… more
- Molina Healthcare (Bowling Green, KY)
- **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements ... not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with… more
- WTW (Nashville, TN)
- …Risk, including adjustments for model limitations, near-term climate conditions, and claims experience. + Working with clients, jointly with other Willis commercial ... in the (re) insurance industry with working knowledge of catastrophe modelling systems (eg, Moody's RMS, Verisk) **Desirable:** + Previous experience of model… more
- Evolent (Nashville, TN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Lead Analyst , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Lead Analyst , Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products. This… more
- Humana (Nashville, TN)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Highmark Health (Nashville, TN)
- …business units, coupled with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and ... the gap between business needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise… more