- Humana (Nashville, TN)
- …our organization's standing within the Medicaid markets. **Complex Ad-Hoc Requests:** The Data and Reporting Professional 2 will address complex ad-hoc ... caring community and help us put health first** The Medicaid Data and Reporting Analyst...operating objectives, including their linkages to related areas. The Data and Reporting Professional 2… more
- Humana (Nashville, TN)
- …etc. Partner with actuarial, financial, and clinical teams to align on data definitions, methodologies, and reporting . Identify cost drivers, utilization ... patterns, and anomalies in Medicaid medical claims data . Maintain dashboards to...degree, recent and relevant work experience, and/or other relevant professional designations. + MAAA + Strong communication skills +… more
- Datavant (Nashville, TN)
- …output to enhance productivity and quality, and turn those needs into actionable reporting + Provide real-time data insights to business on-demand through ad-hoc ... Datavant is a data platform company and the world's leader in...problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold… more
- Humana (Nashville, TN)
- …of our caring community and help us put health first** The Senior Agency Professional ; Finance & Accounting supports data analysis related to compliance and ... determine the best course of action. The Senior Agency Professional ; Finance & Accounting provides support for handling and...Finance & Accounting provides support for handling and analyzing data that pertains to the compliance and commissions of… more
- CVS Health (TN)
- …abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data visualization tools (eg, Tableau, Power BI ... a full time role and is ideal for a data professional with strong coding skills in...to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting . This is… more
- Humana (Nashville, TN)
- …our caring community and help us put health first** The Supply Chain Budget Professional reports to the Director of Enterprise Print Management (EPM) and plays a key ... Print and Postage operations through effective budget development, management, financial reporting , and cost tracking. This position ensures accuracy and efficiency… more
- Humana (Nashville, TN)
- …and overall market sales support. The ideal candidate will be able to summarize reporting data and present ideas and results. If you are detail oriented ... and help us put health first** The Sales Support Professional 1 will provide sales support to the Large...high level of accountability + Synthesizing and analyzing financial data (ex. budgets and income statement forecasts) with consideration… more
- Elevance Health (Nashville, TN)
- …requirements from internal and external requestors to ensure that the team is meeting reporting needs and facilitates seamless data transfer. + Develops ad hoc ... studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of business. **How You... and Medicare Advantage risk adjustment initiatives. + Performs data mining and data -driven analyses to evaluate… more
- CVS Health (TN)
- …systems and data warehouses. **Education** + Bachelor's Degree or equivalent professional work experience required. + Advanced degree in a relevant field, such ... and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid , Medicare Part D, and Public Exchange lines of business. + Conduct… more
- Covenant Health Inc. (Knoxville, TN)
- …knowledge of State and Federal regulations, HCFA guidelines, HIPAA, Medicare/ Medicaid guidelines and other Third Party Payor requirements assuring departmental ... judgment when having discussions related to the revenue process, maintaining a professional and confidential environment. + Supports, models and adheres to the… more
- Covenant Health Inc. (Lenoir City, TN)
- …submits required reports to state and federal agencies. + Complies with required mandatory reporting of the Medicare, Medicaid , and SCHIP Extension Act of 2007. ... program on a day-to-day basis, managing and analyzing risk management data , conducting risk management educational programs, complying with risk management related… more
- Cardinal Health (Nashville, TN)
- …leaders and employees and proactively provides guidance and trainings on policies. Reporting to the Director, Ethics & Compliance, this position supervises and ... manages audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and… more
- Ascension Health (Nashville, TN)
- …and other program staff in evaluating and managing patients. + Completes data capture, analysis and reporting and other administrative functions required ... of Organ Sharing (UNOS) and Centers for Medicare and Medicaid Services (CMS). + Collects and maintains time study data for purposes of reporting pre and post… more
- HCA Healthcare (Nashville, TN)
- …customer needs + Provides guidance and oversight in retrieving, organizing and reporting data + Facilitates problem solving and collaboration within functional ... successes + Selects, evaluates, trains, and provides leadership and direction to reporting staff + Responsible for continuous review and improvement of processes and… more
- Option Care Health (Memphis, TN)
- …compliance with Option Care Infusion Centers policies and procedures, professional standards and local, state, federal regulations/guidelines. + Identify urgent ... and emergent situations and intervene appropriately. + Support compliance reporting through rigorous clinical notes. + Responds promptly and appropriately to patient… more