- Highmark Health (Nashville, TN)
- …areas to support clinical quality auditing, The Senior Risk Compliance Analyst is responsible for monitoring and analyzing medical and utilization management ... matter expert, providing insights and guidance to internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and Case… more
- Highmark Health (Nashville, TN)
- …standard to moderately complex problem solving and in-depth understanding of system functionality. The incumbent reviews significant amounts of information and ... 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Nashville, TN)
- …decision-making within the Health Plan FP&A team. The Lead Financial Analyst will be responsible for complex financial modeling, scenario planning, variance ... streamline forecasting, reporting, and analysis processes, identifying automation and system improvement opportunities to increase accuracy and scalability. + Lead… more
- Highmark Health (Nashville, TN)
- …Accounting Analyst with respect to cost allocation rules and system processes required.80% + Leverages automation to improve reliability and reduce/eliminate the ... etc.) + Demonstrated mastery of an industry-recognized cost accounting system within a clinical or healthcare setting + Ability...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Nashville, TN)
- …degree in Business Administration, Business Management, Information Technology, Information Systems or related field **Substitutions** + 6 years of related ... **Required** + 3 years in a Business Analysis and/or Analyst role **Preferred** + 1 year with Lean/Six Sigma...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- CVS Health (Nashville, TN)
- …and practices. What you will do - Routinely handles cases involving behavioral health or multi-disciplinary provider groups in a prepayment environment - ... and legal review. - Documents all appropriate case activity in case tracking system . - Prepares and presents referrals, both internal and external, in the required… more
- Highmark Health (Nashville, TN)
- …defined and documented, high quality requirements, functional designs, and system supplemental specifications for new Pharmacy Markets applications and/or analyzes ... Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company… more
- Highmark Health (Nashville, TN)
- …automation to greatest extent possible. Develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality. ... **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and… more
- Highmark Health (Nashville, TN)
- …Develop and maintain spreadsheets and databases. + Utilize PC and/or mainframe based systems and software, compile and prepare reports, graphs and charts of data ... Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company… more
- Highmark Health (Nashville, TN)
- …scope and complexity + 5 years with coding languages, analytical software, systems , tools and processes using claims, clinical, enrollment and provider data + ... Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company… more