- CVS Health (Atlanta, GA)
- …heart, each and every day. **Position Summary** As a Healthcare Encounter Senior Analyst for claim reconciliation in the State Medicaid Encounters department, ... from SAS and a proprietary version of AS400. Experience with either of these systems or prior exposure to the PBM or Medicaid industry would be advantageous. The… more
- Quality Technology Services, LLC (Duluth, GA)
- The **Capital Strategy Analyst i** s responsible for the strategy, analysis, and communication of critical development project capital for active and future ... management. * Maintain a high level of knowledge about QTS services, systems , methods of delivery, implementation and support processes, and Service Level Agreements… more
- Molina Healthcare (Macon, GA)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations,… more
- Molina Healthcare (Augusta, GA)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient… more
- Molina Healthcare (Macon, GA)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines… more
- Molina Healthcare (GA)
- …developing requirements for major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues ... related to core systems processing, and coordinates and manages project teams in...and manages project teams in the development of large multi- system , multi-platform projects. This position is responsible for implementing… more
- Lockheed Martin (Kings Bay, GA)
- …\(EACs\) in the Earned Value Management tool \(COBRA\)\. In addition, you will claim performance Budget Cost of Work Performed \(BCWP\) monthly\. \- You will utilize ... the Earned Value Management system to measure cost and schedule performance, as well...both labor and non\-labor inputs, working with various data systems to support contract proposals for new and existing… more
- BrightSpring Health Services (Valdosta, GA)
- …key skills. + Possess the technical aptitude required to understand flow of data through systems as well as system interactions. + HCHB (Home Care Home Base) ... EOBs/Payment Remittances + Through daily work activities identifies trends or patterns, either system or process driven, that can be corrected to show improvement. +… more
- CVS Health (Atlanta, GA)
- …in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases ... 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 (Atlanta, GA)
- …scope and complexity + 5 years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider ... data + 3 years of project leadership in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **LICENSES or… more