- Molina Healthcare (Augusta, GA)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... task and workflow analysis. + Interpret customer business needs in the claims space and translate them into application and operational requirements + Communicate… more
- Molina Healthcare (GA)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Elevance Health (Atlanta, GA)
- **Title: Grievance/Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The **Grievance/Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Elevance Health (Atlanta, GA)
- **Rating/ Claims Systems Implementation Advisor** **Location:** Norfolk, VA; Atlanta, GA (preferred). This role requires associates to be in-office 1 - 2 days per ... not eligible for current or future visa sponsorship._ The **Rating/ Claims Systems Implementation Advisor** will have expert-level experience in...of study and a minimum of 6 years systems analyst or business analyst experience; or any… more
- Elevance Health (Atlanta, GA)
- **Actuarial Analyst III** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... accommodation is granted as required by law. The **Actuarial Analyst III** completes very diverse and complicated projects and...Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and… more
- Elevance Health (Atlanta, GA)
- **Recovery Audit Analyst I** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Recovery Audit Analyst I** is responsible for auditing and facilitating the...is responsible for auditing and facilitating the recovery of claims overpayments as identified by our business partners. Responsible… more
- Prime Therapeutics (Atlanta, GA)
- …our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing Analyst participates ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Atlanta, GA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing ... Analyst participates in the assessment of value generated by...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- Elevance Health (Atlanta, GA)
- **Advanced Analytics Analyst Senior - Medical Economics** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Cincinnati, OH; Chicago, IL (preferred). This ... passionate about transforming American healthcare delivery. The **Advanced Analytics Analyst Senior** measures financial performance of core Carelon products… more