- Elevance Health (Columbus, GA)
- ** Medicare Risk Adjustment Advanced Analytics Analyst ** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst ** is...law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst ** is responsible for employing advanced analytics to gain… more
- Molina Healthcare (Augusta, GA)
- …to the Health Care environment. **Knowledge/Skills/Abilities** The Operational/Regulatory Oversight Analyst works with health plans and operations departments to ... to and compliance with State and Federal regulatory guidelines. The Analyst develops and performs audits and oversight functions involving business-critical… more
- Molina Healthcare (Atlanta, GA)
- …business analysis, task and workflow analysis. + Subject matter expert of Medicare and Healthcare enrollment 834 files. + Interpret customer business needs and ... translate them into application and operational requirements + Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as… more
- Molina Healthcare (Columbus, GA)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require… more
- Elevance Health (Atlanta, GA)
- **Business Information Consultant - Pharmacy Analyst , Trend and Cost of Care** **Location:** This role requires associates to be in-office **1** day per week, ... 8:00am - 5:00pm The **Business Information Consultant - Pharmacy Analyst , Trend and Cost of Care** is responsible for...to Pharmacy cost of care, pharmacy trends, and other Medicare book of business' related issues/metrics. **How you will… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Senior Actuarial Analyst - REMOTE **Job Description** The Senior Actuarial Analyst is ... benefit design and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid). This role will also provide actuarial support in complex… more
- Cognizant (Atlanta, GA)
- **About the role** As a QNXT Config Analyst , you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... cautionary reduction functionality. + QNXT SMEs with experience in Medicare Benefit. + Experience with items like Cost Share....Have worked with QCS. + Familiarity with Medicaid and Medicare programs are minimum requirements, as well as knowing… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible ... Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid) + Other duties as assigned **Education & Experience** +… more