- CVS Health (Atlanta, GA)
- …has an exciting opportunity to join our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health strives ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...team is highly collaborative. You will report to the Senior Reporting Manager within the PBM Finance Data, Analytics,… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- ** Senior Guidewire Business Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Alabama, Birmingham ... Full Time **Position Description:** We are seeking a seasoned Guidewire Business Analyst to support ongoing enhancements and steady-state operations for a regional… more
- Molina Healthcare (Columbus, GA)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- Highmark Health (Atlanta, GA)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- CVS Health (Atlanta, GA)
- …be willing to work EST time zone hours.** **Position Summary** We are hiring a Senior Analyst to support the Complaint, Grievances and Appeals (CG&A) team. This ... and have experience troubleshooting data cleaning workflows. + Experience working in claims or appeals analytics. + Ability to communicate and translate technical… 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 ... 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
- CVS Health (Atlanta, GA)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more
- Highmark Health (Atlanta, GA)
- …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 CERTIFICATIONS** **Required** + None… more
- Prime Therapeutics (Atlanta, GA)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job...project team and various levels of management. With consistent Senior Leadership visibility, the IT BSA Sr is also… more