• Sr . Medicare (PPS) Provider Hospital…

    Humana (Frankfort, KY)
    **Become a part of our caring community and help us put health first** The Sr . Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of ... closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the...under the Provider Process and Network Organization (PPNO). **The Sr . Provider Hospital Reimbursement Analyst will be… more
    Humana (10/18/25)
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  • ACA/Medicare Risk Adjustment Analyst

    Baylor Scott & White Health (Frankfort, KY)
    + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with Healthcare claims , enrollment and pharmacy data is preferred + Knowledge of ACA, Medicare,… more
    Baylor Scott & White Health (10/03/25)
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  • Regulatory Analyst Sr - Remote

    Prime Therapeutics (Frankfort, KY)
    …build the future of pharmacy with us. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is ... functional areas within the corporation (can include Government Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims ,… more
    Prime Therapeutics (11/19/25)
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  • Sr . Medical Analyst , RWD

    Norstella (Frankfort, KY)
    Sr . Medical Analyst , RWD Company: MMIT Location: Remote, United States Date Posted: Nov 20, 2025 Employment Type: Full Time Job ID: R-1548 **Description** At ... (MD/DO) degree. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory data, in an academic or industry… more
    Norstella (10/28/25)
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  • Sr Analyst , Performance Suite…

    Evolent (Frankfort, KY)
    …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... public health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider, clinical vendor, managed care, or… more
    Evolent (11/08/25)
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  • Senior Analyst , Network Strategy,…

    Molina Healthcare (Lexington, KY)
    …health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver ... **Job Description** **Job Summary** Sr . Analyst , Network Strategy, Pricing &...contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access… more
    Molina Healthcare (11/21/25)
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  • Senior Analyst , Network Strategy,…

    Molina Healthcare (Owensboro, KY)
    …health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver ... **Job Description** **Job Summary** Sr . Analyst , Network Strategy, Pricing &...contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access… more
    Molina Healthcare (10/25/25)
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  • Senior Data Analyst - Operations…

    Molina Healthcare (KY)
    …current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr . Analyst , Data is responsible for data compilation, data ... Experience working on SQL, PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required… more
    Molina Healthcare (11/02/25)
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  • Senior QNXT Analyst - Contract…

    Molina Healthcare (Bowling Green, KY)
    …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
    Molina Healthcare (10/01/25)
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  • Senior Analyst , Quality Analytics…

    Molina Healthcare (Owensboro, KY)
    **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...+ 3+ Years of experience with predictive modeling in healthcare quality data. + 3+ Years of experience in… more
    Molina Healthcare (11/13/25)
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