- Molina Healthcare (Atlanta, GA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Molina Healthcare (Macon, GA)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- Molina Healthcare (Macon, GA)
- …**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)
- …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Highmark Health (Atlanta, GA)
- …MUST 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… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior ... and partners with key internal stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement.… 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 ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation and analytic insight… 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...or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation… more
- Carter's/OshKosh (Atlanta, GA)
- …do. There are many reasons to build your career at Carter's. The Technology Analyst , HR & Compliance plays a key role in optimizing Carter's workforce operations by ... and compliant employee data within Workday, and overseeing the unemployment claims process in coordination with a third-party administrator. This position supports… more
- CVS Health (Atlanta, GA)
- …opportunity to join our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health strives to continuously ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more