- Molina Healthcare (Augusta, GA)
- …and/or detects violation of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the Business ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- Molina Healthcare (Savannah, GA)
- … needs. Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment… more
- Molina Healthcare (GA)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... key business issues related to cost, utilization and revenue for...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… more
- CVS Health (Atlanta, GA)
- …sound data presentation * Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the ... data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, including… 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 ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Prime Therapeutics (Atlanta, GA)
- …fuels our passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job ... Description** The IT Business Systems Analyst (BSA) Sr is responsible...project team and various levels of management. With consistent Senior Leadership visibility, the IT BSA Sr is also… more
- Elevance Health (Atlanta, GA)
- **Pharmacy Financial Analyst , Cost of Care - Business Information Consultant** **Location:** This role requires associates to be in-office **1** day per week, ... Monday - Friday, 8:00am - 5:00pm The **Pharmacy Financial Analyst , Cost of Care - Business Information...to Pharmacy cost of care, pharmacy trends, and other Medicare book of business ' related issues/metrics. **How… more
- Molina Healthcare (Augusta, GA)
- **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and… more
- Humana (Atlanta, GA)
- …The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer ... as it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more
- Prime Therapeutics (Atlanta, GA)
- … Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance ... to claims, contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. **Responsibilities** + Executes compliance procedures… more
Recent Jobs
-
Associate Contracts Administrator
- Kratos Defense & Security Solutions, Inc. (Dallastown, PA)
-
Hospice Medical Director
- CareOregon (Portland, OR)