• Sr Claims Systems Data…

    Molina Healthcare (Macon, GA)
    …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
    Molina Healthcare (05/18/25)
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  • Sr Analyst, Provider Config (SQL)

    Molina Healthcare (Macon, GA)
    …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
    Molina Healthcare (04/23/25)
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  • Pre-Pay Editing Analyst Sr

    Elevance Health (Atlanta, GA)
    …** is responsible for providing support, configuration, design, testing and implementation for claims systems . Ensures accurate adjudication of claims , by ... **Pre-Pay Editing Analyst Sr ** **Location:** This role requires associates to be...and the vendor to ensure quality and timeliness of systems /project deliverables. + Configures new designs/updates in the system.… more
    Elevance Health (05/21/25)
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  • Sr Analyst, Healthcare Analytics - Risk…

    Molina Healthcare (Augusta, GA)
    …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst, Healthcare Analytics role will be responsible...I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + Data… more
    Molina Healthcare (05/03/25)
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  • Sr . Group Market Development Manager…

    Medtronic (Atlanta, GA)
    …for these individuals. We are hiring a passionate, fast-paced, and strategic ** Sr . Group Market Development Manager** to manage the healthcare professional (HCP) ... and provides strategic support to reimbursement, clinical, and sales teams. The Sr . Group Market Development Manager will focus on increasing healthcare professional… more
    Medtronic (05/14/25)
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  • Sr Analyst, Network Strategy, Pricing…

    Molina Healthcare (GA)
    …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr . Analyst, Network Strategy, Pricing & Analytics guides...(including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future… more
    Molina Healthcare (05/14/25)
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  • Sr Analyst, Medical Economics (Clinical…

    Molina Healthcare (GA)
    … systems to support executive decision-making + Mine and manage information from large data sources + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...reports, and improvement opportunities based on analyses + Provide data driven analytics to Clinical COE, Finance, Claims… more
    Molina Healthcare (04/12/25)
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  • Sr Analyst, Medical Economics (Medicaid)…

    Molina Healthcare (Macon, GA)
    … systems to support executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical… more
    Molina Healthcare (04/16/25)
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  • Sr Analyst, Performance Suite Analytics

    Evolent (Atlanta, GA)
    …manner that fosters expertise and cooperation.** **Process and validate raw unadjudicated claims data .** **Use programming skills to explore, examine and ... **Familiarity with value-based care and utilization management- Preferred.** **Understanding of data systems and the critical thinking skills to solve… more
    Evolent (04/03/25)
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  • Sr Analyst, Product Performance Analytics

    Evolent (Atlanta, GA)
    …care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical thinking skills to solve new ... activities as well as Product Development efforts. **What You'll Be Doing:** + Analyse claims and authorization data to identify trends, calculate cost of care,… more
    Evolent (04/01/25)
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