- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (Covington, KY)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... adjustment to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms… more
- Molina Healthcare (KY)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and...position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina… more
- Molina Healthcare (KY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... strong experience with Benefits and contracts configuration in QNXT + Must have claims processing experience + Knowledge is SQL + Experience is Excel is required… more
- Evolent (Frankfort, KY)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Senior Analyst , Healthcare Analytics Consultant The Client Analytics team ... our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will...Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify… more
- Elevance Health (Louisville, KY)
- **Business Information Analyst Senior - Provider Economics** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration ... an accommodation is granted as required by law. The **Business Information Analyst Senior ** is responsible for analyzing, reporting and developing… more
- Highmark Health (Frankfort, KY)
- …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 (Frankfort, KY)
- …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
- Highmark Health (Frankfort, KY)
- …and/or create analytics and reporting solutions aligned to the Quadruple Aim of Healthcare : lower per capita health care costs, improved outcomes from and quality of ... to identify, develop and/or monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and… more