- Cognizant (Nashville, TN)
- About the role As a ** Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end ... test strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality … more
- Evolent (Nashville, TN)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Elevance Health (Nashville, TN)
- **Performance Quality Analyst II** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... accommodation is granted as required by law. The **Performance Quality Analyst II** is responsible for driving...claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1… more
- Prime Therapeutics (Nashville, TN)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Insight Global (Nashville, TN)
- …with CMS and/or Payer data feeds, including Medical Claims , Eligibility, Rx Claims , Provider, MMR, and Quality Care Gap data. Advanced SQL proficiency, with ... Job Description Insight Global is partnering with a Healthcare Start-Up based out of Nashville, TN who...Nashville, TN who is looking for a Business Systems Analyst . This individual can sit remotely and requires to… more
- The Cigna Group (Franklin, TN)
- …with local healthcare providers-physicians, hospitals, clinics, and other healthcare facilities-to help deliver high- quality , cost-effective healthcare . ... and negotiate contracts, initiate new agreements, and contribute to building strong healthcare provider networks. **As a Network Contracting Analyst , you will:**… more
- Prime Therapeutics (Nashville, TN)
- …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst … more
- Highmark Health (Nashville, TN)
- …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
- Prime Therapeutics (Nashville, TN)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- Evolent (Nashville, TN)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value...health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider,… more