277 care analyst jobs found in Nashville

Cost of Care Analyst Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. The Cost of Care Analyst (Advanced Analytics Consultant) employs advanced analytics to gain critical insights into member behavior drivers and preferences, product/program concepts and value propositions, operational effectiveness, and efficiencies, and client-specific health gaps and needs. Consults business leaders and internal partners to apply the insights to test and drive product innovation and enhancement, to target the right members for the right service, measure program outcomes and demonstrate value, help win and...

Summary Researches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in compliance with applicable regulations or standards. Description Logistics CGS –one of BlueCross BlueShield's South Carolina subsidiary companies. This position is full time (40 hours/week) Monday-Friday 8:00-4:30PM CST and will be W@H OR On-site at One Century Plaza, Nashville TN . What You Will Do Documents the basis of the appeal or retrospective review in an accurate and timely manner and in accordance with applicable regulations or standards. Performs thorough research of the substance of service appeals by both member and provider based on clinical documentation, contractual requirements, governing agencies, policies and...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Prime Therapeutics. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Sr. IT Risk & Controls Analyst - Contract Negotiations - Remote Job Description We are presenting a unique opportunity for an experienced IT Risk and Controls Analyst with a background in Contract Negotiations. As a...

Company Overview Milo’s Tea Company is one of the fastest-growing beverage companies in the United States. Our culture and operations are built on the belief that we can make a difference in the world. That is why we put People First and strive to continually reduce our environmental impact on the planet. We leverage our world-class operations and decades-long distribution partnerships to grow the footprint of our core products and create new, innovative beverage products. We are the #1 and fastest-growing brand in the Refrigerated Tea Category in the nation. Our core mission: People and Planet First — doing good is good for business. We are committed to unlocking the personal genius of every associate and have a strong focus on growth and learning. Our company is women-led and strongly committed to Diversity, Inclusion, and Belonging. We pledge 1% of profits annually to charitable giving. We are Platinum Certified in Zero Waste Manufacturing:...

Company Overview Milo’s Tea Company is one of the fastest-growing beverage companies in the United States. Our culture and operations are built on the belief that we can make a difference in the world. That is why we put People First and strive to continually reduce our environmental impact on the planet. We leverage our world-class operations and decades-long distribution partnerships to grow the footprint of our core products and create new, innovative beverage products. We are the #1 and fastest-growing brand in the Refrigerated Tea Category in the nation. Our core mission: People and Planet First — doing good is good for business. We are committed to unlocking the personal genius of every associate and have a strong focus on growth and learning. Our company is women-led and strongly committed to Diversity, Inclusion, and Belonging. We pledge 1% of profits annually to charitable giving. We are Platinum Certified in Zero Waste Manufacturing:...

Job Description Due to the nature of the clients we are supporting, US Gov Cloud and DoD (Department of Defense) support requirements, US Citizenship is preferred. As a member of the Support organization, your focus is to deliver post-sales support and solutions to the Oracle customer base while serving as an advocate for customer needs. This involves resolving post-sales non-technical customer inquiries via phone and electronic means, as well as, technical inquiries regarding the use of and troubleshooting for our Electronic Support Services. A main point of contact for customers, you are responsible for facilitating customer relationships with Support and providing advice and assistance to internal Oracle employees on diverse customer situations and escalated issues.As a Principal Support Engineer, you will offer strategic technical support to assure the highest level of customer satisfaction. A primary focus is to create/utilize automated technology and instrumentation...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title IT Systems Analyst - Remote Job Description The IT Systems Analyst is responsible for utilizing various delivery methodologies employed by Prime and assist in the communications interface between IT and the business community in the investigation, identification, and documentation of business application requirements and technical solutions based on applicable technologies within Prime for either the enhancement of existing applications or to foster the development of new applications. Responsibilities Manage application servers including: Installation & Configuration: Determine necessary software and configuration settings to meet requirements and ensure compatibility. Monitoring &...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Prime Therapeutics. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Senior Compliance Analyst - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime’s compliance programs and leads initiatives within their designated areas. This role partners with key...

Become a part of our caring community and help us put health first The Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The In-Home Health and Wellbeing assessment team is seeking a Business Analyst who is adept in data analytics and possesses a keen eye for monitoring and troubleshooting KPIs. This role requires someone who can effectively perform ad-hoc analyses to support our business objectives. The ideal candidate will have insatiable curiosity and a strong aptitude for learning. Key Responsibilities: Develop SQL queries for ad hoc data pulls, analysis, and identification of root cause Utilize existing reports and dashboards to monitor and report...

Become a part of our caring community and help us put health first The Senior Configuration Professional work focuses on accessing and configuring an application or system that is integrated with business processes/data and IT infrastructure including building modules, developing tables/reports, and creating complex functions. The Senior Configuration Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Configuration Professional responsibilities can include advising the business, evaluating requests, implementing new features and changes, troubleshooting, resolving testing issues, configuring processes and experiences. integrating, developing interfaces, and maintaining documentation. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is...

Under general direction, the Treasury Management (TM) Sales Analyst supports the Treasury Management Officers (TMOs) in growing TM revenue. This position is responsible for the creation, analysis and delivery of proposals, RFPs, and sales presentations. The TM Sales Analyst performs pre-call planning, preparation and participates in joint sales calls with TMOs and Commercial Bankers. The TM Sales Analyst provides a high level of internal customer support through understanding and driving the sales culture and vision of the organization within the member banks, maintaining and delivering reporting and metrics; and managing all additional aspects of sales support in the sub lines of business. How you will spend your time: Develop proformas, proposals and customer profitability analysis for Treasury opportunities Prepare pre-call planning prep and materials for TM client and prospect meetings Coordinate proposal responses and works across business lines to...

Job Description What You'll Do Are you an experienced Financial Analyst looking for a new opportunity? Do you love uncovering stories hidden in data? Are you eager to learn and be a team player? Come join us! The Global Business Finance Organization is responsible for supporting the company's executives and officers with financial and operational analysis to drive business decisions that contribute to the success and profitability of Oracle. Within this role, you will be responsible for providing financial support and insights to the Oracle North America Consulting organization. You will be a member of the finance team, partnering with the HQ, Sales and Business operations teams to provide FP&A support. We are seeking a highly motivated and dynamic individual to help the organization drive strategic business decisions and will be responsible for providing various aspects of financial support to Consulting Organization. This position offers an excellent opportunity...

As part of the Credit Oversight team, the Construction Loan Analyst Senior, is accountable for the monitoring of all construction projects for Commercial and Residential construction loan. How you will spend you time: Draw processing, engaging third party consultants; ordering, reviewing and analyzing pre construction costs/examine documentation and draw inspection reports against actual progress of project Ordering and reviewing title policy endorsements and updates Analyze project budget and cost variations Authorize loan and equity funding Identify and assess project trends and manage credit risk within the individual projects Create analytical management reports that provide a summary of the outstanding portfolio to assist in financial capital allocation requirements Advise loan officers, attorneys, staff, and third parties on terms and conditions of construction project structure Follow up on completed and inactive...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. ESSENTIAL RESPONSIBILITIES Processes daily incoming Stop Loss claims including...

Sr Process Performance Reporting Analyst Requisition ID: 15320 Location: Dundee, MI, US, 48131Greenbelt, MD, US, 20770Morgan, UT, US, 84050Hagerstown, MD, US, 21742Addison, TX, US, 75001-4243Ravena, NY, US, 12143Middleton, MA, US, 01949Nashville, TN, US, 37214Chicago, IL, US, 60631Lakewood, CO, US, 80401 Pay Type: Salary Estimated Wage Range $67,200 - $130,000/Annually COMPANY OVERVIEW Amrize is building North America. From bridges and railways to data centers, schools, offices and homes, our solutions are inside the buildings and infrastructure that connect people and advance how we live. And we invite you to come and build with us. As the partner of choice for professional builders, we offer advanced branded solutions from foundation to rooftop. Wherever our customers are, whatever their job, we're ready to deliver. Our 19,000 colleagues work across 1,000 sites supported by an unparalleled distribution network. Infrastructure, commercial and residential, new...

Job Description Job Requirements and Key Responsibilities: Partners with Consulting management to maximize revenue opportunities, achieve the highest utilization, and increase customer satisfaction. Responsible for the collection, management, and communication of detailed resource specifications for assigned practice. Proactively identifies available resources, using a variety of methods, or open specifications. Facilitates resource meetings with Consulting Managers regarding weekly billable utilization and open request. Escalate urgent requests on priority staffing calls. Partner with management to understand assigned consultants' skill levels and experience. Actively monitor the selection/acceptance process for assigned resources. Offer creative solutions when no resources with necessary skill sets are available. Recommend creative ways to utilize consultants who lack high demand skill sets. Identify resourcing...

Job Description Job Requirements and Key Responsibilities: Partners with Consulting management to maximize revenue opportunities, achieve the highest utilization, and increase customer satisfaction. Responsible for the collection, management, and communication of detailed resource specifications for assigned practice. Proactively identifies available resources, using a variety of methods, or open specifications. Facilitates resource meetings with Consulting Managers regarding weekly billable utilization and open request. Escalate urgent requests on priority staffing calls. Partner with management to understand assigned consultants' skill levels and experience. Actively monitor the selection/acceptance process for assigned resources. Offer creative solutions when no resources with necessary skill sets are available. Recommend creative ways to utilize consultants who lack high demand skill sets. Identify resourcing...

Job Description Job Summary: We are seeking a detail-oriented Compensation Analyst to join our team and support a wide range of global compensation compliance and data analysis activities. This role requires advanced Excel skills and the ability to analyze large data sets, identifying trends and potential risks based on the data. While experience with US compliance reporting is a plus, it is not required. The Compensation Analyst will collaborate closely with stakeholders across the organization to ensure compensation programs are administered effectively and meet regulatory requirements. Strong project management abilities and the ability to clearly communicate across all organizational levels are essential for success in this role. Responsibilities Key Responsibilities: Conduct and support data analyses related to compensation compliance and reporting requirements. Prepare regular and ad hoc reports to support global compensation programs....

Company : United Concordia Dental Job Description : JOB SUMMARY This job provides account support activities associated with the implementation and administration of groups and accounts. Provides assistance with non-standard benefit implementation tasks. Identifies and resolves problems related to benefit interpretations, non- standard benefits, handle rating concerns, and coordinate claim extracts and any subsequent adjudication requirements. The incumbent may have direct interaction with producers, clients and sales reps to ensure complete implementation, on-going service and all renewal activity. The incumbent is new to the role and is developing competence in performing work assignments. ESSENTIAL RESPONSIBILITIES Load and maintain group information and benefit files. Interact and provide support activities to Account Managers (For UCD: Accounts Support Analysts are account managers for all small market clients. May also be involved with managing...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Sr. IT Risk & Controls Analyst - Contract Negotiations - Remote Job Description We are presenting a unique opportunity for an experienced IT Risk and Controls Analyst with a background in Contract Negotiations. As a Sr. IT Risk & Controls Analyst you would be responsible for leading the development and execution of processes and people to ensure IT compliance with regulatory, industry and client security requirements. This role is responsible for working with cross-functional teams and management to set direction and secure resources for the operational processes needed to support the Security Governance Risk and Compliance program. Responsibilities Lead the development, implementation and enforcement...

Job Description Serve as a liaison with other divisions such as Finance, Contracts, Legal, Shared Services, Accounts Receivable, Purchasing, and Risk Management in an effort to ensure accurate and timely Data Center invoice processing. Collect, input, verify, correct, and analyze data to measure key performance indicator actual versus business objectives and approved budget. Provide updates to management regarding budget to actual, informing them of deviations and opportunities. Provide management with economic impact and compliance issues surrounding key business decisions and/or deals. Reconcile amounts billed with underlying DC service orders and initiate disputes with suppliers when/as needed. Drive implementation of new processes and procedures. Responsibilities Ensure accurate and timely data entry, verification, correction, and analysis for all Data Center invoices and associated financial transactions. Reconcile invoiced amounts with Data Center service...

Company : Highmark Inc. Job Description : JOB SUMMARY This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. ESSENTIAL RESPONSIBILITIES Coordinate, analyze, and interpret the benefits and claims processes for the department. Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties....

Job Description Our customer is looking for registered dieticians to help support a nutritional standardization and healthtouch implementation project. This will be a non-patient facing role where you will be responsible for reviewing hospital menus, programming changes to menus in the healthtouch system and working support tickets post go live. This role will require a lot of researching and analysis around current menus and the hospitals patient demographic data. The role is local to Nashville and will be onsite 3-5 days a week. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Regulatory Change Management) - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Lead project management efforts for highly sensitive...