Risk Analyst Visa Sponsorship Jobs in Kentucky
Risk analyst visa sponsorship jobs in Kentucky are concentrated in Louisville's finance and insurance sector, with major employers like Humana, Anthem, and PNC Bank historically filing H-1B visa petitions for analytical roles. Lexington also offers opportunities through healthcare and manufacturing firms. Kentucky's growing insurtech and financial services industries make it a viable market for internationally qualified candidates.
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Get Access To All JobsJOB DESCRIPTION
Job Summary
Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy. Makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance.
Essential Job Duties
- Business Leadership & Operational Ownership
- Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment datamining, and overpayment recovery, to improve encounter submissions, reduce general and administrative (G&A) expenses, and drive positive operational and financial outcomes for all payment integrity (PI) solutions.
- Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment recovery initiatives to ensure health plan SAI targets are met.
- Leads efforts to improve claim payment accuracy and financial performance without needing extensive oversight.
- Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
- Serves as a thought partner to health plan leadership and provides well-reasoned recommendations that support short- and long-term business goals.
-
Partners with the network team to communicate recovery projects to ensure provider relations is informed and able to respond to provider inquiries.
-
Analyze data to identify and develop new recovery opportunities
- Analyze data from Payment Integrity and Vendors against contracts, billing, and processing guidelines
- Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
- Conduct peer reviews of recovery concepts and offer recommendations for logical improvements; assist team members in their analysis of data sets and trends.
- Responsible for documenting policies and procedures related to concept approvals
- Conduct trainings and prepare training documentation for teams
- Other duties as assigned
Strategic Business Analysis
- Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps.
- Applies understanding of health care regulations, managed care claims workflows, and provider reimbursement models to shape payment integrity related recommendations and action plans.
- Translates strategic needs into clear requirements, workflows, and solutions that drive measurable improvement.
- Partners with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets.
Applied Analytical Support
- Uses data analysis tools/systems to support business analysis.
- Validates findings and tests assumptions through data, and leads with contextual knowledge of claims processing, provider contracts, and operational realities.
- Creates succinct summaries and visualizations that enable faster leadership decision-making.
Required Qualifications
- At least 4 years of business analyst experience in a managed care organization (MCO), and at least 2 years of experience in Medicaid and/or Medicare programs, or equivalent combination of relevant education and experience.
- Proven experience owning operational projects from concept to execution, especially in the areas of provider reimbursement and claims payment integrity.
- Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules.
- Strong data analysis/queries experience, and ability to analyze data to inform business decisions.
- Strong business judgment, cross-functional coordination, and ownership of high-value deliverables.
- Demonstrated ability to work independently and apply business judgment in a highly regulated, cross-functional environment.
- Strong written and verbal communication skills, including ability to synthesize complex information.
-
Microsoft Office suite (including advanced Excel), and applicable software program(s) proficiency.
-
Claims processing background
- Experience with Medicare, Medicaid, and/or Marketplace lines of business.
Preferred Qualifications
- Experience with Medicare, Medicaid, and/or Marketplace lines of business.
- Certified Business Analysis Professional (CBAP) or Certified Coding Specialist (CCS) certification.
- Project management experience.
- Familiarity with Medicaid-specific scorable action items (SAIs), operational cost-management efforts, payment integrity (PI) programs, and regulatory/compliance adherence.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
JOB DESCRIPTION
Job Summary
Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy. Makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance.
Essential Job Duties
- Business Leadership & Operational Ownership
- Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment datamining, and overpayment recovery, to improve encounter submissions, reduce general and administrative (G&A) expenses, and drive positive operational and financial outcomes for all payment integrity (PI) solutions.
- Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment recovery initiatives to ensure health plan SAI targets are met.
- Leads efforts to improve claim payment accuracy and financial performance without needing extensive oversight.
- Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
- Serves as a thought partner to health plan leadership and provides well-reasoned recommendations that support short- and long-term business goals.
-
Partners with the network team to communicate recovery projects to ensure provider relations is informed and able to respond to provider inquiries.
-
Analyze data to identify and develop new recovery opportunities
- Analyze data from Payment Integrity and Vendors against contracts, billing, and processing guidelines
- Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
- Conduct peer reviews of recovery concepts and offer recommendations for logical improvements; assist team members in their analysis of data sets and trends.
- Responsible for documenting policies and procedures related to concept approvals
- Conduct trainings and prepare training documentation for teams
- Other duties as assigned
Strategic Business Analysis
- Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps.
- Applies understanding of health care regulations, managed care claims workflows, and provider reimbursement models to shape payment integrity related recommendations and action plans.
- Translates strategic needs into clear requirements, workflows, and solutions that drive measurable improvement.
- Partners with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets.
Applied Analytical Support
- Uses data analysis tools/systems to support business analysis.
- Validates findings and tests assumptions through data, and leads with contextual knowledge of claims processing, provider contracts, and operational realities.
- Creates succinct summaries and visualizations that enable faster leadership decision-making.
Required Qualifications
- At least 4 years of business analyst experience in a managed care organization (MCO), and at least 2 years of experience in Medicaid and/or Medicare programs, or equivalent combination of relevant education and experience.
- Proven experience owning operational projects from concept to execution, especially in the areas of provider reimbursement and claims payment integrity.
- Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules.
- Strong data analysis/queries experience, and ability to analyze data to inform business decisions.
- Strong business judgment, cross-functional coordination, and ownership of high-value deliverables.
- Demonstrated ability to work independently and apply business judgment in a highly regulated, cross-functional environment.
- Strong written and verbal communication skills, including ability to synthesize complex information.
-
Microsoft Office suite (including advanced Excel), and applicable software program(s) proficiency.
-
Claims processing background
- Experience with Medicare, Medicaid, and/or Marketplace lines of business.
Preferred Qualifications
- Experience with Medicare, Medicaid, and/or Marketplace lines of business.
- Certified Business Analysis Professional (CBAP) or Certified Coding Specialist (CCS) certification.
- Project management experience.
- Familiarity with Medicaid-specific scorable action items (SAIs), operational cost-management efforts, payment integrity (PI) programs, and regulatory/compliance adherence.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Risk Analyst Job Roles in Kentucky
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Search Risk Analyst Jobs in KentuckyRisk Analyst Jobs in Kentucky: Frequently Asked Questions
Which companies sponsor visas for risk analysts in Kentucky?
Louisville-based employers are the most active sponsors for risk analyst roles in Kentucky. Humana and Anthem have filed H-1B petitions for actuarial and risk-related positions, given their large healthcare operations in the state. PNC Bank and regional insurers also appear in federal LCA disclosure data for finance and risk roles. Manufacturing firms in the Lexington corridor occasionally sponsor risk and compliance analysts as well.
Which visa types are most common for risk analyst roles in Kentucky?
The H-1B is the most common visa for risk analyst positions in Kentucky, as the role typically qualifies as a specialty occupation requiring at least a bachelor's degree in finance, statistics, economics, or a related field. Candidates with relevant STEM degrees may also be eligible for OPT STEM extension periods. TN visa status is an option for Canadian and Mexican nationals whose credentials align with qualifying occupational categories under the USMCA.
How to find risk analyst visa sponsorship jobs in Kentucky?
Migrate Mate is the most direct way to find risk analyst roles in Kentucky where employers are open to visa sponsorship. The platform filters jobs specifically for international candidates, so you can browse Kentucky-based risk analyst postings without manually screening out employers who don't sponsor. Filtering by location and role on Migrate Mate saves significant time compared to reviewing general job listings.
Which cities in Kentucky have the most risk analyst sponsorship jobs?
Louisville is Kentucky's primary market for sponsored risk analyst positions, driven by its concentration of health insurance companies, financial institutions, and corporate headquarters. Lexington is a secondary market with opportunities in healthcare systems like UK HealthCare and manufacturing operations. Frankfort occasionally surfaces government or regulatory risk roles, though sponsorship is far less common in the public sector.
Are there any state-specific considerations for risk analyst candidates pursuing sponsorship in Kentucky?
Kentucky's risk analyst market is heavily weighted toward healthcare and insurance, so candidates with backgrounds in actuarial science, healthcare finance, or enterprise risk management are best positioned. The Department of Labor's prevailing wage requirements apply to all H-1B petitions, and employers in Louisville's insurance sector are generally familiar with the sponsorship process. University of Kentucky and University of Louisville both produce graduates in finance and analytics, creating some local competition for entry-level roles.
What is the prevailing wage for sponsored risk analyst jobs in Kentucky?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.