• Senior Analyst , Healthcare Analytics (Risk…

    Molina Healthcare (OH)
    **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
    Molina Healthcare (07/17/25)
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  • Analyst , Business Quality (Remote)

    Molina Healthcare (OH)
    **Job Description** **Job Summary** Assist business teams with developing requirements for major projects of considerable complexity, prepares system design ... debug/analyze problems. + Fields direct questions from Molina Operations Staff regarding business , technical and operations rules. + Develops technical solutions to … more
    Molina Healthcare (08/10/25)
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  • Senior Analyst , Medical Economics - REMOTE

    Molina Healthcare (Columbus, OH)
    **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
    Molina Healthcare (07/10/25)
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  • Risk Adjustment Audit Operations Analyst…

    Molina Healthcare (Cincinnati, OH)
    **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and… more
    Molina Healthcare (08/08/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Columbus, OH)
    …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid business… more
    Humana (08/14/25)
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  • Sr. Compliance Analyst - Remote

    Prime Therapeutics (Columbus, OH)
    …claims , contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. **Responsibilities** + Executes compliance procedures ... and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance… more
    Prime Therapeutics (08/14/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …actionable opportunities for quality improvement across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid). Integrates diverse data ... with more senior Analysts and management. Consults with and informs business stakeholders of trends, opportunities and risks. **Responsibilities** . Provides… more
    Medical Mutual of Ohio (08/08/25)
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  • Senior Reporting Analyst

    CVS Health (Columbus, OH)
    …to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to continuously innovate ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
    CVS Health (08/16/25)
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  • Analyst , Complaints & Appeals - Work…

    CVS Health (Columbus, OH)
    …on current findings, regulations, and legislation, employing all tools associated with claims and appeals processing to mitigate risks. + Employs expert knowledge of ... to address complaints and appeals and resolve escalated cases. + Educates analysts and business units on identified issues and potential risks related to claims … more
    CVS Health (08/22/25)
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  • Cybersecurity Protect Analyst

    UIC Government Services and the Bowhead Family of Companies (Wright Patterson AFB, OH)
    **Overview** Bowhead seeks an experienced Cybersecurity Protect Analyst to join our team onsite in Vicksburg, MS. The Cybersecurity Protect Analysts will ensure ... or where a rental car must be obtained for business travel purposes, applicants must have a valid driver...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
    UIC Government Services and the Bowhead Family of Companies (08/08/25)
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