- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to… more
- 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 (Cincinnati, 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
- Humana (Columbus, OH)
- …actuarial and business needs for specific product lines. The Actuarial Analyst 2, General work assignments are varied and frequently require interpretation and ... **Become a part of our caring community and help us put health first** The Actuarial Analyst 2, General provides actuarial support across a broad range of… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The Compliance ... launch and beyond, focusing on balancing customer needs with business goals. + Consults with business areas...or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Prime Therapeutics (Columbus, OH)
- …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,...to claims, contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. **Responsibilities** + Executes compliance… more
- 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...achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job… more
- Evolent (Columbus, OH)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... Job Description ** Analyst , Integration Quality** Integration testing in the healthcare ecosystem...+ provide summary information to stakeholders & management answering business questions + create & maintain queries supporting precise… more
- 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 ... an integral part of the Pricer Business and System Support team responsible for administering complex...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CVS Health (Columbus, OH)
- …state government agencies, including but not limited to Center for Medicaid and Medicare (CMS), Department of Public Welfare, Department of Health, and Department of ... address complaints and appeals and resolve escalated cases. + Educates analysts and business units on identified issues and potential risks related to claims and… more