- Molina Healthcare (Columbus, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... ensure all end-to-end business requirements have been documented. + Creates management reporting tools to enhance communication on configurations updates and… more
- Molina Healthcare (Akron, OH)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... or reports to meet their specific needs. May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and… more
- Medical Mutual of Ohio (OH)
- …meetings in Brooklyn, OH monthly; Ohio residents preferred. **Financials Systems Analyst III** **Job Summary:** **Under general supervision, updates and maintains ... with IT to resolve system issues. + Creates analyses and reports for management decision support, regulatory filings and other business needs. + Performs other… more
- Medical Mutual of Ohio (OH)
- …fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the ... initiatives to improve member health. + Orients and trains more junior-level Analyst + Participates in required trainings and performs other duties as assigned.… more
- Molina Healthcare (Cincinnati, OH)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (OH)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Sumaria Systems, Inc. (Fairborn, OH)
- Management Analyst Department: SAS DAYTON, OH Office: Wright Patterson AFB, OH - SAS Location: Fairborn, OH START YOUR APPLICATION ... (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req\_id=3494556&source=3494556-CJB-0) Management Analyst Support Perform AFLCMC/WII program operations,… more
- Elevance Health (Mason, OH)
- …Demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, the company's internal business ... **Title: Grievance/Appeals Analyst I** **Location:** This role enables associates to...with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear,… more
- Elevance Health (Mason, OH)
- **Actuarial Analyst III** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... accommodation is granted as required by law. The **Actuarial Analyst III** completes very diverse and complicated projects and...Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and… more
- Prime Therapeutics (Columbus, OH)
- …or financial analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field + Previous ... our passion and drives every decision we make. **Job Posting Title** Senior Analyst Pricing - Remote **Job Description** The Senior Pricing Analyst participates… more