- 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,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- Medical Mutual of Ohio (OH)
- …quality improvement initiatives by collaborating with more senior Analysts and management . Consults with and informs business stakeholders of trends, opportunities ... related field. . 3 years' experience as a HEDIS Quality Improvement Analyst or equivalent HEDIS analytical project experience programs. **Technical Skills and… more
- Highmark Health (Columbus, OH)
- …Degree **EXPERIENCE** **Required** + 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational ... area (eg claims , billing, customer service, etc.) **Preferred** + 1 -...+ Business Requirements + Collaborative Problem Solving + Project Management **Languages (other than English)** None **Travel Required** 0%… more
- 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 ... and business units on identified issues and potential risks related to claims and appeals. + Initiates frequent communication between constituents to analyze… more
- CVS Health (Columbus, OH)
- …with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider ... and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth research to… more
- 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
- Evolent (Columbus, OH)
- …will partner with stakeholders of various levels across analytics, finance, and account management . **What You Will Be Doing:** + Develop and deploy models and ... into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- Acosta Group (West Chester, OH)
- …and leads client's thinking in how to action/profit from those insights. The Analyst will be responsible for providing actionable analysis of internal and external ... range of strategic business planning including, but not limited to, category management , space management , product evaluation, promotion planning and evaluation,… more
- Molina Healthcare (Cincinnati, OH)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by ... into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver… more
- Molina Healthcare (Dayton, OH)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... into technical solutions. This role works closely with clinicians, care management teams, and business stakeholders to gather requirements and deliver actionable… more