- Cleveland Clinic (Cleveland, OH)
- …role, every member of the Cleveland Clinic team is a caregiver. Serving as Systems Analyst IV, being a caregiver starts in the office, where you will apply your ... Division caregivers + Strong analytical, administrative, presentation, and project management skills + Understanding of networking/distributed computing environment concepts… more
- Molina Healthcare (Cincinnati, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... experience **Required Experience** + 2-4 years increasingly complex database and data management responsibilities + Basic knowledge of SQL + 2-4 years of… more
- Molina Healthcare (Cincinnati, OH)
- …lead for both new and existing features (regression testing). + Vendor Management : Provides single point of contact for various vendors (software and interfaces). ... + SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… more
- CVS Health (Columbus, OH)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- CVS Health (Columbus, OH)
- …in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- Highmark Health (Columbus, OH)
- …met. Individual contributor roles as needed. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but not limited to: involved in hiring ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the… more
- Molina Healthcare (Akron, OH)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** +… more
- Molina Healthcare (Akron, OH)
- …Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of ... healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Prime Therapeutics (Columbus, OH)
- …systems, particularly those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + ... **Additional Qualifications** + A bachelor's degree in business intelligence, management information systems, mathematics, statistics, analytics, computer and information… more
- Parker Hannifin Corporation (Cleveland, OH)
- …the general duties of a Parker Sourcing Specialist, Buyer/Planner and Logistics Analyst . The SCM LDA's primary duties will involve supports individual sourcing ... with the goal to develop skillsets in supervision, team leadership, and management . While in program, rotational assignments are structured to expose participants to… more