- Molina Healthcare (Columbus, OH)
- …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- CVS Health (Columbus, OH)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,...investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate… more
- Molina Healthcare (Akron, OH)
- …health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver ... through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality… more
- Molina Healthcare (Cleveland, OH)
- …health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver ... through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality… more
- Molina Healthcare (Columbus, OH)
- …Experience working on SQL, PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Cognizant (Columbus, OH)
- …you will make an impact by leading the implementation and optimization of Facets Claims solutions for healthcare clients. You will be a valued member of ... **Product Consultant - Facets Claims & Payer Domain** **Work Model: Remote** **Employment...help you stand out** + Certified Facets Professional + Healthcare Payer Professional Certification + Experience driving Agile practices… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …care analytics, or related fields (required) + 3+ years' experience working with healthcare claims , eligibility, and financial datasets (required) + Knowledge of ... functions (budgeting, forecasting, accounting support) and performance analytics functions ( claims /eligibility analysis, value-based contract performance, trend reporting), with the… more
- Humana (Columbus, OH)
- …implement data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization ... that align with customer needs and objectives + Deep understanding of healthcare claims taxonomy (service categories, such as LTSS) **Additional information**… more
- Evolent (Columbus, OH)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... public health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider, clinical vendor, managed care, or… more
- Prime Therapeutics (Columbus, OH)
- …5 years of relevant Healthcare experience including: analyzing and using healthcare claims data, clinical research study design, and/or epidemiology + ... is responsible for the synthesis of data findings in support of clinical claims and programs. **Responsibilities** + Synthesizes a wide variety of data and outputs… more