- Molina Healthcare (Columbus, OH)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (OH)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... adjustment to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience… more
- Molina Healthcare (Akron, OH)
- …advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and ... trends to provide analytic support for finance, pricing and actuarial functions. + Healthcare Analyst I experience desired. + PowerBI, Excel, Power Pivot, VBA,… more
- Molina Healthcare (Cleveland, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (Cincinnati, OH)
- …a critical role in supporting clinical and operational initiatives by translating healthcare business needs into technical solutions. This role works closely ... solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. *… more
- Molina Healthcare (Dayton, OH)
- …a critical role in supporting clinical and operational initiatives by translating healthcare business needs into technical solutions. This role works closely ... technical solutions. + Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and… more
- Molina Healthcare (Cincinnati, OH)
- **Job Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and...+ At least 6 years of experience as a Business Analyst or Program Manager in a… 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
- Evolent (Columbus, OH)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Prime Therapeutics (Columbus, OH)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization + ... drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy...define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business… more