- Molina Healthcare (Akron, OH)
- …and/or detects violation of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the Business ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- Molina Healthcare (OH)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for… more
- Molina Healthcare (Cincinnati, OH)
- …for medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and ... Experience** + 0-2 years of experience in data analytics, business intelligence, or healthcare operations + Foundational...Python or another programming language + Basic familiarity with healthcare data types such as claims , encounters,… more
- Molina Healthcare (Cincinnati, OH)
- **Job Description** **Job Summary** Assist business teams with developing requirements for major projects of considerable complexity, prepares system design ... debug/analyze problems. + Fields direct questions from Molina Operations Staff regarding business , technical and operations rules. + Develops technical solutions to … more
- Molina Healthcare (Dayton, OH)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect … more
- Medical Mutual of Ohio (OH)
- … Analyst ** **Education and Experience:** + Bachelor's degree in healthcare administration, business administration,information technology or a related field ... strategies and goals in alignment with regulatory specification for the annual Healthcare Effectiveness Data and Information Set (HEDIS) lifecycle processes for all… more
- Elevance Health (Mason, OH)
- …are strongly preferred. + Knowledge of SAS. + Knowledge of systems capabilities and Healthcare business operations. + ASC X12 837 EDI experience. + Intermediate ... ** Business Information Analyst Senior - Medicaid...Analyst Senior** is responsible for analyzing and validating healthcare encounter data submissions to CMS (Centers for Medicare… more
- Molina Healthcare (Cincinnati, OH)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Highmark Health (Columbus, OH)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Elevance Health (Mason, OH)
- …BI/Tableau, and actuarial software tools. + Experience working with large administrative claims datasets and healthcare cost/utilization metrics. + Ability to ... **Actuarial Analyst III** **Location:** This role requires associates to...anticipate future health cost drivers and enable faster, smarter business decisions. **How You Will Make An Impact:** +… more