- Prime Therapeutics (Columbus, OH)
- …+ Recommend new and revised financial pricing programs based on analysis of pharmacy claims data , average wholesale drug prices (AWP), and other relevant data ... data + Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings… more
- Prime Therapeutics (Columbus, OH)
- …+ Recommend new and revised financial pricing programs based on analysis of pharmacy claims data , average wholesale drug prices (AWP), and other relevant data ... data + Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings… more
- Evolent (Columbus, OH)
- …quality assurance and database testing, medical benefits, provider, enrollment, and / or claims data . + Demonstrable experience with Testing, Writing Test cases, ... for the culture. **What You'll Be Doing:** Job Description ** Analyst , Integration Quality** Integration testing in the healthcare...equivalent years of work experience + General knowledge of data flow and healthcare end to end… more
- Evolent (Columbus, OH)
- …complex analyses into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make ... data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree,… more
- Medical Mutual of Ohio (OH)
- …report performance on key quality indicators, including but not limited to Healthcare Effectiveness Data and Information Set (HEDIS), STARS, Consumer Assessment ... of Healthcare Providers and Systems (CAHPS) and Healthcare ...utilize certified HEDIS software. . Ability to analyze clinical, claims , pharmacy, encounter, and quality measurement data .… more
- Elevance Health (Mason, OH)
- …using summary statistical procedures. + Develops and analyzes business performance reports (eg for claims data , provider data , utilization data ) and ... **Business Information Analyst Senior - Provider Economics** **Location:** This role...is responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. **How… 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
- CVS Health (Columbus, OH)
- …Trifacta, Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data . + Experience in healthcare industry, including health ... our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to,… more
- CVS Health (Columbus, OH)
- …evaluating and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth ... with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider… more
- Humana (Columbus, OH)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more