• Lead Analyst , Payment Integrity…

    Molina Healthcare (Dayton, OH)
    …**Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
    Molina Healthcare (09/28/25)
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  • Sr. AI Business Analyst - Remote

    Prime Therapeutics (Columbus, OH)
    …and assumptions to define additional resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments ... Provide work plan and detailed estimate based on scope; lead scope management, prioritization and drive scope trade off...within project + Educate and advance business systems analyst practice within the Claims IT team… more
    Prime Therapeutics (10/01/25)
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  • Lead Analyst , Quality Analytics…

    Molina Healthcare (Dayton, OH)
    **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and...various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations *… more
    Molina Healthcare (08/17/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …collection. + Participates in required training and performs other duties as assigned. ** Lead HEDIS Analyst ** + Schedules, assigns, and monitors projects and ... knowledge of NCQA and CMS measurement requirements and quality rating systems. ** Lead HEDIS Analyst ** **Education and Experience:** + Bachelor's degree in… more
    Medical Mutual of Ohio (08/16/25)
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  • Lead Analyst , Healthcare Analytics-…

    Molina Healthcare (Columbus, OH)
    …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
    Molina Healthcare (09/11/25)
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  • Senior Internal Business Systems Analyst

    Highmark Health (Columbus, OH)
    …MUST 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… more
    Highmark Health (10/10/25)
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  • Sr. Compliance Analyst - Remote

    Prime Therapeutics (Columbus, OH)
    …passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior ... and partners with key internal stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement.… more
    Prime Therapeutics (08/14/25)
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  • Analyst , Quality Analytics & Performance…

    Molina Healthcare (Columbus, OH)
    **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,… more
    Molina Healthcare (09/18/25)
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