- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job Description** The ... IT Business Systems Analyst (BSA) Sr is responsible for serving as a...Management (PBM) or healthcare experience with understanding of Medicare, Medicaid , the Exchanges along with regulatory compliance requirements (HIPAA… more
- Elevance Health (Mason, OH)
- **Business Information Analyst Senior - Medicaid Encounters Data** The **Business Information Analyst Senior** is responsible for analyzing and validating ... healthcare encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role involves ensuring the accuracy and completeness of data,… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing … more
- Molina Healthcare (Cincinnati, OH)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Molina Healthcare (Cincinnati, OH)
- …Description** **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 shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** + Assists… more
- Medical Mutual of Ohio (OH)
- …for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid ), including HEDIS audit submission, Consumer Assessment of Healthcare Providers ... fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the… 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 Operations ... and processing. This role will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... analysis across multiple states and lines of business (Medicare, Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing health care… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible ... client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned **Education & Experience** + Bachelor's… more