- Molina Healthcare (Akron, OH)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... oversight to ensure that the contracts are configured correctly in QNXT. The claims are reviewed to ensure that the configured services are correct. Maintain the… more
- Molina Healthcare (Dayton, 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 executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… 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 ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… 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
- Baylor Scott & White Health (Columbus, OH)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina… more
- Molina Healthcare (Dayton, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- 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 ... health plan reports related to Risk and Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP * Develops custom health plan...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and… more
- Molina Healthcare (Cleveland, OH)
- **JOB DESCRIPTION** **Job Summary** The Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. This position designs and ... to use reports related to Risk and Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. **Job Duties** + Work with...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… more
- 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 ... as well as automated analytical Reporting modules related to Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. + Analysis and reporting related to Managed… more