- CVS Health (Columbus, OH)
- …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning ... the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator,… more
- Molina Healthcare (Cincinnati, OH)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and… more
- Molina Healthcare (Akron, OH)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- Molina Healthcare (Cleveland, OH)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- OhioHealth (Columbus, OH)
- …meeting per month in Columbus, Ohio. The Intermediate Informatics Data Analyst will support OhioHealth Pharmacy Services by analyzing and managing healthcare ... And Duties:** Extracts data from various data sources including electronic medical record, decision support, clinical quality, clinical registries, and claims… more
- Evolent (Columbus, OH)
- …team at Evolent. This individual will be primarily focused on distilling medical economics insights from product strategy analyses and translating them to complex ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- CVS Health (Columbus, OH)
- …analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost drivers and identifies ... opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. + Assesses impacts of new risk-sharing… more
- 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 ... Finance, Economics, Math, Accounting or related fields Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators: + Proactively… more
- Intermountain Health (Columbus, OH)
- …Classification of Diseases ICD-10 and Diagnosis Related Groups (DRG) codes for claims concurrently while a patient is in a hospital. It ensures accurate ... coding in an inpatient hospital setting. AND Demonstrated understanding of medical terminology, medical acronyms, anatomy and physiology. AND Demonstrated… more
- CVS Health (Columbus, OH)
- …and security requirements. **Required Qualifications** + 1 year minimum of claims processing experience + Experience with system testing and post go-live ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
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