• Medicare Risk Adjustment Advanced Analytics…

    Elevance Health (Independence, OH)
    ** Medicare Risk Adjustment Advanced Analytics Analyst ** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst ** is...law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst ** is responsible for employing advanced analytics to gain… more
    Elevance Health (07/29/25)
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  • Operational Regulatory Oversight Analyst

    Molina Healthcare (OH)
    …to the Health Care environment. **Knowledge/Skills/Abilities** The Operational/Regulatory Oversight Analyst works with health plans and operations departments to ... to and compliance with State and Federal regulatory guidelines. The Analyst develops and performs audits and oversight functions involving business-critical… more
    Molina Healthcare (07/19/25)
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  • Senior Business Analyst ( Medicare

    Molina Healthcare (Cincinnati, OH)
    …business analysis, task and workflow analysis. + Subject matter expert of Medicare and Healthcare enrollment 834 files. + Interpret customer business needs and ... translate them into application and operational requirements + Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as… more
    Molina Healthcare (07/27/25)
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  • Senior Actuarial Analyst ( Medicare

    Molina Healthcare (Cincinnati, OH)
    **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment… more
    Molina Healthcare (07/25/25)
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  • Senior Medicaid & Medicare Reimbursement…

    OhioHealth (Columbus, OH)
    …Description 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… more
    OhioHealth (06/07/25)
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  • Master Data Management Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Master ... Data Management Analyst III** The MDM Analyst within the...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
    Medical Mutual of Ohio (08/02/25)
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  • CRM Business Systems Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Business System Analyst I Provides the ... business needs. Experience with Microsoft Dynamics 365 preferred. Business System Analyst II Provides the interface between the business and information technology… more
    Medical Mutual of Ohio (05/17/25)
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  • Financial Analyst

    Medical Mutual of Ohio (Brooklyn, OH)
    …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides basic analysis ... complete special projects, and conduct monthly activities.** **Responsibilities:** Financial Analyst I-II . Supports corporate departments, both within and outside… more
    Medical Mutual of Ohio (05/22/25)
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  • Actuarial Analyst 2

    Humana (Columbus, OH)
    …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require… more
    Humana (07/31/25)
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  • Senior Analyst , Healthcare Analytics (Risk…

    Molina Healthcare (Cleveland, OH)
    **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
    Molina Healthcare (07/17/25)
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