- Molina Healthcare (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 (Akron, OH)
- …to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, ... and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and performs audits and oversight functions involving business-critical… more
- 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
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Supports corporate and ... lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment… more
- 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 (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. This position has ... meetings in Brooklyn, OH monthly; Ohio residents preferred. **Financials Systems Analyst III** **Job Summary:** **Under general supervision, updates and maintains… more
- 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 complex ... as a resource for colleagues with less experience.** **Responsibilities:** Sr. Finacial Analyst . Supports corporate departments, both within and outside of Finance,… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Produces reporting and ... for quality improvement across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid). Integrates diverse data sources to report… 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
- 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...Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid, the Exchanges along with regulatory compliance requirements… more