- Humana (Columbus, OH)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (OH)
- …activities at individual state health plans. **KNOWLEDGE/SKILLS/ABILITIES** The Compliance Analyst position is primarily responsibility for supporting the day to ... inquiries. + Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. + Create and… more
- CVS Health (Columbus, OH)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Molina Healthcare (Cincinnati, OH)
- …etc. **PREFERRED EXPERIENCE:** + SQL expertise + Excel expertise + Medicare , Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is ... generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods.… more
- CVS Health (Columbus, OH)
- …Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree in Criminal Justice or ... equivalent experience **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $112,200.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the… more
- CVS Health (Columbus, OH)
- …managing insurance, healthcare, or benefit accounts - Experience with Medicaid, Commercial, and/or Medicare Part D Plans In the role, you must be able to travel ... up to 20%. Travel may require, but is not limited; to flights, overnight stays, local travel on short notice and other travel deemed necessary by the Company. **Education** Bachelor's degree or Equivalent Experience required **Anticipated Weekly Hours** 40… more
- Molina Healthcare (Columbus, OH)
- …experience on researching, presenting and documenting is required, + Experience with Medicare , Medicaid and Marketplace is required. + Medical coding experience is ... highly preferred. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination of education and experience **Required Experience** 7-9 years **Preferred Education** Graduate Degree or equivalent experience **Preferred Experience**… more
- 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
- Molina Healthcare (Akron, OH)
- …coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** + ... At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization...At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept… more
- Molina Healthcare (Akron, OH)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization...At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept… more
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