- Elevance Health (Mason, OH)
- …team driving advanced analytics and actuarial innovation across Local Group, Individual, Medicaid , and Medicare businesses. We are pioneering the use of ... **Actuarial Analyst III** **Location:** This role requires associates to...anticipate future health cost drivers and enable faster, smarter business decisions. **How You Will Make An Impact:** +… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... 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… more
- Molina Healthcare (Cincinnati, OH)
- …+ Exposure to Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS audit processes ... **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the...senior analysts. + Document data sourcing steps, methodologies, and business rules to promote traceability and team learning. +… more
- Molina Healthcare (Cincinnati, OH)
- …etc. **PREFERRED EXPERIENCE:** + SQL expertise + Excel expertise + Medicare , Medicaid , Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment ... **Job Description** **Job Summary** Assist business teams with developing requirements for major projects...+ Fields direct questions from Molina Operations Staff regarding business , technical and operations rules. + Develops technical solutions… more
- Humana (Columbus, OH)
- …actuarial and business needs for specific product lines. The Actuarial Analyst 2, General work assignments are varied and frequently require interpretation and ... community and help us put health first** The Actuarial Analyst 2, General provides actuarial support across a broad...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Prime Therapeutics (Columbus, OH)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance… more
- Molina Healthcare (Columbus, OH)
- …experience on researching, presenting and documenting is required, + Experience with Medicare , Medicaid and Marketplace is required. + Medical coding experience ... data among operational and claims systems and application of business rules as they apply to each database. Validate...to be housed on databases and ensure adherence to business and system requirements of customers as it pertains… more
- CVS Health (Columbus, OH)
- …Prior Healthcare experience managing insurance, healthcare, or benefit accounts - Experience with Medicaid , Commercial, and/or Medicare Part D Plans In the role, ... and can build long-lasting, mutually beneficial relationships with our key business stakeholders. Additionally, Account Managers are expected to demonstrate a… more
- CVS Health (Columbus, OH)
- …+ Pharmacy Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree in ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Molina Healthcare (Cincinnati, OH)
- …synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid , and Marketplace lines of business . + Certified ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State...+ At least 7 years of experience as a Business Analyst or Program Manager in a… more