- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Senior Business Analyst - Medicaid Implementations - Remote **Job Description** ... The Business Analyst (BA) Senior will execute on medium projects as...tools (MS Word, Excel, Visio, etc.) + Experience in Pharmacy Benefit Management (PBM) or healthcare industry Every employee… more
- Medical Mutual of Ohio (OH)
- …Data and Information Set (HEDIS) lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid ), including HEDIS audit ... fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the… more
- Molina Healthcare (OH)
- … needs. Performs analysis across multiple states and lines of business (Medicare, Medicaid , Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Prime Therapeutics (Columbus, OH)
- …change process + Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned ... passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible… more
- Elevance Health (Mason, OH)
- **Actuarial Analyst III** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. The **Actuarial Analyst III** completes very diverse and complicated projects and performs very complex… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The Compliance ... launch and beyond, focusing on balancing customer needs with business goals. + Consults with business areas...legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated… more
- Elevance Health (Mason, OH)
- **Data Scientist Analyst ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... granted as required by law. As a **Data Scientist Analyst ** , you will support the development of innovative...solutions that uncover early signals in cost trends across Medicaid , Medicare, Local Group, and Individual markets. You'll collaborate… more
- Prime Therapeutics (Columbus, OH)
- …research and resolve regulatory inquiries/complaints related to claims, contracting and pharmacy reimbursement. Works directly with business partners across the ... and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Claim Technical Analyst - JUDI Ops Team - Remote **Job Description** The Claims Technical ... Analyst is responsible for serving as the claims analysis...performing intermediate level and some complex client, member and pharmacy remediation analysis caused by errors coded into the… more
- CVS Health (Columbus, OH)
- …seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/ Pharmacy /Broker Investigative Team within Aetna's Special Investigations Unit. In this ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more