- Medical Mutual of Ohio (Brooklyn, OH)
- …activities. Acts as a resource for colleagues with less experience.** **Responsibilities:** Sr . Finacial Analyst . Supports corporate departments, both within ... or accounting ramifications. . Performs other duties as assigned **Qualifications** Sr . Finacial Analyst **Education and Experience:** . Bachelors degree with… more
- Molina Healthcare (Akron, OH)
- …pertaining to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr . Analyst works with health plans and operations departments to ... of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the...and compliance with State and Federal regulatory guidelines. The Sr . Analyst develops and performs audits and… more
- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr . Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & ... Complaints Senior Compliance Analyst assists in the implementation...to claims, contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. **Responsibilities** + Executes compliance… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** This Sr . Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... needs. Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and… 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 ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....in required training and performs other duties as assigned. ** Sr HEDIS Analyst ** + Leads analytical and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …on daily activities to other staff members. . Performs other duties as assigned. Sr . Finacial Analyst . Supports corporate departments, both within and outside ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....to junior staff members relative to the relevant systems. Sr . Finacial Analyst **Education and Experience:** .… more
- Medical Mutual of Ohio (OH)
- …filings and other business needs. + Performs other duties as assigned. ** Sr . Financials Systems Analyst ** **Job Summary:** **Performs a lead role in the ... to interpret and articulate standard business and financial concepts. ** Sr . Financials Systems Analyst ** **Education and Experience:** + Bachelor's degree… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... key business issues related to cost, utilization and revenue for...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… more
- CVS Health (Columbus, OH)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Medical Mutual of Ohio (OH)
- …identify actionable opportunities for quality improvement across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid). Integrates ... senior Analysts and management. Consults with and informs business stakeholders of trends, opportunities and risks. **Responsibilities** . Provides analytical… more