- Evolent (Columbus, OH)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree, ... candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions. Our team values accuracy,… more
- Highmark Health (Columbus, OH)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Molina Healthcare (OH)
- …pertaining to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr . Analyst works with health plans and operations departments to ... ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr . Analyst develops and performs audits and oversight functions involving… more
- Molina Healthcare (OH)
- …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst , Healthcare Analytics role will...functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data … more
- Molina Healthcare (Cleveland, OH)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, ... follow up, and performance monitoring. + Understands provider, member, and, inbound claims data compliance in relation to encounters submission requirements +… more
- Molina Healthcare (Cleveland, OH)
- …in data analysis. Performs research and deep-dive analysis of complex healthcare claims data , CMS return files, and financial cost, revenue, and vendor ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst , Healthcare Analytics role will...and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... + Develops custom health plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and collaborates with… more
- Elevance Health (Cincinnati, OH)
- **Advanced Analytics Analyst Senior - Medical Economics** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Cincinnati, OH; Chicago, IL (preferred). This ... leaders passionate about transforming American healthcare delivery. The **Advanced Analytics Analyst Senior ** measures financial performance of core Carelon… more
- Evolent (Columbus, OH)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Senior Analyst , Healthcare Analytics Consultant The Client Analytics team provides a ... our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will...narratives for stakeholders. **What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... from various systems to support executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to… more