- CVS Health (Columbus, OH)
- …more compassionate. And we do it all with heart, each and every day. **Position Summary** Claim Audit Quality Analyst is responsible for ensuring the ... accuracy and quality of claim audits across multiple areas within Meritain. This role...within Meritain. This role demands a deep understanding of claims , plan documents, eligibility, coverages, and the unique requirements… more
- Molina Healthcare (OH)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...and in accordance with unit standards. **Knowledge/Skills/Abilities** * Trains audit staff on configuration functionality, enhancements and updates. *… more
- Elevance Health (Independence, OH)
- **Performance Quality Analyst II** **Location:** This role...a minimum of 1 year related experience in a quality audit capacity; or any combination of ... accommodation is granted as required by law. The **Performance Quality Analyst II** is responsible for driving...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Molina Healthcare (Akron, OH)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... develops reporting solutions to assist HEDIS audit , rate tracking, and Identifying targeted Interventions and tracking...Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support… more
- Prime Therapeutics (Columbus, OH)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is ... business partners with regard to related regulatory activity and quality efforts involving utilization and/or medication therapy management, network management,… more