- Molina Healthcare (Columbus, OH)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Elevance Health (Columbus, OH)
- **JR144681 Business Analyst III /Senior Tester** A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of ... live within 50 miles of one of our Elevance Health PulsePoint locations. The ** Business Analyst III/Senior Tester** will be responsible for serving as the… more
- Elevance Health (Columbus, OH)
- ** Business Analyst ** A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a ... of one of our Elevance Health PulsePoint locations. The ** Business Analyst III** is responsible for serving...and/or healthcare operations is required. + Exposure to PBM Claims Adjudication is a significant advantage. Please be advised… more
- Evolent (Columbus, OH)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides...team provides a unique opportunity to collaborate with key business , analytics, product, and operational leaders to deliver client-specific… more
- Norstella (Columbus, OH)
- Analyst Company: Panalgo Location: Remote, United States Date Posted: Mar 4, 2025 Employment Type: Full Time Job ID: R-943 **Description** Analyst , Analytic ... to address their health care research needs.We are an analyst community and culture where group learning, support, and...analyze a variety of large, real-world data assets (eg, claims , EMR), and be able to articulate IHD data… more
- Humana (Columbus, OH)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid business… more
- Molina Healthcare (Columbus, OH)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… more
- Molina Healthcare (Columbus, OH)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Columbus, OH)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in contracts and benefits configuration. + Strong background in claims is required. + Experience working on Networx, QNXT… more
- Sedgwick (Columbus, OH)
- …their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Data Analyst **PRIMARY PURPOSE** : To create comprehensive reporting and analysis of… more
- Molina Healthcare (Columbus, OH)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (Columbus, OH)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Highmark Health (Columbus, OH)
- …patterns in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities. This position ... strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought… more
- Highmark Health (Columbus, OH)
- …in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities. **ESSENTIAL ... strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought… more
- Western Digital (Columbus, OH)
- …offer an expansive portfolio of technologies, storage devices and platforms for business and consumers alike. Our data-centric solutions are comprised of the Western ... owner to drive improvements and alignment across all aspects of rebates and claims settlements, as we harmonize rebate programs across all subsidiaries. + Actively… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Columbus, OH)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more
- Elevance Health (Columbus, OH)
- …and summarizes performance using summary statistical procedures. + Develops and analyzes business performance reports (eg for claims data, provider data, ... **HEDIS Business Information Consultant** **Location:** This position will take...analysts. The position is part of the **Enterprise HEDIS Analyst Team** . It will be responsible for working… more
- Highmark Health (Columbus, OH)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... lower level HMIG Underwriters. **ESSENTIAL RESPONSIBILITIES** + Responsible for a book of business of renewing accounts and writing new business at profitable… more