- Public Consulting Group (Columbus, OH)
- …Project and Grants Management + Assessments and Feasibility Studies Analyzes claims for accuracy, provides client support, documents inquiries, supervises staff, ... process improvements. **Duties and Responsibilities** + Analyzes and reviews claims for accuracy, completeness and eligibility. + Provides leadership, supervision… more
- HomeSafe Alliance (Columbus, OH)
- **Title:** Lead IT Business Process Analyst ( Lead Product Owner) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... + Coordinate release planning with operations, customer care, supply chain, claims , and other departments. **Customer** **Feedback and Continuous Improvement:** +… more
- Molina Healthcare (Columbus, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... completion dates with Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and configuration of all… 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 ... cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develops, implements, and uses software and systems to… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic… 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 ... and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify...Python, R, etc.) to answer a given problem + Lead monthly trend presentations to plan leadership and other… more
- Molina Healthcare (Columbus, OH)
- …and claims functionality. Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. + Complex ... and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive...and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,… more
- CVS Health (Columbus, OH)
- …who is skilled at identifying outliers through data extraction and analysis. The lead reviewer is accountable for the validation of existing Fraud Waste and Abuse ... to fraud, waste, and abuse when reviewing a new lead or referral. -Keep current with new and emerging...of data interpretation and analysis experience. -Experience with internal claims data and healthcare coding. -Must be able to… more
- Lumen (Columbus, OH)
- …connect the world and shape the future. **The Role** We are seeking a Lead Product Marketing Manager to drive the creation and delivery of unique market positioning ... to identify and develop valuable messaging that will drive engaging content. The Lead Product Marketing Manager is expected to be a content marketing expert across… more
- Prime Therapeutics (Columbus, OH)
- …tools, such as self-service capabilities and standard report packages. May lead efforts to create curriculum to improve user adoption. + Ensures ... years of work experience. + Prior experience as a Business Intelligence Developer/ Analyst or Data Analyst supporting business intelligence, reporting, analytics… more