- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Sedgwick (Cincinnati, OH)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Performance Assurance Analyst - Property Claims (Part Time Opportunity) **PRIMARY PURPOSE** ... to meet established operational and technical audit requirements. + Coordinates with the Analyst Team in implementing Sedgwick business unit (SBU) and national… more
- Elevance Health (Mason, OH)
- …Computer Science or related field of study and a minimum of 8 years systems analyst or business analyst experience; or any combination of education and ... **Rating/ Claims System Senior Advisor** **Location:** This position will...team located in CGS's India site. + Works with business owners to identify and analyze requirements and processes… more
- Elevance Health (Mason, OH)
- ** Business Information Analyst I** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within ... miles of one of Elevance's Pulse Point locations. The ** Business Information Analyst I** is responsible for...you will make an impact:** * Develops and analyzes business performance reports (eg claims data, provider… more
- Molina Healthcare (Covington, KY)
- **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...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Covington, KY)
- …market-specific business rules, facilitating the accurate and timely payment of claims . Analyzes complex business problems and issues using data from ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** The Analyst , Encounters is responsible for monitoring inbound and outbound encounters processes and ensuring timely, accurate, ... for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounters data and develops recommendations based on data and industry… more
- Elevance Health (Mason, OH)
- …and summarizes performance using summary statistical procedures. * Develops and analyzes business performance reports (eg for claims data, provider data, ... **Advanced Analytics Analyst Senior** **Location:** This position will work a...creating statistical models to predict, classify, quantify, and/or forecast business metrics, while designing model studies to address specific… more
- Elevance Health (Mason, OH)
- **Provider Contract/Cost of Care Analyst Senior** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must ... of one of Elevance's Pulse Point locations. The **Provider Contract/Cost of Care Analyst Senior** is responsible for providing analytical support to the Cost of Care… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …a career in banking at Fifth Third Bank. GENERAL FUNCTION: Foreclosure Analyst II is responsible for ensuring the Foreclosure process is completed accurately ... codes and status codes are processed by the 3rd business day of each month. + Understand data error...(BPO or appraisal), the marketability of the property, any claims possible against third parties (PMI claim, repurchase or… more
- Molina Healthcare (Covington, KY)
- …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...solutions and ability to use critical thinking to analyze claims issues. * Works with internal and external stakeholders… more
- Molina Healthcare (Covington, KY)
- …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...+ Must have experience working on SQL. + Medicare claims experience is a huge plus + Medicare Fee… more
- Molina Healthcare (Covington, KY)
- …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 (Covington, KY)
- …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...+ Must have experience working on SQL. + Medicare claims experience is a huge plus + Medicare Fee… more
- Molina Healthcare (Covington, KY)
- …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
- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and related financial data like risk...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Molina Healthcare (Covington, KY)
- …from various sources to identify risks and opportunities. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and other data sources to identify early signs of trends or ... studies related to the quantification of medical interventions + Work with business owners to track key performance indicators of medical interventions + Perform… more
- Molina Healthcare (Covington, KY)
- …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
- Molina Healthcare (Covington, KY)
- …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
- HUB International (Cincinnati, OH)
- …team_** that is responsible for conducting in-depth analysis on medical and pharmacy claims data to identify trends and key indicators that ultimately result in ... costs and utilization are tracking relative to expectations + Analyzing health care claims data to provide clients with an understanding of what is driving their… more