- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. ... 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)
- **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...tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex… 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)
- …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)
- …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
- Elevance Health (Mason, OH)
- **Rating/ Claims System Senior Advisor** **Location:** This...of study and a minimum of 8 years systems analyst or business analyst experience; ... Indianapolis, IN; Chicago, IL; Manchester, NH; Boston, MA.** The **Rating/ Claims System Senior Advisor** leads the activities...team located in CGS's India site. + Works with business owners to identify and analyze requirements and processes… more
- Elevance Health (Mason, OH)
- **Advanced Analytics Analyst Senior ** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live ... 50 miles of one of Elevance's Pulse Point locations. The **Advanced Analytics Analyst Senior ** is responsible for creating statistical models to predict,… 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 ... 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… more