• Business Analyst ( Claims

    Molina Healthcare (Cincinnati, OH)
    …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business ...experience ** Required Experience** + 3-5 Years of business analysis + 4+ years managed care experience +… more
    Molina Healthcare (01/13/25)
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  • Analyst , Business -( Claims

    Molina Healthcare (Cincinnati, OH)
    …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... Required Education** Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business analysis + 4+… more
    Molina Healthcare (01/13/25)
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  • Clinical Content Analyst

    Elevance Health (Mason, OH)
    **Clinical Content Analyst ** **Location:** This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles ... MO, Wallingford, CT, Grand Prairie, TX or Louisville, KY. The **Clinical Content Analyst ** will be responsible for driving the development and execution of the… more
    Elevance Health (12/21/24)
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  • Business Information Analyst Sr.

    Elevance Health (Mason, OH)
    ** Business Information Analyst Sr.** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within ... 50 miles of one of Elevance's Pulse Point locations. **The Business Information Analyst Sr.** is responsible for providing utilization management services, and… more
    Elevance Health (01/08/25)
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  • Sr Business Systems Analyst

    Molina Healthcare (Cincinnati, OH)
    …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
    Molina Healthcare (01/13/25)
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  • Sr Analyst , Medical Economics (NY Medicaid…

    Molina Healthcare (Cincinnati, OH)
    **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 (eg authorization) to identify… more
    Molina Healthcare (01/13/25)
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  • IT Systems Analyst Specialist

    Sedgwick (Cincinnati, OH)
    …years of related experience or equivalent combination of education and experience required . Experience in multi-line claims management processes and system ... of LLMs + RESTFUL APIs + Knowledge of third party administration and claims management business and technology + Oral and written communication skills… more
    Sedgwick (12/07/24)
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  • Sr Analyst , Business (Remote)

    Molina Healthcare (Cincinnati, OH)
    …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Education** Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business or experience system… more
    Molina Healthcare (01/13/25)
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  • Bus Info Analyst Sr.

    Elevance Health (Mason, OH)
    ** Business Information Analyst Sr.** **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 Sr.** is responsible for...performance using summary statistical procedures. * Develops and analyzes business performance reports (eg for claims data,… more
    Elevance Health (01/11/25)
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  • Provider Contract/CofC Analyst Sr.

    Elevance Health (Mason, OH)
    **Provider Contract/CofC Analyst Sr.** **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 **Provider Contract/Cost of Care Analyst Sr.** is responsible for analytical support to the Cost of Care and/or… more
    Elevance Health (01/11/25)
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  • Sr Analyst , Config Info Mgmt - Remote…

    Molina Healthcare (Cincinnati, 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...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
    Molina Healthcare (01/13/25)
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  • QA Analyst - ETL / Agile

    Molina Healthcare (Cincinnati, OH)
    …Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
    Molina Healthcare (01/13/25)
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  • Lead Analyst - QNXT Benefit Configuration

    Molina Healthcare (Cincinnati, 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...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
    Molina Healthcare (12/29/24)
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  • Sr Benefits Analyst - Config info Mgmt…

    Molina Healthcare (Cincinnati, OH)
    …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... Experience working in a managed care environment and commercial line of business is preferred. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree or… more
    Molina Healthcare (01/13/25)
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  • HEDIS Research Analyst

    Elevance Health (Mason, OH)
    …and summarizes performance using summary statistical procedures. + Develops and analyzes business performance reports (eg for claims data, provider data, ... PulsePoint sites used for collaboration, community, and connection The **HEDIS Research Analyst ** is responsible for serving as an expert in HEDIS data analysis,… more
    Elevance Health (01/07/25)
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  • Analyst , Data (Remote)

    Molina Healthcare (Cincinnati, OH)
    …systems to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or ... used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables… more
    Molina Healthcare (01/13/25)
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  • Healthcare Analytics Analyst - REMOTE

    Molina Healthcare (Cincinnati, OH)
    **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Math, Computer… more
    Molina Healthcare (01/10/25)
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  • Business Information Consultant Sr.

    Elevance Health (Mason, OH)
    ** Business Information Analyst Sr.** **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 Sr.** is responsible for...performance using summary statistical procedures. * Develops and analyzes business performance reports (eg for claims data,… more
    Elevance Health (01/14/25)
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  • Senior Implementation Specialist

    Elevance Health (Mason, OH)
    …Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and ... support, configuration, design, testing and implementation for ratings or claims systems. **How you will make an impact:** +...edits to drive cost saving results. + Works with business owners to identify and analyze requirements and processes… more
    Elevance Health (12/21/24)
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  • Manager, Medical Economics (Medicare) - REMOTE

    Molina Healthcare (Cincinnati, OH)
    …meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching, ... and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan… more
    Molina Healthcare (01/13/25)
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