- Molina Healthcare (Cleveland, OH)
- …Operations teams . Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... SKILLS & ABILITIES: . 2-5 years of experience in medical claims processing, research , or a related field . Demonstrates familiarity in a variety… more
- Molina Healthcare (Cleveland, OH)
- …processing issues + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... cross functionally across multiple business areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing… more
- Molina Healthcare (Cleveland, OH)
- …+ Must have experience in research , review and audits for adjudication rates of claims + Must be able to work in cross functional teams + Must have experience ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Molina Healthcare (Cleveland, OH)
- …ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, ... and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex...Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. +… more
- Molina Healthcare (Cleveland, 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 (Cleveland, OH)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Molina Healthcare (Cleveland, 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** + Develop ad-hoc reports using SQL programming, SQL… more
- Molina Healthcare (Cleveland, OH)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business… more
- Molina Healthcare (Cleveland, OH)
- …analysis. + Works with internal, external and enterprise clients as needed to research , develop, and document new standard reports or processes. + Implements and ... to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent… more