- Molina Healthcare (Dayton, OH)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... remediation plans and fixes, overall progress, and status of impacted claims **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or equivalent… more
- Molina Healthcare (Dayton, OH)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (Dayton, 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...in research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- UIC Government Services and the Bowhead Family of Companies (Wright Patterson AFB, OH)
- **Overview** ENTERPRISE ARCHITECT/ BUSINESS ANALYST (EAS): Bowhead is seeking an experienced Enterprise Architect/ Business Analyst to join our team ... minimum of five (5) years of relevant experience is required of which can include business analyses...characteristics EOE/AA/M/F/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- 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
- Molina Healthcare (Dayton, 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 (Dayton, 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 (Dayton, 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
- 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 (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 (Mason, OH)
- **Provider Contract Cost of Care Analyst Senior** **Location:** This position will work a hybrid model (remote and in office one day per week). Ideal candidates will ... one of our Pulse Point locations. The **Provider Contract Cost of Care Analyst Senior** provides analytical support to the Cost of Care and/or Provider Contracting… more
- Molina Healthcare (Dayton, 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 (Dayton, OH)
- …data and vendor competencies. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of...+ Must be able to lead meetings **Job Qualifications** ** REQUIRED EDUCATION:** Bachelor's degree in Business or… more
- Molina Healthcare (Dayton, 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 (Dayton, OH)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… more
- Molina Healthcare (Dayton, 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, Computer Science **… more
- Molina Healthcare (Dayton, 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 (Dayton, OH)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more
- Molina Healthcare (Dayton, 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