- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... successful implementation of provider engagement programs. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims from compliance against contracts, billing, and processing guidelines… more
- Molina Healthcare (Louisville, KY)
- …trends or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. + Work ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Molina Healthcare (Louisville, KY)
- **Job Description** **Job Summary** The Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. ... The analyst will support existing lines of business and expansion...Technical Configuration and Configuration Information Management. **Job Duties** + Research , review, and decipher state-specific Medicaid and Medicare reimbursement… more
- Molina Healthcare (Louisville, KY)
- …around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research , analysis and modeling of complex healthcare claims data, ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...provides insights needed to support strategic investment decisions + Research and develop reports and analyses for senior management… more
- Molina Healthcare (Louisville, KY)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... technical teams + Appeals & Grievance, healthcare services, or claims background **Preferred License, Certification, Association** Certified Business Analysis… more