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Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or New York, New York, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Green Bay, Wisconsin, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Louisville, Kentucky, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Albuquerque, New Mexico, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Salt Lake City, Utah, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Milwaukee, Wisconsin, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Covington, Kentucky, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or El Paso, Texas, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or St. Petersburg, Florida, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Sr Analyst, Medical Economics (Clinical Analytics UM/CM) - REMOTE

Molina Healthcare

•

Remote or Rochester, New York, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business issues related to UM and CM processes and outcomes, as well as its impact on medical cost, utilization and revenue for multiple Molina Healthcare products. Understands and assess critical UM and CM data and designs / develops reports to monitor UM and CM process and outcomes, as well as those progra
Posted 3 days ago | Updated moments ago

Medical Billing Specialist /Medical Coder

CMCI

•

Remote or Glendora, California, USA

Full-time

Position: Medical Billing Specialist Location: Remote / On-site Department: Revenue Cycle Management Overview: CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expertise in medical coding, claims submission, payer interactions, and denial management, ensuring optimized billing practic
Easy Apply
Posted 60+ days ago | Updated 14 days ago

Applied Behavioral Analyst - Quality Monitor Clinician

TriWest Healthcare Alliance

•

Phoenix, Arizona, USA

Full-time

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires ship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary Reviews medical documentation and claims to ensure Applied Behavior Analysis (ABA) provider compliance wi
Posted 6 days ago | Updated 9 hours ago

Application Analyst - Professional Billing

Duke Health

•

Durham, North Carolina, USA

Full-time

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health Technology Solutions Pursue your passion for caring and innovation with Duke Heath Technology Solutions, which is dedicated to the transformation, development, and management of enterprise information technology solutions across Duke Health.
Posted 60+ days ago | Updated 6 hours ago

Healthcare Financial Analyst Strategy & Performance

Thinkbyte Consulting, Inc.

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No location provided

Contract

Required Qualifications: Bachelor s degree in Finance, Business Administration, Healthcare Management, or related field Minimum 5 years of experience conducting financial analysis and reporting within a healthcare environment Proven experience interpreting medical records using CPT, ICD-10, and HCPCS coding frameworks Strong technical expertise with healthcare data systems and electronic health records (e.g., Epic, Cerner) Review healthcare contracts and perform ROI analyses for strategic initia
Posted 2 days ago | Updated 1 day ago

Facets Developer

New York Technology Partners

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Remote

Third Party, Contract

Job Title: Facets Developer Remote - CST preference Experience: 10+ Years Job Description/ Responsibilities Oversee the integration of data with Facets systems to ensure seamless workflow and system functionality.Provide expertise in Facets Benefit Configuration to optimize benefit structures and improve overall efficiency.Substantial intelligence of Facets system applications and understanding in multiple product lines (HMO, POS, PPO, Dental, Indemnity, Medicare and Medicaid).Understanding of P
Easy Apply
Posted 7 days ago

Facets Developer

RiseIT Solutions

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Remote

Third Party, Contract

Company: iTech US, Inc. Job Title: Facets Developer Location : Richardson - TX (Remote - CST preference) Job Responsibilities : Oversee the integration of data with Facets systems to ensure seamless workflow and system functionality.Provide expertise in Facets Benefit Configuration to optimize benefit structures and improve overall efficiency.Substantial intelligence of Facets system applications and understanding in multiple product lines (HMO, POS, PPO, Dental, Indemnity, Medicare and Medicaid
Easy Apply
Posted 1 day ago

HealthRules Configuration Lead

People Force Consulting Inc

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Remote

Contract

As an HRP Configuration Lead, you must be highly organized and detail-oriented, with strong analytical, problem solving, and prioritization skills. You should also be able to handle multiple tasks in a fast-paced, deadline-driven environment, both independently and as part of a team. It is also important that you display excellent verbal and written communication and interpersonal skills, as well as the ability to effectively present information and respond to questions from groups of managers a
Easy Apply
Posted 60+ days ago | Updated 7 hours ago

HIM Hospital Coder I

Mastech Digital

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Remote or Wailuku, Hawaii, USA

Contract

Mastech Digital provides digital and mainstream technology staff as well as Digital Transformation Services for all American Corporations. We are currently seeking a HIM Hospital Coder I for our client in the IT Services domain. We value our professionals, providing comprehensive benefits and the opportunity for growth. This is a Contract position, and the client is looking for someone to start immediately. Duration: 6 Months Contract Location: Wailuku, HI (This is a 100% remote role only from H
Easy Apply
Posted 36 days ago | Updated 1 hour ago

Medical Case Manager (Behavioral Health - Utilization Management)

CalOptima

•

Orange, California, USA

Full-time

Medical Case Manager (Behavioral Health - Utilization Management) CalOptima CalOptima Health is seeking a highly motivated an experienced Medical Case Manager (Behavioral Health - Utilization Management) to join our team. The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing requests for authorization and notification of behavioral health services from health professionals, clinical facilities and ancillary providers. The incumbent will be respons
Posted 28 days ago