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Data Analyst jobs at HCA Healthcare - 84 jobs

  • Certified Oncology Data Specialist Part Time

    HCA 4.5company rating

    Data analyst job at HCA Healthcare

    Introduction Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Certified Oncology Data Specialist Part Time today with Parallon. Fully flexible schedule after training Sunday-Saturday! Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: * Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. * Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. * Free counseling services and resources for emotional, physical and financial wellbeing * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan with 10% off HCA Healthcare stock * Family support through fertility and family building benefits with Progyny and adoption assistance. * Referral services for child, elder and pet care, home and auto repair, event planning and more * Consumer discounts through Abenity and Consumer Discounts * Retirement readiness, rollover assistance services and preferred banking partnerships * Education assistance (tuition, student loan, certification support, dependent scholarships) * Colleague recognition program * Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) * Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Come join our team as a(an) Certified Oncology Data Specialist Part Time. We care for our community! Just last year, HCA Healthcare and our colleagues donated 13.8 million dollars to charitable organizations. Apply Today! Job Summary and Qualifications As a Certified Cancer Registrar, work from home, you will be responsible for case finding and abstraction of cancer data for HCA hospitals. In this role you will: * Completes case-finding for assigned facilities, including review of pathology reports, the disease index, suspense list in Meditech and merging appropriate cases into Metriq * Responsible for reviewing medical records to abstract information according to the standards of the American College of Surgeons (ACOS) and the appropriate State Central Cancer Registry * Performs timely abstraction of assigned cases to ensure compliance with ACOS standards, i.e. within six months of patient contact * Completes edit checks and makes appropriate changes on a timely basis * Follow ACOS and state data standards and coding instructions to abstract all reportable cases * Attend state and national educational activities as approved by Director * Submit data to the National Cancer Data Base (NCDB) in accordance with the annual Call for Data * Submit data monthly to the appropriate State Central Cancer Registry * Resolve errors resulting in the rejection of records from the NCDB and the state data systems What you will need: * Oncology Data Specialist (ODS) certification required * 1-3 years of Cancer Data Abstraction experience required * 3-5 years of Cancer Data Abstraction or Medical Records experience preferred Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. " "The great hospitals will always put the patient and the patients family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Certified Oncology Data Specialist Part Time opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
    $64k-81k yearly est. 12d ago
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  • Sr. Healthcare Data Analyst (New Mexico Health Plan) - REMOTE

    Molina Healthcare 4.4company rating

    Columbus, OH jobs

    Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management, data analysis, and reporting + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or applications + Prepares well-organized, easily understood reports, analysis, and summary of findings for use by management + Assists in preparation of regularly produced reports to support executive decision-making + Researches and analyze report results identifying opportunities and trends + Works with internal, external and enterprise individuals as needed to research, develop, and document new standard reports or processes + Consolidates data from multiple sources, using industry-based tools or manually; able to process data effectively using Microsoft Excel + Supports management and other team members as requested on all things data related. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** 3-5 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJShared \#LI-AC1 Pay Range: $80,168 - $141,371 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-141.4k yearly 32d ago
  • Healthcare Analytics Analyst (REMOTE - Connecticut Based Candidate Preferred)

    Molina Healthcare 4.4company rating

    Dayton, OH jobs

    ***** Ideal Candidate would work remotely but reside in Connecticut** 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 Server Reporting Services (SSRS), Medinsight, RxNavigator, Crystal Reports, Executive Dashboard, and other analytic / programming tools as needed. + Generate and distribute standard reports on schedule using SQL, Excel, and other reporting software. + Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce report writing errors and rework. + Identify and complete report enhancements/fixes; modify reports in response to approved change requests; retain old and new report design for audit trail purposes. + Analyze data sets and trends for anomalies, outliers, trend changes, and opportunities. + Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures. + Assist with completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** **Required Education** + Bachelor's Degree in Finance, Economics, Math, Computer Science; or equivalent experience **Required Experience** + 2-4 years increasingly complex database and data management responsibilities + Basic knowledge of SQL + 2-4 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics **Preferred Education** + Bachelor's Degree in Finance, Economics, Math, or Computer Science **Preferred Experience** + Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators + Proactively identify and investigate complex suspect areas regarding medical cost issues + Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan + Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc. + Analysis and forecasting of trends in medical costs to provide analytic support for finance, pricing and actuarial functions + Excel, Visio, Access To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-128.5k yearly 19d ago
  • Sr. Healthcare Data Analyst (New Mexico Health Plan) - REMOTE

    Molina Healthcare 4.4company rating

    Long Beach, CA jobs

    Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. KNOWLEDGE/SKILLS/ABILITIES With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management, data analysis, and reporting Extracts and compiles various sources of information and large data sets from various systems or applications Set up process for monitoring, tracking and trending information and data using various systems or applications Prepares well-organized, easily understood reports, analysis, and summary of findings for use by management Assists in preparation of regularly produced reports to support executive decision-making Researches and analyze report results identifying opportunities and trends Works with internal, external and enterprise individuals as needed to research, develop, and document new standard reports or processes Consolidates data from multiple sources, using industry-based tools or manually; able to process data effectively using Microsoft Excel Supports management and other team members as requested on all things data related. JOB QUALIFICATIONS Required Education Associate degree or equivalent combination of education and experience Required Experience 3-5 years Preferred Education Bachelor's Degree or equivalent combination of education and experience Preferred Experience 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJShared #LI-AC1
    $111k-146k yearly est. Auto-Apply 7d ago
  • Sr. Healthcare Data Analyst (New Mexico Health Plan) - REMOTE

    Molina Healthcare 4.4company rating

    Cincinnati, OH jobs

    Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management, data analysis, and reporting + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or applications + Prepares well-organized, easily understood reports, analysis, and summary of findings for use by management + Assists in preparation of regularly produced reports to support executive decision-making + Researches and analyze report results identifying opportunities and trends + Works with internal, external and enterprise individuals as needed to research, develop, and document new standard reports or processes + Consolidates data from multiple sources, using industry-based tools or manually; able to process data effectively using Microsoft Excel + Supports management and other team members as requested on all things data related. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** 3-5 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJShared \#LI-AC1 Pay Range: $80,168 - $141,371 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-141.4k yearly 32d ago
  • Sr. Healthcare Data Analyst (New Mexico Health Plan) - REMOTE

    Molina Healthcare 4.4company rating

    Akron, OH jobs

    Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management, data analysis, and reporting + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or applications + Prepares well-organized, easily understood reports, analysis, and summary of findings for use by management + Assists in preparation of regularly produced reports to support executive decision-making + Researches and analyze report results identifying opportunities and trends + Works with internal, external and enterprise individuals as needed to research, develop, and document new standard reports or processes + Consolidates data from multiple sources, using industry-based tools or manually; able to process data effectively using Microsoft Excel + Supports management and other team members as requested on all things data related. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** 3-5 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJShared \#LI-AC1 Pay Range: $80,168 - $141,371 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-141.4k yearly 32d ago
  • Sr. Healthcare Data Analyst (New Mexico Health Plan) - REMOTE

    Molina Healthcare 4.4company rating

    Dayton, OH jobs

    Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management, data analysis, and reporting + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or applications + Prepares well-organized, easily understood reports, analysis, and summary of findings for use by management + Assists in preparation of regularly produced reports to support executive decision-making + Researches and analyze report results identifying opportunities and trends + Works with internal, external and enterprise individuals as needed to research, develop, and document new standard reports or processes + Consolidates data from multiple sources, using industry-based tools or manually; able to process data effectively using Microsoft Excel + Supports management and other team members as requested on all things data related. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** 3-5 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJShared \#LI-AC1 Pay Range: $80,168 - $141,371 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-141.4k yearly 32d ago
  • Sr. Healthcare Data Analyst (New Mexico Health Plan) - REMOTE

    Molina Healthcare 4.4company rating

    Ohio jobs

    Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management, data analysis, and reporting + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or applications + Prepares well-organized, easily understood reports, analysis, and summary of findings for use by management + Assists in preparation of regularly produced reports to support executive decision-making + Researches and analyze report results identifying opportunities and trends + Works with internal, external and enterprise individuals as needed to research, develop, and document new standard reports or processes + Consolidates data from multiple sources, using industry-based tools or manually; able to process data effectively using Microsoft Excel + Supports management and other team members as requested on all things data related. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** 3-5 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJShared \#LI-AC1 Pay Range: $80,168 - $141,371 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-141.4k yearly 32d ago
  • Business Analyst (Medicare Strategy)

    Molina Healthcare Inc. 4.4company rating

    Columbus, OH jobs

    Responsible for creating business unit and state-specific strategies as well as driving key strategic initiatives to transform the Medicare organization. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * Develops and maintains state and product-specific Medicare growth strategies * Assesses strategic impact of regulatory changes * Monitors sources to ensure all updates are aligned. * Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. * Conducts analysis to identify root cause and assist with problem management as it relates to state requirements. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts that can impact financials. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Medicare experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS). * Strong analytical and problem-solving skills. * Ability to frame strategic challenges with research and synthesis and draw out solutions and create action plans * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $60,168 - $97,363 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $60.2k-97.4k yearly 1d ago
  • ServiceNow Business Analyst

    Community Health Systems 4.5company rating

    Remote

    We are seeking a ServiceNow Business Analyst with strong experience in both business analysis and the ServiceNow platform. This role will be responsible for gathering and translating business requirements into functional specifications, supporting the design and implementation of ServiceNow modules, and ensuring solutions align with enterprise goals and user needs. Key Responsibilities: Collaborate with business stakeholders to gather, analyze, and document requirements for ServiceNow solutions (ITSM, SPM, EA, BCM, HRSD, CSM, etc.). Translate business needs into clear, detailed functional requirements and user stories. Support configuration, testing, and deployment of ServiceNow modules and enhancements. Serve as a liaison between technical teams and business users to ensure successful solution delivery. Assist in creating process documentation, training materials, and user guides. Participate in agile ceremonies and contribute to continuous process improvement. Monitor platform usage and identify opportunities for optimization and automation. Required Qualifications: 3+ years of Business Analyst experience, preferably in an IT or enterprise application environment. 2+ years of hands-on experience with ServiceNow, including knowledge of key modules like ITSM, SPM, EA, BCM, CMDB, or HRSD. Strong understanding of software development lifecycles and agile methodologies. Excellent communication, analytical, and problem-solving skills. Ability to manage multiple priorities and work effectively across teams. Preferred Qualifications: ServiceNow Certified System Administrator or Business Analyst certification. Experience with ServiceNow reporting, workflows, or scripting a plus. Familiarity with ITIL or IT service management principles.
    $71k-96k yearly est. Auto-Apply 19d ago
  • Analyst, Quality Analytics & Performance Improvement

    Molina Healthcare Inc. 4.4company rating

    Cleveland, OH jobs

    The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and tracking outcomes on performance metrics. ESSENTIAL JOB DUTIES: * Work cross functionally with various departments to capture and document requirements, build reporting solutions, and educate users on how to use reports. * Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics along with corresponding tracking of progress and impact of such interventions. * Assist retrospective HEDIS rate tracking and supplemental data impact reporting. * Develop Medical Record Review project reporting to track progress and team productivity reporting. * Development and QA of ad-hoc as well as automated analytical Reporting modules related to Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. * Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates. * Assist Quality department with HEDIS measure deep dive to support HEDIS audit and revenue at risk reporting. * Calculate and track HEDIS rates for all intervention outcome and for overall markets and LOB. * Work in an agile business environment to derive meaningful information out of complex as well as large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis. * Do root cause analysis for business data issues as assigned by the team lead. * Analyze data sets and trends for anomalies, outliers, trend changes and opportunities, using statistical tools and techniques to determine significance and relevance. Utilize extrapolation, interpolation, and other statistical methodologies to predict future trends in cost, utilization, and performance. * Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline REQUIRED EXPERIENCE: * 3+ Years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data. * 3+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design * 3+ years of experience in working with Microsoft T-SQL, SSIS and SSRS. * Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage. * Familiarity with Microsoft Azure, AWS or Hadoop. * 1-3 Years of experience with predictive modeling in healthcare quality data. * 1-3 Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare/MMP. * 1-3 Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics. * 1-3 Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $80.2k-128.5k yearly 2d ago
  • Oracle Enterprise Data Scientist

    Community Health Systems 4.5company rating

    Remote

    We are seeking a highly specialized and experienced Enterprise Data Scientist to drive data quality, standardization, and insight generation across our core Oracle operational suite. This role serves as the authoritative expert on translating complex, high-volume data from Oracle Supply Chain Management (SCM), Oracle Procurement, Oracle Revenue Cycle Management (RCM), and Oracle Inventory into actionable business intelligence. The successful candidate will be focused on ensuring absolute data integrity-a critical function in a regulated healthcare environment-and transforming raw transactional data into high-value operational reports, interactive dashboards, and predictive models that optimize cost-per-case, enhance inventory accuracy, and accelerate the revenue cycle. Essential Functions 1. Data Validation, Integrity, and Compliance (Critical Focus) Healthcare Data Quality Assurance: Design and implement automated data validation frameworks specific to healthcare operations, ensuring transactional data (e.g., supply usage, procedure charging, contract pricing) is accurate. Compliance Verification: Develop reports and monitoring tools to detect anomalies and discrepancies that could impact regulatory reporting, financial audits (e.g., SOX implications), or compliance with GPO contracts and payer rules. Revenue Leakage Identification: Specifically focus on validating the link between inventory consumption (SCM) and patient billing (RCM) data to prevent charge capture errors, ensuring accurate patient bills and maximizing appropriate reimbursement. Root Cause Analysis: Investigate and diagnose data errors originating in Oracle system configurations (EBS or Fusion), ensuring the integrity of critical data points like item master definitions, vendor codes, and pricing tiers. 2. Standardized Operational Analytics and Reporting KPI Development (Healthcare Specific): Define, standardize, and institutionalize critical operational metrics across the organization, such as: Inventory Accuracy Rate for Critical Supplies Procurement Compliance Rate (Off-Contract Spend) Days of Supply (DOS) for high-value pharmaceuticals and implants Cost-Per-Case Variance analysis (linking supply cost to procedure type) Claims Denial Rate Analysis linked to operational inputs High-Value Reporting: Develop and maintain standardized operational reports and interactive dashboards (e.g., Tableau, Power BI) focused on optimizing the efficiency and spend within the OR, Clinics, and centralized purchasing departments. Executive Insights: Create visually compelling and accurate reports for executive leadership on the overall health and financial performance driven by Oracle system outputs. 3. Advanced Modeling and Process Optimization Predictive Inventory Modeling: Develop sophisticated models to forecast demand volatility (e.g., flu season spikes, pandemic-related surges) for critical supplies and pharmaceuticals, minimizing shortages and excess waste. Revenue Cycle Modeling: Build predictive models to forecast cash flow, anticipate denials based on procurement/charging patterns, and prioritize RCM work queues based on expected return. Efficiency Optimization: Utilize machine learning techniques to optimize logistics (e.g., warehouse routing, supply replenishment schedules) and procurement processes (e.g., automated purchase order generation based on consumption velocity). 4. Collaboration and System Expertise Serve as the technical data expert for functional Oracle teams (Finance, Clinical Operations, Materials Management), bridging the gap between business needs and data structure. Document data lineage, metric definitions, and model methodologies to ensure transparency and trust in derived insights across the enterprise. Required Qualifications: Education: Master's degree in Data Science, Health Informatics, Statistics, Industrial Engineering, or a related quantitative field. Experience: 2+ years of experience in a specialized data science, BI, or analytics role, working within a large healthcare system, hospital, or payer environment. Deep Oracle Domain Expertise (Mandatory): Proven practical experience analyzing, querying, and understanding the complex data models within at least two of the following Oracle applications (EBS or Fusion): Oracle Supply Chain Management (SCM) & Inventory: Specific understanding of item masters, warehouse transactions, and consumption data. Oracle Procurement: Expertise in purchase order data, contract management, and vendor performance metrics. Oracle Revenue Cycle Management (RCM): Understanding of charge capture, billing, and the data linkage to operational inputs. Technical Proficiency: Expert-level SQL skills for complex database querying, including experience navigating Oracle tables/views. Proficiency in Python or R, with experience in statistical modeling, time series analysis, and machine learning libraries. Experience developing advanced visualizations using industry-leading tools (Tableau, Power BI). Demonstrable experience working with large-scale Enterprise Data Warehouses (EDW) in a regulated environment. Preferred Skills and Attributes Familiarity with clinical coding standards (CPT, ICD-10) as they relate to procedure costing and RCM data. Understanding of HIPAA, HITECH, and general healthcare data governance standards. Experience with advanced analytics applied to surgical services or procedural areas. Excellent collaboration and communication skills, with the ability to present complex analytical findings to clinical and executive audiences. Certification in Oracle applications or cloud platforms is a plus.
    $99k-128k yearly est. Auto-Apply 60d+ ago
  • Enterprise Data Scientist

    Community Health Systems 4.5company rating

    Remote

    This role is responsible for leveraging your expertise in data analytics, advanced statistical methods, and programming to derive insights from clinical data. As a member of the Enterprise Data Science team, this role will be responsible for analyzing complex clinical datasets, developing data visualizations and dashboards, assisting with data model and/or feature development, and translating insights into actionable recommendations for improving patient care and operational outcomes. Responsibilities: Collaborate with cross-functional teams including clinical leaders, data scientists, and software engineers to identify data-driven opportunities for enhancing clinical processes and patient care. Utilize cloud-based technologies, such as Google Cloud Platform (GCP), for scalable data processing and analysis. Develop easily consumable dashboards from complex clinical and operational data to provide visualizations derived from best practices and data consumption theory that drive healthcare and business performance. Implement best practices for data management, including data quality assessment, data validation, and data governance. Utilize Python programming and associated libraries such as PyTorch, Keras, Pandas and NumPY to create, train, test and implement meaningful data science models. Lead the analysis of operational data to identify patterns, trends, and correlations relevant to healthcare outcomes. Collaborate with healthcare professionals and domain experts to understand operational needs and design data-driven solutions. Design and conduct experiments, interpret results, and communicate findings to both technical and non-technical stakeholders Requirements: Master's degree in Data Science, Data Analytics, Computer Science, or a related field. Proven experience in analyzing complex healthcare data and building customer facing dashboards and data visualizations. Proficiency in Python programming and associated libraries. Experience with cloud-based platforms such as Google Cloud Platform (GCP) for data storage, processing, and deployment. Strong problem-solving skills and ability to work independently and collaboratively in a fast-paced environment. Excellent communication and presentation skills with the ability to translate technical concepts to non-technical audiences.
    $99k-128k yearly est. Auto-Apply 48d ago
  • Analyst, Quality Analytics & Performance Improvement

    Molina Healthcare Inc. 4.4company rating

    Cincinnati, OH jobs

    The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and tracking outcomes on performance metrics. ESSENTIAL JOB DUTIES: * Work cross functionally with various departments to capture and document requirements, build reporting solutions, and educate users on how to use reports. * Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics along with corresponding tracking of progress and impact of such interventions. * Assist retrospective HEDIS rate tracking and supplemental data impact reporting. * Develop Medical Record Review project reporting to track progress and team productivity reporting. * Development and QA of ad-hoc as well as automated analytical Reporting modules related to Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. * Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates. * Assist Quality department with HEDIS measure deep dive to support HEDIS audit and revenue at risk reporting. * Calculate and track HEDIS rates for all intervention outcome and for overall markets and LOB. * Work in an agile business environment to derive meaningful information out of complex as well as large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis. * Do root cause analysis for business data issues as assigned by the team lead. * Analyze data sets and trends for anomalies, outliers, trend changes and opportunities, using statistical tools and techniques to determine significance and relevance. Utilize extrapolation, interpolation, and other statistical methodologies to predict future trends in cost, utilization, and performance. * Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline REQUIRED EXPERIENCE: * 3+ Years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data. * 3+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design * 3+ years of experience in working with Microsoft T-SQL, SSIS and SSRS. * Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage. * Familiarity with Microsoft Azure, AWS or Hadoop. * 1-3 Years of experience with predictive modeling in healthcare quality data. * 1-3 Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare/MMP. * 1-3 Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics. * 1-3 Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $80.2k-128.5k yearly 2d ago
  • Sr. Data Analyst, L3, Information Technology

    Community Health Systems 4.5company rating

    Remote

    As a Senior Data Analyst for the Information Technology organization, you'll be responsible for identifying, curating, publishing, and visualizing data in a way that is easily interpreted and understood. Successful data analysts have strong SQL skills, a deep understanding of data warehousing and data products, and the ability to quickly understand the structure and relationship of data from a broad range of sources. You will have the opportunity to work with various programming languages, technologies, and both structured and unstructured data. A Qualified Candidate: Is a Lifelong Learner and Passionate about Technology Is Experienced with Business Intelligence (BI) and data visualization and can show examples of past work Is very proficient with SQL, with the ability to demonstrate understanding of various concepts, capabilities, and functions including, but not limited to, the following: Joins, grouping, ordering, common table expressions, case functions, regex Derives joy from tackling complex problems and working through solution tradeoffs Can learn on the fly and fill knowledge gaps on demand Has experience working with a variety of people at various levels Has a strong ability to interpret datasets and identify information, trends, and patterns. Has excellent data management and QA skills - Process Oriented Recognizes business requirements in the context of data visualization and reporting and creates data models to transform raw data into relevant insights Has aptitude for data presentation and ability to transform raw data into meaningful, actionable reports Has experience with Looker / Google Data Studio or similar platforms Has strong exploratory data analysis skills and can translate stakeholder requirements into data products Has excellent communication skills Essential Functions Provides technical consultation on data product projects by analyzing end to end data product requirements and existing business processes to lead in the design, development and implementation of data products. Collaborates with stakeholders to understand data needs and requirements for visualizations taking a “Design Thinking” approach to problem solving and interactive solutioning. Collaborates with stakeholders to define metrics and cultivate data sources to support reporting insights aligned to business goals. Creates dashboards and interactive visualizations that allow users to explore data in meaningful ways. Develops complex SQL queries to combine and transform raw data into datasets needed for metrics and other analytical functions. Provides training and support to end-users on how to interpret and interact with data visualizations. Produces data views, data models, and data flows for varying client demands such as dimensional data, standard and ad hoc reporting, data feeds, dashboard reporting, and data science research & exploration. Translates business data stories into a technical story breakdown structure and work estimate so value and fit for a schedule or sprint is determined. Collaborates with enterprise teams and other internal organizations on CI/CD best practices experience using JIRA, Jenkins, Confluence etc. Implements production processes and systems to monitor data quality, ensuring production data is always accurate and available for key stakeholders and business processes that depend on it. Practices code management and integration with engineering Git principle and practice repositories. Participates as an expert and learner in team tasks for data analysis, architecture, application design, coding, and testing practices. Qualifications: Required Education: Bachelor's degree in computer science, information systems, cyber security, business, statistics, mathematics, or a related field Preferred Education: Master's degree in computer science, information systems, cyber security, business, statistics, mathematics, or a related field Computer Skills Required: Advanced skills with SQL Experience with python, javascript, CSS, or other languages a plus. Desired experience in: Looker Studio / Google Data Studio, BigQuery Required Experience: 3+ years of experience with developing compelling stories and distinctive visualizations. 3+ years of relevant experience with data quality rules, data management organization/standards, practices and software development. 4+ years of SQL experience. 3+ years of dashboarding / BI tool experience (Looker Studio, PowerBI, Tableau, etc). Experience in statistical analysis, data models, data warehousing, and queries. Data application and practice knowledge. Good problem solving, oral and written communication skills. Strong working knowledge of graphic design or UI design. Preferred Experience: Healthcare/Insurance/financial services industry knowledge Python Javascript CSS Looker Studio / Google Data Studio
    $81k-103k yearly est. Auto-Apply 50d ago
  • Business Analyst (Medicare Strategy)

    Molina Healthcare Inc. 4.4company rating

    Cleveland, OH jobs

    Responsible for creating business unit and state-specific strategies as well as driving key strategic initiatives to transform the Medicare organization. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * Develops and maintains state and product-specific Medicare growth strategies * Assesses strategic impact of regulatory changes * Monitors sources to ensure all updates are aligned. * Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. * Conducts analysis to identify root cause and assist with problem management as it relates to state requirements. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts that can impact financials. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Medicare experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS). * Strong analytical and problem-solving skills. * Ability to frame strategic challenges with research and synthesis and draw out solutions and create action plans * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $60,168 - $97,363 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $60.2k-97.4k yearly 1d ago
  • Business Analyst (Medicare Strategy)

    Molina Healthcare Inc. 4.4company rating

    Akron, OH jobs

    Responsible for creating business unit and state-specific strategies as well as driving key strategic initiatives to transform the Medicare organization. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * Develops and maintains state and product-specific Medicare growth strategies * Assesses strategic impact of regulatory changes * Monitors sources to ensure all updates are aligned. * Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. * Conducts analysis to identify root cause and assist with problem management as it relates to state requirements. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts that can impact financials. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Medicare experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS). * Strong analytical and problem-solving skills. * Ability to frame strategic challenges with research and synthesis and draw out solutions and create action plans * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $60,168 - $97,363 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $60.2k-97.4k yearly 1d ago
  • Business Analyst (Medicare Strategy)

    Molina Healthcare Inc. 4.4company rating

    Dayton, OH jobs

    Responsible for creating business unit and state-specific strategies as well as driving key strategic initiatives to transform the Medicare organization. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * Develops and maintains state and product-specific Medicare growth strategies * Assesses strategic impact of regulatory changes * Monitors sources to ensure all updates are aligned. * Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. * Conducts analysis to identify root cause and assist with problem management as it relates to state requirements. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts that can impact financials. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Medicare experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS). * Strong analytical and problem-solving skills. * Ability to frame strategic challenges with research and synthesis and draw out solutions and create action plans * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $60,168 - $97,363 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $60.2k-97.4k yearly 1d ago
  • Business Analyst (Medicare Strategy)

    Molina Healthcare Inc. 4.4company rating

    Ohio jobs

    Responsible for creating business unit and state-specific strategies as well as driving key strategic initiatives to transform the Medicare organization. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * Develops and maintains state and product-specific Medicare growth strategies * Assesses strategic impact of regulatory changes * Monitors sources to ensure all updates are aligned. * Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. * Conducts analysis to identify root cause and assist with problem management as it relates to state requirements. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts that can impact financials. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Medicare experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS). * Strong analytical and problem-solving skills. * Ability to frame strategic challenges with research and synthesis and draw out solutions and create action plans * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $60,168 - $97,363 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $60.2k-97.4k yearly 1d ago
  • Certified Oncology Data Specialist Part Time

    HCA Healthcare 4.5company rating

    Data analyst job at HCA Healthcare

    **Introduction** Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Certified Oncology Data Specialist Part Time today with Parallon. **Fully flexible schedule after training Sunday-Saturday!** **Benefits** Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity and Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits (********************************************************************** **_Note: Eligibility for benefits may vary by location._** Come join our team as a(an) Certified Oncology Data Specialist Part Time. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today! **Job Summary and Qualifications** As a Certified Cancer Registrar, work from home, you will be responsible for case finding and abstraction of cancer data for HCA hospitals. **In this role you will:** + Completes case-finding for assigned facilities, including review of pathology reports, the disease index, suspense list in Meditech and merging appropriate cases into Metriq + Responsible for reviewing medical records to abstract information according to the standards of the American College of Surgeons (ACOS) and the appropriate State Central Cancer Registry + Performs timely abstraction of assigned cases to ensure compliance with ACOS standards, i.e. within six months of patient contact + Completes edit checks and makes appropriate changes on a timely basis + Follow ACOS and state data standards and coding instructions to abstract all reportable cases + Attend state and national educational activities as approved by Director + Submit data to the National Cancer Data Base (NCDB) in accordance with the annual Call for Data + Submit data monthly to the appropriate State Central Cancer Registry + Resolve errors resulting in the rejection of records from the NCDB and the state data systems **What you will need** : + Oncology Data Specialist (ODS) certification **required** + 1-3 years of Cancer Data Abstraction experience **required** + 3-5 years of Cancer Data Abstraction or Medical Records experience preferred **Parallon** provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. " "The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Certified Oncology Data Specialist Part Time opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the possibilities and apply today!** We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
    $64k-81k yearly est. 11d ago

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