24 policy analyst jobs found in Mason, OH

Grievance and Appeals Analyst II (Executive Concierge Analyst) Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Grievance and Appeals Analyst II is responsible for providing support services for multiple states, enterprise-wide functions and/or complex issues through complex assignments and projects, which utilize recognized areas of specialization and knowledge...

Actuarial Analyst III Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Actuarial Analyst III supports Medicare Advantage pricing and bid development within the Medicare Actuarial team. How You Will Make an Impact: Primary duties may include, but are not limited to: Benefit Ownership: Manage assigned pricing models and benefits, ensuring data accuracy,...

Advanced Analytics Analyst Location: This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. ? Ideal candidates will be able to report to our Pulse Point locations in Atlanta, GA, Mason, OH, Indianapolis, IN or Richmond, VA. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Advanced Analytics Analyst employs advanced analytics to gain critical insights into member behavior drivers and preferences, product/program concepts and value...

Financial Accounting Analyst - FEP Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Federal Employee Program - FEP , is a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, and the foundation upon which we are creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. The Financial Accounting...

Systems Analyst Advisor Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Preferred Location: Norfolk, VA. The Systems Analyst Advisor is responsible for defining and managing the scope of Business Systems projects. How You Will Make An Impact: Defines functional, usability, reliability, performance and support requirements of a system. Creates and...

Risk Adjustment Actuarial Analyst II - Advanced Analytics On-Site Requirement: Hybrid 1; This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Risk Adjustment Actuarial Analyst II - Advanced Analytics is responsible for completing projects and performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of...

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations could be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work schedule: Monday - Friday. Half day Saturday rotation, once a month. The Behavioral Health Medical Director-Psychiatrist Appeals is responsible for the administration of behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical...

DevSecOps Engineer Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Preferred Location: Indianapolis, IN. The DevSecOps Engineer will play a key role in embedding security into our development pipelines and cloud infrastructure, ensuring compliance with healthcare regulations such as HIPAA, PCI, and other data security compliance requirements. Your mission is to...

Audit & Reimbursement III Location:? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid...

Location: St. Louis MO, Mason OH, Atlanta GA, Richmond VA, Grand Prairie TX Hours: Monday - Friday Travel: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Position Overview: Responsible for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent Medicaid claims. How You Will Make an Impact: Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health plan, line of business and/or state Claim reviews...

Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Clinical Fraud...

Audit & Reimbursement III- Medicare Cost Report Audit Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for...

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Ideal candidates will be able to report to one of our Pulse Point locations in Mason, OH, Chicago, IL, Wallingford, CT, Atlanta, GA, Indianapolis, IN, Richmond, VA or Middletown, NY. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Business Information Developer Consultant Senior is viewed as an expert in the development and execution of data mining analyses and will...

Clinical Analytic Pharmacist A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. Office location: The selected candidate must reside within 50 miles of a PulsePoint office. Preferably Mason, OH; St. Louis, MO; Durham, NC; Grand Prairie, TX; Chicago, IL; Indianapolis, IN; Nashville, TN. Alternate locations may be considered if candidates reside within a commuting distance from an office. In Office Expectation: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a...

Audit & Reimbursement Senior Location: ? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. *Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement Senior will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid...

Manager Senior Engineering Location: This role requires associates to be in-office 2-3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Manager Senior Engineering is responsible for providing analytical support to the Cost of Care and/or Provider Contracting organizations. How you will make an impact: Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider...

Engineer Lead Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Engineer Lead is responsible for full delivery of end to end system development and maintenance on medium enterprise wide technology platforms. How You Will Make An Impact: Develops and defines application scope and objectives and supervises the preparation of technical and/or functional...

Hybrid: This role requires associates to be in-office 1 - 2 days per week , fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: Monday - Friday, 8:00am - 5:00pm Eastern Time The Pharmacy Benefit Manager Process Expert Senior supports multiple operations departments by participating in project and process work. How You Will Make An Impact Researches operations workflow problems and system irregularities. Develops, tests,...

Nurse Appeals -Licensed Nurse Location : Ohio, candidates must be residents of Ohio to be considered. Hybrid 1 : This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule : Monday - Friday, 8:00AM - 5:00PM Eastern Time; some flexibility in hours will be necessary and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and processing and medical necessity appeals requests from members and providers. How You Will Make an...

Audit & Reimbursement III Location : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services...

Cloud FinOps Principal Engineer Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future visa sponsorship. At Elevance Health, we are transforming how cloud technology supports healthcare delivery and innovation. We are seeking a Cloud FinOps Principal Engineer to lead enterprise-wide initiatives that...

Customer Care Representative I Location : Virtual; This role enables associates to work virtually full-tine, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Hours : Monday - Friday, an 8 hour shift between 8:30 - 6 pm EST. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Customer Care Representative is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. How will you make an impact: Responds to internal and external customer questions via telephone and...

Manager of DRG Coding Audit-Program/Project Locations: The selected candidate must reside within a reasonable commuting distance of the designated posting location(s): Virginia, Indiana, Georgia, Ohio, District of Columbia (Washington, DC); Maryland; New Jersey, New York and Texas. ?Hybrid 2 : This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud...

Group Underwriting Consultant Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Group Underwriting Consultant is responsible for determining acceptability of insurance risks and appropriate premium rates for large and complex group cases. Position is a technical underwriting expert. How You Will Make an Impact Primary duties may include, but are not limited...