Provider Reimbursement Analyst
Company: Medical Mutual of Ohio
Posted on: June 13, 2021
Provides analytical support during contract negotiation process.
Assists contracting in building tools that model rate. Provides
understanding of financial impact based on history. Performs claims
repricing, discount analyses, etc. to support group sales efforts
and RFPs. Measures accuracy of projections. In the forefront of
managing and tracking medical costs for senior leadership team by
implementing strategic and tactical solutions.
- Provides tactical support and recommendations to contracting by
assisting with analyses, projects, etc. Supports negotiation and
contract interpretation and compliance.
Plans, monitors and evaluates current network performance to
determine effectiveness and develop and implement system
enhancements by defining business requirements to ensure MMO's
competitive advantage. Often requires coordination among multiple
Maintains project-level responsibility for projects and
deliverables through collaboration with other analyst(s) and
support staff. Provides peer review, training and limited
- Synthesizes information and imparts personal knowledge related
to cost and quality transparency efforts for multiple audiences
including, providers and consumers.
- Bachelor's degree in business administration, economics,
statistics, IT or related field
- 2 - 6 years' experience in health care consulting, provider
contracting, or provider reimbursement experience.
- Demonstrated experience and knowledge of systems applications
and implementations, including spreadsheet and database
- Strong mathematical aptitude with a demonstrated ability to
make quantitative and analytical assessments, forecasts and
- Demonstrated leadership skills and/or project management
- Knowledge of CMS pricing methodologies preferred.
Medical Mutual is looking to grow our team! We truly value and
respect the talents and abilities of all of our employees. That's
why we offer an exceptional package that includes:
A Great Place to Work:
- Top Workplace in Northeast Ohio. Year after year we've received
- On-site wellness center at most locations. Enjoy personal
trainers, towel service, locker room, weight room, elliptical
machines, and a variety of classes!
- On-site cafeteria serving hot breakfast and lunch, at most
locations. Choices ranging from salad bar, made to order, hot and
cold sandwiches, or a variety of entrees cooked fresh daily.
Convenience store at most locations
- Employee discount program. Discounts at many places in and
around town, just for being a Medical Mutual team member
- Business casual attire
Excellent Benefits and Compensation:
- Competitive compensation plans
- Employee bonus program
- 401(k) with company match and an additional company
- Excellent medical, dental, vision, and disability
An Investment in You:
- Career development programs and classes
- Mentoring and coaching to help you advance
- Education reimbursement up to $5K per year
About Medical Mutual:
We strive to create peace of mind. Our customers can trust us to
do things right and to help them get value from their health plan.
We're the largest health insurer in Ohio and for over 80 years,
we've been serving our members and the Ohio communities where they
live and work. Medical Mutual is a Top Place to Work in Northeast
Ohio with exceptional career opportunities that offer challenge,
growth and a great work/life balance. We want talented, innovative,
and driven people to help us continue to be the best health
insurance choice of Ohioans and help make Ohio the best it can be!
Our headquarter building is located in the heart of downtown
Cleveland and we have multiple offices throughout the state. Join
us at one near you!
At Medical Mutual we celebrate differences and are mutually
invested in our employees and our community. We are proud to be an
Equal Employment Opportunity and Affirmative Action Employer.
Qualified applicants will receive consideration for employment
regardless of race, color, religion, sex, sexual orientation,
gender perception or identity, national origin, age, marital
status, veteran status, or disability status.
We maintain a drug-free workplace and perform pre-employment
substance abuse and nicotine testing.
Keywords: Medical Mutual of Ohio, Cleveland , Provider Reimbursement Analyst, Other , Cleveland, Ohio
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