Jobs At Medical Mutual In Brooklyn, OH | CareerArc

Jobs at Medical Mutual in Brooklyn, OH

14 job openings within 25 miles

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Claims/Customer Care Specialist II-TPA

Medical Mutual - Brooklyn, OH

Processes routine to moderately complex healthcare claims and responds to inquiries from third party administration and/or ancillary product services customers regarding benefits, coverage or claim status, in accordance with established performance expectations and service philosophy. Responsibilities Processes routine to moderately com...

Benefit Implementation Specialist

Medical Mutual - Brooklyn, OH

Interacts with the Sales Department and customers to define and finalize medical, drug, vision and dental benefit designs for all market segments. Ensures benefits can be systematically administered and meet state and federal mandates. Coordinates workflow among the Sales, Membership, Certificate Development, Actuarial and Underwriting Departments to expedite group/products installation.&nbs...

Staff Accountant

Medical Mutual - Cleveland, OH

Performs a primary or supporting role in the monthly close process. Completes operational procedures to administer the financial aspects of fully-insured and self-insured related products. Assists in the preparation and analysis of the financial results. Responsibilities Processes and handles operational functions within Finance areas such as ...

Group Contract Specialist II

Medical Mutual - Cleveland, OH

Prepares fully insured large group health plan contracts and maintains signed contracts. Works with internal areas to review and respond to group-requested contract changes and prepares non-disclosure agreements for data requests from groups and consultants. Responsibilities Prepares, reviews and processes various non-disclosure agreements,...

Manager, Customer Experience Learning & Development

Medical Mutual - Brooklyn, OH

Establishes and drives the learning strategy, design, development, implementation, and evaluation of Learning & Development across the Customer Experience Division. Manages multiple learning and performance projects and implements high quality learning solutions across various functions, locations, and audiences: instructor-led, eLearning, and virtual. Responsibilities

Proposal Specialist

Medical Mutual - Cleveland, OH

Manages the development, completion and submission of responses to routine to complex Requests for Proposals (RFPs) with minimum supervision under strict deadlines. Collaborates with internal departments to develop proposal strategy and content that effectively communicates Company capabilities, policies, products and services. Provides assistance, guidance and training to other specialis...

Tech Lead (.NET Developer)

Medical Mutual - Cleveland, OH

Leads the process of translating user stories and customer acceptance criteria of increasing complexity into a logical, efficient and optimal systems design. Develops and maintains new and existing web applications by writing code based on the aforementioned design to ensure that business rules, security standards and government regulations are met. Works on a self-organizing, co...

Software Developer III

Medical Mutual - Cleveland, OH

Responsibilities Assists in the process of translating user requirements and systems objectives of increasing complexity into a logical, efficient and optimal systems design. Develops and maintains new and existing applications by writing code based on the aforementioned design to ensure that business rules, security standards and government regulations are met....

Healthcare Biostatistician - Job Family - Level II, Senior, Lead

Medical Mutual - Cleveland, OH

Responsibilities Design and execute quantitative and qualitative analyses to enable measurement of efficiency and effectiveness, and improve outcomes, from programs that address the Triple Aim: lowered costs, improved quality and enhanced member engagement. Leveraging principles of program evaluation to examine effects on costs of care, utilization, clinical quality, members' experiences...

Senior Data Analyst (Payment Integrity Analyst)

Medical Mutual - Brooklyn, OH

Under limited supervision, leverages payment integrity program output to increase accuracy of claims payments and efficiency while minimizing associated program costs for the Company and its self-funded groups. Compares internal payment integrity program output to that of outsourced vendors and generates program benchmarks. Partners with management team to present analytical findings a...

Provider Reimbursement Analyst

Medical Mutual - Cleveland, OH

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 impl...

Clinical Intervention Pharmacist - Medical/Specialty Drug

Medical Mutual - Cleveland, OH

This position is primarily responsible for medical benefit drug interventions. Develops strategies and engages members and/or providers to conduct clinically and financially meaningful interventions that impact member drug therapy. These interventions are aimed at improving pharmaceutical care for our members, reducing total cost of drug therapy and improving pharmacy related quality measu...

RN Case Manager

Medical Mutual - Cleveland, OH

Under limited supervision, evaluates and provides support to members, their families, and physicians in addressing member needs. Educates members and families to make informed personal health care decisions and determines the most effective treatment options. Facilitates communication between member, physician and community. Responsibilities ...

Contracting and Provider Relations Manager

Medical Mutual - Cleveland, OH

Responsible for developing and executing the strategic direction for Managed Care Networks.Facilitates the management of provider networks. Responsibilities Interacts on various projects, administration of policies and procedures with various areas in managed care operations; including credentialing, network performance, care management, and provider registration. ...