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IT Project Manager IV
Medical Mutual - Cleveland, OH
Manage large highly complex enterprise projects, programs, and teams with support, in compliance with the Company's defined IT project management standards with the goal of delivering project objectives on time and within budget. The methodology being used within those standards may be Waterfall, Scrum, (Agile), Kanban (Agile), or some other. Plan, develop and implement the project lifecycle co...
Data Engineering Developer II
Medical Mutual - Brooklyn, OH
Software developer for the design and development of the company's data lake, data warehouse, and data marts, and development of related business intelligence dashboards and visualizations. Job duties involve profiling data, developing data transformation jobs and processes, measuring data quality, and designing data warehouse data models, evaluating usability and testing data models, and de...
Population Health and Evaluation Analyst - Level II, Level I, Senior, Lead (Job Family)
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...
Human Resource Business Partner
Medical Mutual - Brooklyn, OH
Medical Mutual provides health insurance to more than 1.6 million Ohioans. For more than 85 years, the Company has improved the lives of its members by offering high-quality group and personal healthcare coverage. Medical Mutual is seeking a Human Resource Business Partner to provide HR consultation and guidance to assigned business units. Acts as employee champion and change agent. I...
Software Developer III (COBOL Developer)
Medical Mutual - Brooklyn, OH
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. Provides management with recommendations&nb...
Certificate Development Specialist
Medical Mutual - Cleveland, OH
Participates in an on-the-job training program in order to prepare routine and/or standard documents (certificates of coverage) describing benefits for fully insured health plans. Responsibilities Receives extensive training on the Company's products and related certificates of coverage and the certificate publishing system and the use of the Corp...
Dental Network Specialist- Superior Dental Care
Medical Mutual - Centerville, OH
Work with the Supervisor of Network Development to build and strengthen the company's dental networks in the marketplace. Requires coordination of efforts with multiple teams including Claims, Sales, Account Services, Marketing, and Information Systems. * Superior Dental Care (SDC) is a subsidiary of Medical Mutual Responsibilities &n...
Enrollment Associate- Superior Dental Care
Medical Mutual - Centerville, OH
Provide administrative support to the Finance and Enrollment teams; process all incoming enrollment documentation and ensure complete and accurate installation of clients and members in the enrollment system. * Superior Dental Care (SDC) is a subsidiary of Medical Mutual Responsibilities Accurately install and maintain...
Operations Business Analyst
Medical Mutual - Brooklyn, OH
Acts as a primary contact with third party audit firms during the course of medical and prescription drug audits and operational assessments. Responds to audit findings through explanation of business processes and provides evidence to support the Company's actions on each issue raised in an audit. Prepares written audit responses for internal and external review and distribution. Driv...
Senior 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...
Lead Software Application Developer - Clinical Applications (Software Developer IV)
Medical Mutual - Cleveland, OH
Leads 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. Provides management with recommendations ...
Actuarial Assistant
Medical Mutual - Cleveland, OH
Estimates current and future liabilities. Proposes premiums that achieve company goals. Works under supportive supervision. *Medicare Supplement Insurance knowledge preferred. Responsibilities Estimates future claims Estimates current claims (reserving: estimates unpaid claim liabilities). Analyzes historical ...
Underwriting Manager - Superior Dental Care
Medical Mutual - Centerville, OH
Compiles data and analyzes risk in group dental benefit proposals to produce rates for new and renewing business using rating model. *Superior Dental Care (SDC) is a subsidiary of Medical Mutual. Responsibilities Supervises and monitors duties of Risk Analyst position, ensuring that all responsibilities are properly documented for training purposes.
Software Developer III
Medical Mutual - Brooklyn, OH
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. Provides management with recommendations for issu...
Provider Contracting Representative- Job Family
Medical Mutual - Cleveland, OH
Job Summary: Develops, manages, promotes, guides and monitors, as well as services, and educates Providers, Institutions and Network Communities in order to establish business relationships. Provides coaching and mentoring to other contracting reps and coordinators. Responsibilities: Negotiates non-standard contracts. Requires minimal assistance with non-sta...
