An Ohio-based Fortune 500 company, Medical Mutual sells life and health insurance to individuals, families, and groups. Commonly referred to as MedMutual, the c
Hospital Reimbursement Analyst
Location
New York + 1 moreAll locations: New York | Ohio
Posted
10 hours ago
Salary
0
Seniority
Senior
Job Description
Hospital Reimbursement Analyst
Medical Mutual
Title: Hospital Reimbursement Analyst Location: Cleveland, Ohio, 44144, United States Department: Provider Reimbursement Analyst Job Category: Provider Reimbursement Analyst Requisition Number: PROVI001247 Full-Time Hybrid Job Description: Medical Mutual employees must submit their applications through MySource. Note: The Hospital Reimbursement Analyst should have a strong understanding of hospital reimbursement methodologies. Alos, this is a hybrid role requiring 3 days per week on-site in our Brooklyn, Ohio office. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Performs routine to moderately complex financial analyses to support provider contracting strategies for Professional Providers. Begins to gain exposure to Institutional Provider analytics. Collaborates with Network Management and senior analysts to deliver actionable insights that support business initiatives and decision-making. Maintains market intelligence and contributes to the evaluation of network performance. Responsibilities Hospital Reimbursement Analyst - Develop complex deal models in collaboration with Network Management to support contracting. Analyze performance using utilization, cost, contract valuation, competitive benchmarks, and financial impact metrics. Communicate findings to support decision-making. - Support rate strategy development by identifying opportunities to optimize contracted rates and protect favorable structures through financial analysis. - Update and validate provider rate loading to ensure accuracy and compliance with contract terms. - Analyze emerging payment models and pricing strategies. Apply knowledge of commercial and Medicare reimbursement policies to inform contracting decisions. - Provide tactical support to senior analysts by extracting, cleaning, and preparing data for robust quantitative analysis. - Forecast contract rates and utilization trends. Build financial models and ‘what-if’ scenarios using claims and healthcare data. - Assist in building and validating rate methodologies. Ensure documentation is clear, repeatable, and aligned with update timelines. - Interpret complex contract language to assess financial implications of proposed changes. - Performs other duties as assigned. Senior Hospital Reimbursement Analyst - Collaborate with Network Management to shape rate strategies and contract methodologies that optimize financial outcomes. Identify opportunities to enhance or safeguard favorable rate structures by analyzing the financial impact of corporate initiatives, including policy changes. Deliver strategic insights through clear communication of recommendations, analytical summaries, and presentations to senior leadership. - Build and refine complex deal models in collaboration with Network Management to support contracting efforts. Apply advanced analytical techniques and business acumen to evaluate deal projections, benchmark performance, and assess financial impacts using utilization data, cost trends, contract valuation, and competitive analysis. - Ensure accuracy and consistency in provider rate loading through regular updates and quality assurance reviews. - Mentor and guide junior analysts, providing training, support, and quality oversight. Serve as a resource for resolving complex analytical and operational issues. - Partner with Actuaries and Underwriting to assess regional financial impacts of contracted rates and support short- and long-term forecasting. - Develops, builds and quality checks Institutional Reimbursement Methodologies, ensuring documentation around each build is clear and repeatable. Documents what Methodologies need to be updated when. - Forecasts contract rates, utilization trends and creates financial models using claims and other healthcare data. Creates ‘what if’ scenarios to help guide analytical decision making. - Interpret complex contract language to assess financial implications of proposed changes and support negotiation strategies. - Investigate claim disputes to validate pricing accuracy and conduct root cause analysis on inquiry data. Recommend system enhancements, targeted training, and process improvements to mitigate future errors and strengthen operational integrity. - Performs other duties as assigned. Qualifications Hospital Reimbursement Analyst Education and Experience - Bachelor’s degree in business or healthcare administration, finance, accounting, or related field. - Equivalent education and experience directly related to the role may substitute for a degree. - 3-4 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis on Provider Contracting/Network Management. Technical Skills and Knowledge - Intermediate Microsoft Office Excel, Word, Access, and PowerPoint - Working knowledge of SAS and/or SQL; knowledge of writing queries and analytical reports preferred. - Ability to quickly learn and use software business intelligence tools. - Experience working with relational databases. Senior Hospital Reimbursement Analyst Education and Experience - Bachelor’s degree in business or healthcare administration, finance, accounting or related field. - Equivalent education and experience directly related to the role may substitute for a degree. - 5 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis on Provider Contracting/Network Management. Technical Skills and Knowledge - Advanced financial analysis skills including forecasting and payment modeling. - Advanced computer skills including Excel, Word, Access, and PowerPoint. - Ability to utilize SAS programming language in assigned analysis. - Ability to quickly learn and use software BI tools. - Experience working with relational databases. - Ability to apply technical skills and operational knowledge to produce actionable results and analysis. #LI-JT1 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: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
Senior Consulting Analyst, Intercompany
ClearsultingClearsulting is a business consulting services company that acts as a link across its clients’ businesses and connects their visions with the technology, proc
Title: Senior Consulting Analyst, Intercompany Location: Cleveland, OH Department: Intercompany Job Description: Who We Are: Clearsulting is a global consulting company with the motivation to deliver positive change through digital finance. Our team consists of finance specialists that bring experience and technical capabilities across the spectrum of finance, including financial close, digital reporting, risk advisory, treasury and more. Clearsulting stands by its culture, shaped by our five Core Values: GRIT, Growth Mindset, Joy, Accountability, and Teamwork. Our unwavering dedication to these principles has garnered national recognition for our strong leadership, innovative approach, and outstanding workplace environment. Below are some of the awards and accolades that honor our commitment to excellence: - Sunday Times Best Places to Work Award (2025) - ‘Great Place to Work’ Certified (2022-2026) - Fortune’s Best Workplaces in Consulting (2022-2024) - Inc. 5000 Fastest-Growing Private Companies in America (2020-2023) Role: Senior Analyst, Intercompany Location: - Clearsulting is headquartered in Cleveland, OH, with additional offices located in Chicago, IL; Columbus, OH; and Dallas, TX. Other cities are welcome remotely. - Office Options: Hybrid or Remote. Team members residing within a 45 minute commuting radius of a Clearsulting office, we expect 8 days of in-person work per month, allowing flexibility choosing these days to accommodate client meetings, team syncs and individual schedules. - Travel Expectations: Up to 40% What you'll do - Strategic Mindset & Executive Presence: Partner with finance and accounting leaders at complex organizations to assess intercompany challenges and deliver practical, scalable solutions. - Technical Knowledge: Support the design and implementation of intercompany processes and technology solutions, including invoicing, matching, reconciliation, netting, settlement, journal entries, and reporting. - Functional Knowledge: Evaluate current-state processes, policies, and trade flows to identify gaps, improve controls, and recommend leading practices. - Data Analysis & Test Execution: Assist with data preparation, validation, testing, and issue resolution to enable successful solution delivery and adoption. - Engagement Support: Drive project execution by managing workstream activities, communicating status and risks, and contributing to client meetings, trainings, and executive-ready deliverables. - AI Strategy & Practice Development: Help grow the practice by developing reusable tools, supporting business development efforts, and advancing AI and automation-enabled intercompany capabilities. What You'll Bring: - Bachelor’s or Master's Degree in a business-related field of study - 3+ years of professional work experience in Blackline implementations, intercompany transactions, transfer pricing, Alteryx AND/OR Power BI - 3+ years of professional work experience supporting global organizations or clients. - Willingness and ability to travel Applicants must be authorized to work in the United States without current or future employer-sponsored visa support. Nice-to-Haves: - Certified Public Accountant (CPA) - BlackLine/Alteryx/Fabric Certified - Experience with implementation of digital transformation projects with a focus on intercompany transaction processing, intercompany allocations, transaction matching, reconciliation, accounting, and reporting processes - Understanding of BlackLine’s intercompany capabilities (or similar technology) and solutions for end-to-end intercompany processing, including implementation experience - Project management experience including workplan creation and updates, milestone tracking, risk management, status updates, change management, and communications Benefits that Benefit You: We want to cultivate a thriving culture and company—and we know that your health and well-being matter. We offer a benefits package and perks for our team members that include: - Medical, dental, and vision coverage - Unlimited PTO - Paid parental leave - Retirement plans - Flexible work environment - Cell phone reimbursement - Access to mental health apps - Life insurance and disability coverage - Opportunities for ad hoc bonuses The compensation range for this position is $84,000-$110,000. We are committed to ensuring our offers reflect the value each candidate brings to the role. Final salary placement will be based on upon several factors, including, level of expertise, relevant work experience, technology certifications, educational background, geography and alignment with industry standards. This role is eligible for our bonus program. #LI-NB1 #LI-Remote
Title: Junior Analyst (Freelance) Job Description: Location: Remote (PST) Engagement: Freelance Reports To:Associate Director of Analytics About Us UNFOLD is an award-winning digital creative agency based in Los Angeles, partnering with some of the world’s most dynamic entertainment and brand clients. We create culturally relevant, digitally driven work that connects audiences and brands across platforms. The Role Our Analytics team is seeking an Analyst / Junior Analyst to support social, content, and media performance reporting across client work. This role is ideal for someone early in their career who is excited by data, curious about audience behavior, and eager to grow their ability to turn performance trends into clear insights. You will help organize, clean, QA, and analyze datasets across platforms including TikTok, Instagram, YouTube, and X. The ideal candidate is detail-oriented, comfortable working in Excel or Google Sheets, and interested in understanding the drivers behind content and campaign performance. You will collaborate with strategists, creatives, and cross-functional teams to help make reporting accurate, useful, and easy to understand. Here’s What You’ll Do Data Quality & Reporting - Organize, clean, and QA datasets to ensure reporting accuracy and consistency. - Maintain recurring trackers and reporting files across social and media campaigns. - Support dashboard updates and data pulls from internal and third-party tools. Performance Analysis & Insights - Monitor social and content performance across TikTok, Instagram, YouTube, and X. - Identify basic trends, anomalies, and patterns in paid and organic results. - Help translate performance data into clear takeaways and actionable observations. Audience & Listening Support - Review comment sections and conversations to surface audience sentiment and themes. - Support social listening efforts to identify reactions, trends, and content drivers. - Track how audiences engage with content and flag notable shifts in behavior. Collaboration & Growth - Partner with strategists, creatives, and media teams to support integrated reporting. - Present findings in a clear, simple way that helps others understand performance. - Stay open to feedback and build skills across tools, platforms, and methodologies. Here’s What It Takes - Bachelor’s degree or equivalent practical experience in analytics, marketing, media, or a related field. - 0–3 years of experience in analytics, social media, media planning, or data strategy. - Internship, freelance, academic, or hands-on project experience is welcomed. - Basic understanding of major social platforms and performance metrics across TikTok, Instagram, YouTube, and X. - Growing proficiency in Microsoft Excel or Google Sheets. - Strong attention to detail and accuracy when working with data. - Interest in understanding content performance drivers and audience behavior. - Exposure to tools such as Sprout, Sprinklr, Tableau, or reporting dashboards is a plus. - Basic understanding of paid versus organic metrics is a plus. - Strong curiosity, a proactive mindset, and a willingness to ask thoughtful questions. - Ability to make data easy to understand through clear written and verbal storytelling. About Our Culture UNFOLD is a minority-owned business led by two diverse founders who embrace diversity across all areas of the company. We are committed to building teams that reflect a wide range of backgrounds, perspectives, and skills. Employment decisions are based on business needs, job requirements, qualifications, and performance. We strive to maintain a positive, safe, and respectful workplace and have a zero-tolerance policy for discrimination or harassment of any kind.
Senior Consulting Analyst
ClearsultingClearsulting is a business consulting services company that acts as a link across its clients’ businesses and connects their visions with the technology, proc
Title: Senior Consulting Analyst, Workiva Location: - Chicago, IL - Dallas, TX - Columbus, OH - Cleveland, OH Department: Digital Reporting and Compliance Job Description: Who We Are: Clearsulting is a global consulting company with the motivation to deliver positive change through digital finance. Our team consists of finance specialists that bring experience and technical capabilities across the spectrum of finance, including financial close, digital reporting, risk advisory, treasury and more. Clearsulting stands by its culture, shaped by our five Core Values: GRIT, Growth Mindset, Joy, Accountability, and Teamwork. Our unwavering dedication to these principles has garnered national recognition for our strong leadership, innovative approach, and outstanding workplace environment. Below are some of the awards and accolades that honor our commitment to excellence: - Sunday Times Best Places to Work Award (2025) - ‘Great Place to Work’ Certified (2022-2026) - Fortune’s Best Workplaces in Consulting (2022-2024) - Inc. 5000 Fastest-Growing Private Companies in America (2020-2023) Role: Senior Consulting Analyst, Workiva Location: - Clearsulting is headquartered in Cleveland, OH, with additional offices located in Chicago, IL; Columbus, OH; and Dallas, TX. Other cities are welcome remotely. - Office Options: Hybrid or Remote. Team members residing within a 45 minute commuting radius of a Clearsulting office, we expect 8 days of in-person work per month, allowing flexibility choosing these days to accommodate client meetings, team syncs and individual schedules. - Travel Expectations: Up to 10% What you'll do - Support clients across financial reporting, sustainability reporting, and/or audit, risk and controls by understanding their requirements and translating them into effective Workiva solutions. - Assist in the design and configuration of Workiva solutions to streamline reporting processes, including data connectivity (Wdata, queries, automations). - Participate in system development lifecycle activities, including requirements documentation, solution design, configuration, testing, training, and deployment. - Collaborate with team members and client stakeholders to ensure successful project delivery, proactively communicating progress and challenges. - Manage individual workstreams or tasks within larger projects, balancing technical implementation with effective team coordination. What You'll Bring: - 2-4 years of experience in either: A reporting or controls focused role (financial, regulatory, sustainability or audit/risk and controls), or a professional services role delivering Workiva solutions to clients. - Familiarity with at least one domain such as SEC/SEDAR, statutory reporting, sustainability frameworks, SOX/ICFR, or audit/risk management. - Demonstrated experience in system implementations or process improvements, with the ability to bridge reporting requirements and technical solutions - Strong communication and collaboration skills, with the ability to work effectively across finance, compliance, and technology teams - Detail-oriented with strong organizational skills; able to manage multiple priorities in a deadline-driven environment. Applicants must be authorized to work in the United States without current or future employer-sponsored visa support. Nice-to-Haves: - Experience with Workiva or similar cloud reporting platforms. - CPA, CFA, or other relevant professional designations (or progress toward one), including Workiva certifications. - Project management experience including workplan creation and updates, milestone tracking, risk management, status updates, change management, and communications - Exposure to data modeling, automation, or integration tools. Benefits that Benefit You: We want to cultivate a thriving culture and company—and we know that your health and well-being matter. We offer a benefits package and perks for our team members that include: - Medical, dental, and vision coverage - Unlimited PTO - Paid parental leave - Retirement plans - Flexible work environment - Cell phone reimbursement - Access to mental health apps - Life insurance and disability coverage - Opportunities for ad hoc bonuses Excited about what we're doing but don't fit every requirement? No problem! At Clearsulting, we're forward-thinkers on a mission to redefine consulting excellence. We're all about diversity and inclusion, committed to assembling teams that mirror the world around us. So, if you're passionate about our mission, you could be the perfect fit for this role or another within our dynamic team. Don't hesitate to apply! The compensation range for this position is $84,000 – $110,000. We are committed to ensuring our offers reflect the value each candidate brings to the role. Final salary placement will be based on upon several factors, including, level of expertise, relevant work experience, technology certifications, educational background, geography and alignment with industry standards. This role is eligible for our bonus program. #LI-AU1
Role Description We're looking for a QA Analyst to join our Technical Team. As the QA Analyst your role will involve: - Reducing the number of bugs that go to field - Assuring quality You should apply for this role if you have a passion for IT systems and have previously worked in the retail industry. This role requires: - Experience in functional testing - Experience in exploratory testing - Experience in API testing - IT qualification - ISTQB certification (highly advantageous) You'll enjoy this role if you thrive in a fast-paced environment, juggling multiple projects. Key skills for success include: - Attention to detail - Strong analytical skills - Excellent verbal and written communication skills This role is fully remote; however, you might be required at Head Office (Parklands, Cape Town) from time to time. Why wait, when you can Apply now! Qualifications - Passion for IT systems - Previous experience in the retail industry - Experience in functional testing - Experience in exploratory testing - Experience in API testing - IT qualification - ISTQB certification (highly advantageous) Requirements - Attention to detail - Strong analytical skills - Excellent verbal and written communication skills - Ability to thrive in a fast-paced environment - Capability to juggle multiple projects Company Description
